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Section 4: Appeals and Hearings

Date effective
February 1, 2024

An appeal can be filed within 30 days after the VCF has notified you of the eligibility or compensation decision on your claim. You can file an appeal if you have been found ineligible to receive compensation from the VCF, or if you believe the VCF erroneously calculated the amount of your award. You may appeal only if your eligibility denial letter or award letter includes an Appeal Request Form.  If the VCF sent you a request for additional information while reviewing your claim, and you did not respond with the requested information, the VCF may at its discretion, decide that your appeal request is not valid.  If this should happen, the VCF will notify you in writing of the next steps on your claim.

Eligibility Appeals: If you receive a letter from the VCF notifying you that you do not meet certain eligibility requirements and are therefore not eligible for compensation on that basis, the letter will include an appeal form and instructions for how to appeal the decision.  For example, if the letter explains that the VCF could not confirm your presence in the NYC Exposure Zone based on the information you submitted with your claim, you could file an appeal if you believe that the information you submitted to support your claim does in fact establish your presence in the NYC Exposure Zone, and you have exhausted all possibilities for obtaining additional proof of presence documents. 

You should only appeal the eligibility decision if you are unable to obtain additional documents to support your claim, and coming to an appeal hearing and providing testimony is the only way to prove your presence.  Before filing your appeal, the VCF encourages you to think about other documents that may be available to show your presence – perhaps from an employer, union, school, former co-worker, or others who were with you at the time.  By submitting these documents as an amendment to your claim, you may be able to prove you meet the eligibility requirements without having to go through the appeals and hearings process.

Compensation Appeals: Once the VCF finds you eligible for compensation and notifies you of the amount of your award, you may appeal if you disagree with certain aspects of your award decision.  For example, you may believe the VCF used an incorrect annual salary to calculate your lost earnings, or did not include in the calculation specific benefits information that you provided in your claim submission.  You should only appeal the compensation decision if you are challenging the award determination already issued, and think that the VCF did not properly consider certain facts and information you presented in your claim when determining the amount of your loss.

Note: Compensation appeals are not permitted in cases involving an award for non-economic loss only, where medical records were not submitted at the initial claim review stage.  These award letters will not include an option to appeal.  If you did not submit medical records, and you believe your non-economic loss award does not adequately address the severity of your condition, you must submit the medical records with a compensation amendment.  For a listing of the types of documents that can assist the VCF in the evaluation of your claim, see Section 2.1.c. – “Documentation of non-economic loss”.  

If you are appealing the amount of your non-economic loss award and you previously submitted medical records as part of your claim, the VCF, at its discretion, may determine that your appeal is not valid if you do not submit additional medical records from the past three years with your appeal request, or a detailed explanation as to why the records are not available.

Compensation appeals are also not permitted as to replacement services awards, unless one of the following applies: (1) in a deceased claim: the victim had a household member who qualified for a Special Needs Add-On as described in Section 2.4(b), and the VCF did not award the add-on, or (2) in a PI claim: you believe that you qualify for an award under exceptions 1, 2, or 3 as described in Section 2.4(b), and the VCF did not make an award under the applicable exception. If you request an appeal relating to replacement services, we will review your request and decide whether it is valid.

Filing an appeal vs. amending your claim

You should not appeal, but should instead amend your claim, if you filed a personal injury claim and are seeking a revised determination based on one or more of the following: (1) new information that was not previously submitted with your claim; (2) information previously requested by the VCF in connection with review of your claim that you did not submit within the response timeframe provided; or (3) your circumstances have changed since receiving your decision letter.  Section 5 includes more detailed information about amending your claim. Note that amendments will not be permitted in deceased claims, except in limited circumstances as described in Section 5.

For further information concerning when an appeal is appropriate vs. when to amend your claim, see: When to Appeal vs. When to Amend.

 

4.1 Filing an Appeal

When you receive the letter with your eligibility or compensation decision if the decision includes the right to appeal, the letter will include an Appeal Request Form with instructions for how to appeal the decision. If you intend to appeal you must follow the instructions in the letter, which are also outlined below.

