What Happens If Your VCF Claim is Denied?

If you or a loved one submitted a claim for financial compensation to the September 11th Victim Compensation Fund (VCF) and the claim was denied, the situation can feel discouraging. It may seem like you've hit a wall. We want to assure you, however, that a denial from the VCF is not a dead end, but rather a hurdle that can be surmounted with the right assistance and knowledge.

It's crucial to understand that a denial is not a final verdict. There is a comprehensive appeal process specifically designed to provide claimants with the opportunity to address the reasons for the denial and seek a review of the decision. This appeal process can, at times, seem daunting, especially considering the intricate requirements and stringent deadlines. It's a path often laden with complex legal terminology, intricate paperwork, and the need for compelling evidence, but our dedicated 9/11 attorneys are here to help navigate this process. 

We have represented thousands of 9/11 survivors, victims, and their families, and we understand the intricacies of filing a claim, the reasons a VCF claim may be denied, the difference between appeals and amendments to claims, and the different appeal claim forms. There is also a similar but separate process of navigating denials for medical treatment and diagnosis from the World Trade Center Health Program (WTCHP), but we will address that in a separate post. 

Can a VCF Claim Be Denied?

While it can be disheartening, it's important to understand that a VCF claim can indeed be denied. The VCF is a federal program tasked with the critical responsibility of providing compensation for individuals or their representatives who experienced physical harm, illness, or death as a result of the tragic terrorist-related aircraft crashes of September 11, 2001. This also extends to the subsequent debris removal efforts in the immediate aftermath of these events. 

Despite its broad mandate, the VCF has to adhere to stringent eligibility criteria, and claims can be denied if there isn't sufficient evidence to satisfy these requirements. This evidence can range from insufficient medical records that meet the requirements of the WTCHP or, even more commonly, the failure by a claimant to submit sufficient proof of presence at the crash sites or the affected areas during the specified timeframes or the correct location.

Why Was Your VCF Claim Denied?

Understanding the reasons for a VCF claim denial is the first step in preparing a strong appeal. A VCF claim may be denied due to a range of issues. 

For example, a denial may be issued if the claimant cannot sufficiently prove a health condition related to the 9/11 attacks. The WTC Health Program, a separate but related entity, certifies conditions for VCF purposes, and a lack of certification could lead to a denied claim. For a deceased/wrongful death claim, these claims can be denied for the same reasons and also denied for the failure to show a causal link between the 9/11-related condition and the deceased victim’s death. 

Another common reason for claim denial is a lack of adequate proof of presence. This refers to evidence showing the claimant was within the disaster area, or the NYC Exposure Zone, within specific timeframes – evidence that meets the strict and very particular requirements of the VCF.  A claim can be denied if there's a failure to provide such proof or if the VCF deems the provided evidence insufficient, as that sufficiency is determined by the VCF.

Finally, economic and non-economic losses must be adequately substantiated in the claim. Failure to provide proper documentation or a comprehensive narrative and proof supporting these losses could be another factor leading to a denied claim.

Submitting an Appeal to the VCF

If your VCF claim was denied, remember there is still a path forward: submitting an appeal. Submitting an appeal to the VCF is a multi-step process that involves a thorough understanding of the reason for the denial, a careful collection of supporting documentation, and precise completion of required forms. Below is a step-by-step guide on how to submit an appeal to the VCF:

1. Understand the Denial: Start by thoroughly reviewing the VCF’s denial letter, which should specify the reasons for the denial. It's important to understand whether the denial was related to eligibility (the VCF's determination that you don’t meet the necessary criteria to be considered for compensation) or compensation (the VCF's determination about the amount of compensation to be awarded). 
2. Choose the Right Appeal Type: Based on the reason for the denial, you will file either an "Eligibility Appeal" or a "Compensation Appeal." Eligibility Appeals contest a denial based on eligibility factors, while Compensation Appeals contest the amount of compensation you have been awarded.
3. Fill Out the Appropriate Appeal Request Form: Complete the Appeal Request Form that corresponds to the type of appeal you are filing. You will need to provide your name, claim number, contact information, and a detailed reason for your appeal. Be as thorough and specific as possible in describing why you believe the VCF's decision was incorrect.
4. Compile Supporting Documentation: Collect and include any additional supporting documentation that addresses the VCF's reasons for denial. This might involve additional medical records, employment history, proof of presence, or other evidence relevant to your appeal.
5. Submit Your Appeal: Appeals must be submitted within 30 days of the date on the determination letter. You can submit the Appeal Request Form and any supporting documents via the online claims system, or you can mail your appeal package to the VCF's mailing address.

The appeal process can be complex and navigating it on your own can be challenging. It's often beneficial to work with a legal representative who is familiar with the VCF, the appeal process, and 9/11-related claims. They can provide guidance, help compile necessary documentation, and represent you during the hearing to ensure your appeal has the best chance of success.

Have All Your Documentation Ready

Before submitting an appeal, gather all necessary documentation. Depending on the reasons for denial, you might need to supply additional medical records, present a more comprehensive proof of presence, or produce additional supporting documents for your economic and non-economic losses.

Accuracy and thoroughness are paramount when presenting documentation in an appeal. Any oversights, inaccuracies, or missing documents can adversely impact the outcome of your appeal, making this a critical step in the appeal process.

Attend an Appeal Hearing

After submitting an appeal, you may be required to attend a hearing. The purpose of this hearing is to allow you to present your case verbally to a VCF Hearing Officer, answer any queries the VCF might have, and supply any new evidence. Your testimony (and the testimony of all necessary witnesses in support of your claim) and presentation during this hearing can significantly impact the outcome of your appeal, emphasizing the importance of robust preparation and strong representation.

Filing an Appeal Versus an Amendment

When dealing with denied claims, it is crucial to differentiate between filing an appeal and filing an amendment. If you disagree with the VCF's decision, you should file an appeal. If, however, you've acquired new or supplementary information that wasn't incorporated in your original claim or if your circumstances have changed significantly (such as receiving a new diagnosis from the WTCHP), then you may choose to submit an amendment to your claim. An amendment to a claim may be filed after receiving an award, as well as after a claim has been denied.

Our Experienced 9/11 VCF Attorneys Are Here to Help

Having a VCF claim denied can feel like an insurmountable setback, but our team of dedicated 9/11 attorneys are here to assist. The attorneys at Hansen & Rosasco, LLP have substantial experience in guiding 9/11 victims and their families through the appeal process, ensuring they're well-prepared for any hearing, and providing the expertise needed to secure the compensation they deserve from the 9/11 Victim Compensation Fund.

The journey from a denied claim to a successful appeal can be a challenging one, but you don't need to travel it alone. Our team of experienced 9/11 attorneys stands ready to walk this journey with you. We understand the immense personal and emotional toll the events of 9/11 have had on your life, and we are committed to helping you overcome this legal hurdle. Contact us today for a free consultation.