Section R10-4-108. Compensation Award Criteria

A.      The Board shall meet at least every 60 days to decide, based on the findings made by the operational unit, whether to make a compensation award and if so, the terms and amount of the compensation award. The Board shall make a decision within 60 days after the operational unit receives a claim under R10- 4-107 unless good cause exists. The Board shall inform the claimant in writing within 10 days of the Board’s decision.

B.       The Board shall not make a compensation award unless it determines that the prerequisites in R10-4-106 are met.

C.      The Board shall make a compensation award only for the fol- lowing:

1.        Reasonable and customary medical expenses due to the victim’s physical injury, medical condition, or death.

a.        The Board shall include the following as a medical expense:

i.         Repair of damage to a prosthetic device, eye- glasses or other corrective lenses, or a dental device; and

ii.        Durable medical equipment.

b.        The Board shall not include as a medical expense a charge for a private room in a hospital, clinic, conva- lescent home, nursing care facility, or other institu- tion that provides medical services unless the Board determines that the private room is medically neces- sary;

2.        Reasonable and customary work loss expenses for:

a.        A victim whose ability to work is reduced due to physical injury, mental distress, or medical condition resulting from the criminally injurious conduct or act of international terrorism;

b.        A victim or derivative victim to make a medical or mental health counseling and care visit or attend a court proceeding directly related to the criminally injurious conduct or act of international terrorism;

c.        A derivative victim listed in R10-4-101(10)(a) through (c) if the Board determines the death resulted in a loss of support from the victim to the derivative victim;

d.        A parent or guardian of a minor victim to transport or accompany the minor victim to a medical or men- tal health counseling and care visit or court proceed- ing directly related to the criminally injurious conduct or act of international terrorism;

e.        A derivative victim to make funeral arrangements or tend to the affairs of a deceased victim if the deriva- tive victim made the funeral arrangements or tended to the affairs of the deceased victim; or

f.         A family member or guardian or a person living in the victim’s household in a relationship similar to those listed in R10-4-101(10)(a) to provide non- skilled nursing care for the victim that is required as a result of the criminally injurious conduct or act of international terrorism;

3.        Reasonable and customary funeral expenses. Expenses for clothing, travel, lodging, food, or per diem to attend a victim’s funeral, Native American ceremony, or burial are not reasonable and customary funeral expenses and shall not be included in a claim for a compensation award;

4.        Reasonable and customary mental health counseling and care expenses due to a victim’s or derivative victim’s mental distress resulting from the criminally injurious conduct or act of international terrorism if:

a.        The mental health counseling and care is provided by an individual who:

i.         Is licensed for independent practice by the Board of Behavioral Health Examiners,

ii.        Is a behavioral health professional as defined at

A.A.C. R9-20-101,

iii.      Is a behavioral health technician as defined at

A.A.C. R9-20-101 and employed by an agency licensed by the Department of Health Services, or

iv.      Is authorized to perform mental health counsel- ing and care by the laws of a federally recog- nized tribe; and

b.        The mental health counseling and care expenses do not include a charge for a private room in a hospital, clinic, convalescent home, nursing care facility, or any other institution that provides medical services unless the Board determines that the private room is medically necessary;

5.        Reasonable and customary crime scene cleanup expenses due to a victim’s homicide, aggravated assault, or sexual assault; and

6.        Reasonable and customary transportation costs related to:

a.        Obtaining medical care as defined in subsection (C)(1),

b.        Obtaining mental health counseling and care as defined in subsection (C)(4),

c.        Attending a court proceeding directly related to the incident of criminally injurious conduct or act of international terrorism that is the subject of the claim,

d.        The victim obtaining a medical forensic examination or participating in a medical forensic interview, and

e.        Responding to a substantiated threat to the safety or well-being of the victim or a derivative victim listed in R10-4-101(10)(d).

D.      The Board shall not make a compensation award to a claimant that exceeds:

1.        Twenty-five thousand dollars for all economic loss sub- mitted under a claim as a result of an incident of crimi- nally injurious conduct or act of international terrorism;

2.        The amount available to the operational unit and not com- mitted to other compensation awards at the time the Board makes the compensation award determination;

3.        For work loss expenses:

a.        Work loss expenses under subsections (C)(2)(a) and (C)(2)(c) are limited to an amount per calendar week equal to 40 hours at the current minimum wage and the maximum amount specified in subsections (D)(1) and (D)(2),

b.        Work loss expenses under subsections (C)(2)(b) and (C)(2)(d) are limited to an amount per calendar month equal to 40 hours at the current minimum wage and the maximum amount specified in subsec- tions (D)(1) and (D)(2),

c.        Work loss expenses under subsection (C)(2)(e) are limited to an amount equal to 24 hours at the current minimum wage, and

d.        Work loss expenses under subsection (C)(2)(f) are limited to an amount equal to 160 hours at the cur- rent minimum wage;