  • Within 30 days of the date of your decision letter: Complete and sign the Appeal Request Form and return it to the VCF.  If your completed Appeal Request Form is not uploaded to your online claim or postmarked by the due date in your decision letter, you will have waived your right to an appeal.
  • Gather the necessary documents and assemble your Appeal Package: Your Appeal Package must include the following:
    • Completed Pre-Hearing Questionnaire (enclosed with your decision letter).
    • “Explanation of Appeal” as explained below.
    • All relevant documentation to support your appeal, along with a listing of the documents and the specific component of your appeal to which each document applies.
  • Within 60 days of the date of your decision letter: Submit your complete Appeal Package as one package.  Your completed package must be submitted or postmarked by the due date in your decision letter or your request for an appeal will be denied.

Explanation of Appeal

The Explanation of Appeal is a written statement that should clearly explain the following:

  • The specific components of your award, or the specific eligibility denial reasons, that you believe were not properly decided or calculated and that you intend to raise on appeal.
  • The specific issues you intend to raise at your hearing for each component of your decision being appealed.
  • A listing of the documents you are submitting as part of your Appeal Package to support your argument for each component of your decision being appealed. 

The goal of the Explanation of Appeal is for you to fully explain the arguments you intend to raise at your hearing, and the reasons why you believe your claim was not properly decided.  Please carefully review the information enclosed with your decision letter to ensure you submit a complete Appeal Package.

Once your complete Appeal Package is submitted, the VCF will review the information to confirm that you have a valid appeal, and will notify you of the next steps specific to your appeal and the scheduling of your hearing.

Important Reminders

  • You should only submit the Pre-Hearing Questionnaire, Explanation of Appeal, and applicable supporting documents once you have all of the information you intend to submit in support of your appeal.  All materials should be uploaded to your claim or mailed to the VCF as one package. 
  • Submit your complete Appeal Package as one package.  Your Appeal Package must be submitted to the VCF by the deadline stated on the appeal form included with your decision letter. 
  • With very limited exceptions, documentation provided to the VCF after your Appeal Package is submitted will not be considered as part of your appeal.  It is therefore very important to include all relevant information with your Appeal Package.
  • If the VCF previously requested a document during the review of your claim, and you did not submit it when originally requested (or did not provide an explanation as to why you are unable to provide the document), the VCF may, at its discretion, decide that your appeal request is not valid.  This will provide you an opportunity to seek to obtain the document and file an amendment for the VCF’s consideration, should you choose to do so.  Any document previously requested by the VCF should not be submitted for the first time as part of your Appeal Package.

If the VCF determines that a hearing is the most appropriate mechanism for addressing the issues raised in your appeal request  (which includes confirmation that your Appeal Request Form and complete Appeal Package are submitted by the deadlines identified in your decision or award letter), the VCF will send you a letter with your assigned hearing date and time and important details about your hearing. If the VCF determines that your appeal request will not move forward to a hearing, we will notify you in writing that a hearing is not appropriate, explain the next steps you should take, and if applicable, process any pending payment on your claim.

 

4.2 Hearings Process

Once the VCF has assigned your hearing date and time, it cannot be changed except in rare circumstances of an urgent nature, as determined by the VCF.  Requests to reschedule a hearing must be made in writing, and should include an explanation of the reason for the request.  With very limited exceptions, your appeal will be denied and the prior decision on your claim will be considered final if you miss your scheduled (or rescheduled) hearing. 

If you decide after returning your appeal form that you do not want to appeal the decision on your claim, please notify the VCF so that we can update our records and take the appropriate action.

Hearing Format: You may choose to have your hearing in-person or remotely via video format using the Zoom conferencing platform.  In-person hearings are preferred, as it provides an opportunity for you to sit across the table from VCF staff to tell your story, and it reduces the potential for a hearing cancellation due to technical issues.  If you choose to have your hearing via video, you must ensure you and your witnesses have the appropriate technology in order to do so.

If you have a unique circumstance that may impact your ability to fully participate in the hearing (e.g., hearing difficulty, current hospitalization, difficulty speaking), you should include a description of your circumstances on your Pre-Hearing Questionnaire so the VCF can provide the appropriate accommodations.

