VCF Claim Form - Summary of Changes

VCF Claim Form - OMB #1105-0092

Summary of Changes

The September 11th Victim Compensation Fund (“VCF”) is submitting an information collection request, entitled the VCF Claim Form, to the Office of Management and Budget (OMB) for review and approval of an extension of a currently approved collection in accordance with the Paperwork Reduction act of 1995. The currently approved collection, OMB Control Number 1105-0092, expires on June 30, 2019. The VCF requests an extension of this collection because, under current law, the VCF will continue to accept claims until December 18, 2020, the statutory claim filing deadline. James Zadroga 9/11 Victim Compensation Fund Reauthorization Act, Public Law 114-113 (December 18, 2015).

In connection with the request to extend this collection, the VCF made updates to the VCF Claim Form in an effort to maximize the utility of the information collected and minimize the burden imposed on the public by simplifying or clarifying questions; reformatting or restructuring questions to make the form more user-friendly; and updating questions to ensure conformity to current policies and procedures. The VCF also added explanatory information and/or instructions in an effort to enhance transparency, minimize claimant confusion, and improve claim submissions. The following are examples of the changes made in the VCF Claim Form:

Purpose: Simplifying/Clarifying Questions

• Question 7: The current claim form asks “On the list below, select the sites at which the victim was present at some point between September 11, 2001 and May 30, 2002.” (emphasis added) In the updated claim form, the VCF changed this language to “On the list below, select the sites at which the victim was present at some point beginning September 11, 2001 through May 30, 2002.” (emphasis added). This change was made to clarify that the relevant time period included both September 11, 2001 and May 30, 2002.

• Question 8: The current claim form asks “Why was the victim present in the NYC Exposure Zone during the period beginning September 11, 2001 through May 30, 2002?” The question includes as a potential response “Part of the rescue, recovery, and debris clean-up” and a follow-up question “Was the victim acting in a capacity as a responder?” In the updated claim form, the VCF deleted this follow-up question as it was duplicative.

Purpose: Reformatting/Restructuring Questions to Improve User-Friendliness

• Question 20: The current claim form includes a table/chart requesting certain information regarding each claimed condition. After the table are additional questions that relate back to the conditions claimed. In the updated claim form, the VCF embedded these questions in the table/chart in an effort to minimize claimant confusion and to improve claim submissions.

Purpose: Conforming Questions to Current Policies and Procedures

• Question 21: The current claim form asks “What losses are you seeking for the victim’s 9/11-related physical injury or condition? Select all that apply” and includes among the options “Medical Expenses.” It also includes a subsequent question seeking additional information about the Medical Expenses claimed. Since the current claim was approved in 2016, the VCF revised its policy on medical expenses loss such that medical expenses can no longer be claimed on initial submission (they will only be considered on amendment). For that reason, in the updated claim form, the VCF deleted “Medical Expenses” as an option in Question 21, and deleted the follow-up question. These changes were made to conform to current policies and procedures.

June 2019 1 of 1 www.vcf.gov / VCF Helpline 1-855-885-1555