4.        For mental health counseling and care expenses, $5,000 per victim or derivative victim;

5.        For funeral expenses, $10,000;

6.        For crime scene cleanup expenses, $2,000 for cleanup provided by a professional service, of which $500 may be for crime scene cleanup not provided by a professional service to include only repair or cleanup material costs for one-time use items; and

7.        For transportation costs, $1,500 paid as reimbursement of actual transportation expenses.

E.       If the Board determines a victim is totally and permanently disabled, the Board may expedite a compensation award for the victim. The Board shall determine the amount of the expe- dited compensation award to the maximum allowed under sub- section (D) and determine whether to provide the amount awarded in a lump sum or periodic payments.

F.       The Board shall deny or reduce a compensation award to a claimant if:

1.        The victim or claimant has recouped or is eligible to recoup the economic loss from a collateral source except if the Board determines that use of a collateral source, excluding benefits from a federal or federally financed program, to pay for mental health counseling and care expenses is not in the best interest of the victim or deriva- tive victim, the Board shall not deny or reduce a compen- sation award for the mental health counseling and care expenses;

2.        The Board determines that the victim or claimant earned income from substitute work or unreasonably failed to perform available substitute work; or

3.        The Board determines that the victim’s physical injury, medical condition, mental distress, or death was due in substantial part to the victim’s:

a.        Negligence,

b.        Intentional unlawful conduct that was the proximate cause of the incident of criminally injurious conduct or act of international terrorism, or

c.        Conduct intended to provoke or aggravate that was the proximate cause of the incident of criminally injurious conduct or act of international terrorism.

G.      The Board shall deny or reduce a compensation award under subsection (F)(3) in proportion to the degree to which the

Board determines the victim is responsible for the victim’s physical injury, medical condition, mental distress, or death.

H.      The Board shall deny a compensation award to a claimant if:

1.        The Board determines that the victim or claimant did not cooperate fully with the appropriate law enforcement agency and the failure to cooperate fully was not due to a substantial health or safety risk. The Board shall use the following criteria to determine whether failure to cooper- ate fully with law enforcement warrants that a claim be denied:

a.        The victim or claimant failed to assist in the prose- cution of a person who engaged in the criminally injurious conduct or act of international terrorism or failed to appear as a witness for the prosecution;

b.        The victim or claimant delayed assisting in the pros- ecution of a suspect and as a result, the suspect of the criminally injurious conduct or act of interna- tional terrorism escaped prosecution or the prosecu- tion of the suspect was negatively affected; or

c.        A law enforcement authority indicates to the Board that the victim or claimant delayed giving informa- tion pertaining to the criminally injurious conduct or act of international terrorism, failed to appear when requested without good cause, gave false or mislead- ing information, or attempted to avoid law enforce- ment authorities; or

2.        The Board determines that the victim or claimant know- ingly made a false or misleading statement on the claim or in writing on supporting documents submitted to the Board or operational unit.

I.        If there are insufficient funds to make a compensation award, the Board may;

1.        Deny the claim,

2.        Make a partial award and reconsider the claim later during the fiscal year, or

3.        Extend the claim into a subsequent fiscal year.

J.        The Board shall not make a compensation award to pay attor- ney’s fees incurred by a victim or claimant.

K.      The operational unit, in its discretion, may pay a compensation award directly to a claimant or to a provider.

L.       The operational unit may close an inactive claim:

1.        Five years after the claim is submitted for an adult victim or derivative victim except in a homicide case;

2.        Ten years after the claim is submitted for a minor victim or derivative victim except in a homicide case; and

3.        Fifteen years after the claim is submitted for a homicide victim or derivative victim.

Historical Note

Adopted effective December 31, 1986 (Supp. 86-6).

Amended effective October 28, 1994 (Supp. 94-4).

Amended effective June 12, 1997 (Supp. 97-2). Former Section R10-4-108 renumbered to R10-4-106; new Sec- tion R10-4-108 renumbered from R10-4-110 and amended by final rulemaking at 6 A.A.R. 4727, effective November 20, 2000 (Supp. 00-4). Former R10-4-108 renumbered to R10-4-110; new R10-4-108 renumbered from R10-4-106 and amended by final rulemaking at 13

A.A.R. 4124, effective January 5, 2008 (Supp. 07-4). Amended by final rulemaking at 18 A.A.R. 3309, effec-

tive February 3, 2013 (Supp. 12-4).