Section 26-A1805. NOTICE OF ELIGIBILITY AND AWARD

 

1805.1An investigation shall be made in order to determine the eligibility and award of the victim.

 

1805.2The determination for loss of earnings shall include replacement services not exceeding fifty ($50) dollars per day.

 

1805.3Work loss shall be determined through review of the documentation and information provided by the victim, including but not limited to, the following items:

 

(a)Receipts;

 

(b)W-2 forms;

 

(c)Payroll stubs; and

 

(d)Any other evidence that the Administration finds relevant and credible.

 

1805.4The determination of medical and funeral expenses shall be based upon but not limited to the following factors:

 

(a)Receipts showing services rendered by medical providers or funeral establishments; and

 

(b)Any other evidence that the Administration finds relevant and credible.

 

1805.5Determination of the cost of Medical services under the Act shall include those services rendered by the treatment of injuries suffered by the victim as a result of the accident as well as those services provided for the rehabilitation of the victim of such injuries.

 

1805.6Determinations of funeral expenses under the Act shall include those services rendered for the disposition of the deceased victim whose death was the result of injuries sustained in the accident which forms the basis of the claim.

 

1805.7The Administration shall send a notice of the determination by first class mail to the victim.

 

1805.8The notice of determination shall contain the following information:

 

(a)Disposition of the claim;

 

(b)The specific reason(s) for any denial;

 

(c)The amount of the award and whether the award is to be made in installments or in one lump sum;

 

(d)The date, time, and place of a proposed hearing if the victim disagrees with the determination; and

 

(e)Any other information the Administration finds relevant.

 

1805.9A statement of agreement shall accompany the determination.

 

1805.10If the victim agrees with the determination, the victim shall complete the statement of agreement and return it to the Administration within ten (10) days of receipt of the determination. The statement of agreement shall be signed and returned to the Administration prior to the payment of any award.

 

1805.11If the victim request a hearing under §1805.8(d) he or she shall sign a request for hearing which will accompany the determination and return it to the Administration. If a request is timely made, the hearing shall be held on the date contained in the notice, or not less than fourteen (14) days after a new hearing notice is mailed to the victim.

 

1805.12If within ten (10) days the victim does not inform the Administration as to whether a hearing is desired or whether the determination is agreed to, the final determination and award shall remain with the Administration until further notice from the victim.

 

source

Final Rulemaking published at 35 DCR 7649(October 21, 1988).