Ariz. Admin. Code § 10-4-108

Current through Register Vol. 30, No. 50, December 13, 2024

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, the eligibility of the claimant, whether to make a compensation award, and the terms and amount of any compensation award. The Board shall make a decision within 60 days after the operational unit receives a complete and actionable claim under R10-4-107 unless good cause for delay exists. The Board shall inform the claimant in writing within 10 business 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 following:

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

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

i. Repair of damage to a victim's prosthetic device, eyeglasses or other corrective lenses, or a dental device; and

ii. Durable medical equipment required for treatment of the victim.

b. The Board shall not include as a medical expense:

i. A charge for a private room in a hospital, clinic, convalescent home, nursing care facility, or other institution that provides medical services unless the Board determines that the private room is medically necessary; and

ii. Any drug, substance, or chemical included under Schedule I of the Federal Controlled Substances Act 21 U.S.C. § 812(c).

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;

b. A victim or derivative victim to:

i. Make a medical or mental health counseling and care visit; or

ii. Attend a criminal court proceeding, clemency hearing, parole hearing, or execution directly related to the criminally injurious conduct.

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:

i. A medical or mental health counseling and care visit; or

ii. A criminal court proceeding, clemency hearing, parole hearing, or execution directly related to the criminally injurious conduct.

e. A derivative victim to make funeral arrangements for a deceased victim, or tend to the affairs of a 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 medically necessary as a result of the criminally injurious conduct;

3. Reasonable and customary funeral expenses. Personal attendee 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 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, or

iii. Is authorized to perform mental health counseling and care by the laws of a federally recognized 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. A victim or derivative victim attending a criminal court proceeding, clemency hearing, parole hearing, or execution directly related to the incident of criminally injurious conduct,

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 submitted under a claim as a result of an incident of criminally injurious conduct;

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

3. For medical expenses for a victim, the maximum amount specified in subsections (D)(1) and (D)(2).

4. For work loss expenses:

a. Work loss expenses under subsections (C)(2)(a), (C)(2)(b), (C)(2)(d), (C)(2)(e), and (C)(2)(f), 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. Loss of support under subsection (C)(2)(c) may be awarded to the maximum allowed under subsections (D)(1) and (D)(2) in a lump sum or periodic payments;

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

6. For funeral expenses, $10,000;

7. 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

8. For transportation costs, $2,000 per victim or derivative victim 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 expedited compensation award to the maximum allowed under subsection (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 an obtainable and accessible collateral source, including benefits from a federal or federally financed program;

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 incident of criminally injurious conduct that is the subject of the claim 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

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

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 incident of criminally injurious conduct that is the subject of the claim.

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 medical, mental health, or safety risk. The Board shall use the following criteria to determine whether failure to cooperate fully with law enforcement warrants that a claim be denied:

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

b. The victim or claimant delayed assisting in the prosecution of a suspect and as a result, the suspect of the criminally injurious conduct escaped prosecution or the prosecution of the suspect was negatively affected; or

c. A law enforcement authority indicates to the Board that the victim or claimant delayed giving information pertaining to the criminally injurious conduct, failed to appear when requested without good cause, gave false or misleading information, or attempted to avoid law enforcement authorities.

2. The Board determines that the victim or claimant knowingly 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 attorney'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.

Ariz. Admin. Code § R10-4-108

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 Section 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, effective February 3, 2013 (Supp. 12-4). Amended by final rulemaking at 24 A.A.R. 377, effective 4/7/2018. Section expired under A.R.S. § 41-1056(J) at 29 A.A.R. 1674, effective 6/1/2023. New Section made by emergency rulemaking at 29 A.A.R. 1700, effective 7/14/2023 (EMERGENCY). New Section made by emergency rulemaking at 30 A.A.R. 315, effective 1/22/2024, exp. 7/20/2024(Emergency). New Section made by final rulemaking at 30 A.A.R. 2405, effective 7/3/2024.