DTA

Whether you were approved for compensation of rekeying your locks or a visit to the hospital, specific documentation is required before any payment can be made.

Crime Victim Compensation is the payor of last resort which means all services must first be billed to your and/or the defendant's insurance if applicable. In addition, if you receive payment for the same services paid for by Crime Victim Compensation from any other source including but not limited to an insurance or civil settlement, you are required to refund the program the same dollar amount which was expended on your behalf.

The following documentation may be required once your claim is approved and before payment can be made:

Medical bills

  • An itemized bill which includes the date, type of service, and billed amount. If you do not have an itemized bill, contact the service provider to request this;
  • If you have insurance, a copy of your explanation of benefits (EOB) from your insurance company. This document is typically mailed to you by your insurance company and explains what amount the service provider billed your insurance, what your insurance pays for, and what (if any) your responsibility is. If you do not have a copy of your explanation of benefits, contact your insurance carrier to request this.

Mental health/counseling bills

  • Your therapist will be required to submit a treatment plan for board review before payment can be issued;
  • Your therapist should submit itemized billing directly to Crime Victim Compensation along with an explanation of benefits if applicable.

Doors, locks, windows

  • An itemized bill including service provider, date of service, and total amount due;
  • A benefits summary from your home owners insurance if applicable.

Funeral/burial

  • An itemized billing statement

Lost wages

  • A statement/letter from your employer which includes your employment status (full/part time), how many hours you missed as a result of the crime, your hourly wage, and if you had available or used any paid time off (vacation, sick, etc);
  • If you missed more than three days of work, you will also need to submit a letter from your doctor and/or mental health provider which indicates how long you will be/were restricted from working due to the crime.
  • A pay statement or pay stub from close to the date of the crime.

Household Support

  • Certified statement included in the application and the submission of supporting household expense documents. This can include copies of the household bills being requested for compensation.

Relocation

  • Itemized receipts for moving truck, boxes, gas, bus ticket, airfare, etc.
  • Copy of new lease agreement

If you have already remitted payment to the service provider, please also include with the above listed documentation a proof of payment to expedite your reimbursement.