Hearings related to Presence at the Site: If the VCF found you were not eligible for compensation because we could not confirm your presence at a 9/11 crash site or in the NYC Exposure Zone, and you are appealing that decision, we strongly encourage you to bring to your hearing anyone who provided a written statement (such as an affidavit or a VCF Witness Presence Statement) on your behalf that was previously submitted with your claim.   If you plan to bring someone to your hearing as a witness to your presence at the site, and you have not already submitted a written statement from this individual as part of your claim, you must submit a Witness Presence Statement from this person at least one week prior to your hearing date.  The VCF will only hear testimony during your hearing from individuals whose written statement has been provided in advance.

Hearing Participants: All individuals you plan to bring to your hearing should be identified on your Pre-Hearing Questionnaire. If you need to add any hearing witnesses after submission of your Pre-Hearing Questionnaire, you may submit an updated Pre-Hearing Questionnaire within one week of your hearing date.  The VCF will not consider updated Pre-Hearing Questionnaires submitted after that time. 

The VCF encourages you to explain to your hearing participants that although we ask that they be available for the entirety of the hearing, there is a chance their participation may not be needed.    This may happen if the Hearing Officer determines, based on what has already been said during the hearing, that a specific witness’s information is no longer needed.  Please refer to the “What to Expect at your Hearing” insert that was included with your Hearing Confirmation letter for additional details.  

Please note that immigration status has no bearing on your hearing and undocumented individuals can attend a VCF hearing without risk of exposure.

Foreign Language Interpreters: If you, or one of the individuals you are bringing as a witness to your hearing. does not speak English, you should request on your Pre-Hearing Questionnaire that the VCF provide an interpreter for your hearing (and for whom the interpretation is needed).  Interpreters are provided at no cost to you.  The request for an interpreter needs to be made in advance, at the time you submit your Pre-Hearing Questionnaire (with your appeal packet) by checking the appropriate box on the form and indicating the specific language.  If you do not submit your request for an interpreter for yourself in a timely manner, the hearing will be rescheduled at the VCF’s discretion.  If you do not submit your request for an interpreter for a witness in a timely manner, the hearing will proceed as scheduled without the witness.  Please note that anyone requesting an interpreter at your hearing (including you) should have submitted a statement in the native language, with a certified translation into English. For example, if your presence witness needs an interpreter, their affidavit should have been written in their native language, with a certified translation provided to the VCF.  Please note that these interpreters are for the hearing only.  If you need interpretation services before or after the hearing, you will need to provide your own interpreter.  VCF hearing interpreters may not be used outside of the hearing itself.

What happens at a hearing: Hearings are held in a non-adversarial manner. Hearings are conducted by a Hearing Officer from the Special Master’s office. These Hearing Officers are attorneys  who are trained expressly for these proceedings. While hearings vary in length, they rarely last more than one hour.

The objective of the hearing is to give you a chance to present information or evidence that you believe is necessary to support your appeal.  You are encouraged, but not required, to present witnesses (particularly for appeals involving your presence at the site), including expert witnesses. The Hearing Officers will be permitted to examine the credentials of any experts who participate in a hearing. If you are represented by an attorney, your attorney must attend the hearing with you. Any individual who provides testimony at a hearing will be sworn in and will provide testimony under oath.

For hearings taking place via video (Zoom), you must ensure – in advance of the hearing – that you have the appropriate technology to participate in the hearing

With very limited exceptions that must be made via a request in writing in advance of the hearing (and granted at the VCF’s discretion), all hearings will begin with testimony by the claimant first.  Each hearing participant is expected to testify alone, without anyone else in “earshot” of their voice.  This means, for example, that if two family members are providing hearing testimony, one leaves the room while the other provides testimony and then they switch places. The Hearing Officer will determine the order in which the remaining hearing participants will be heard. Hearing participants should not communicate with each other in any way while the hearing is underway

After the hearing: A new determination is not made on the spot at a hearing. VCF staff participating in the hearing will make a recommendation to the Special Master.  The Special Master will review the information presented at the hearing, including your testimony, the testimony of any witnesses, your Explanation of Appeal, and any supporting documentation. You will receive a follow-up letter explaining the decision on your appeal.