Appeals

When a claimant disagrees with the claim decision, he or she may request a Reconsideration or Review under §§ 19.2-368.8 or 19.2-368.7 of the Code of Virginia. In accordance with the authority mandated under § 19.2-368.3, the Commission sets forth the following procedures for Reconsideration/Appeal/Review, most commonly referred to as an “Appeal.” Any such request must be made by the crime victim or the claimant. The claimant, at his own expense, may have an attorney represent him at any stage of the process, including appeals; however, legal representation is not required. Individuals that are not a party to the claim may not make these requests, though they may provide information to assist in this process.

After an applicant applies for benefits, VVF reviews the information supporting the claim and determines if the claimant is eligible for compensation. If approved, VVF will determine what expenses can be covered and notify the claimant outlining the decision. If the claimant disagrees with the decision, he or she has the legal right to appeal VVF’s decision.

Any portion of the decision can be appealed, including the original decision on the application, whether a cost can be covered, or the compensation amount (if there was a reduction). To appeal, claimants should follow the instructions included in their decision letter. Time limits for the appeal process should be followed carefully.

There are four levels in the appeals process. If any given level of appeal is successful, there is no need to go to the next level. Questions about the process should be directed to VVF or the Crime Victim Ombudsman. It is important to follow instructions and submit the required documentation within the time limit for each appeal level process. If deadlines are not met, the right to appeal may be forfeited. Appeals must be mailed or faxed; emails are not accepted.

The reconsideration review level is designed to be an informal, efficient way of appealing the decision by VVF. VVF will send the claimant a written decision. If the claimant disagrees with that decision, he or she may request that VVF reconsider it. This request must be signed and include a detailed explanation as to why the claimant disagrees with the decision. The request for reconsideration should also include any additional documentation the claimant feels may support the request for a new decision. The signed written request must be received by VVF within forty-five (45) days of the date of the decision unless good cause is shown.

Upon receipt of the request for reconsideration, VVF will notify the claimant in writing. The Claims Examiner will review the case file – including all reports in the file, victim or witness statements, and any additional information provided by the claimant – and submit a recommendation to the Director. The Director will review the case file and recommendations from the Examiner and render a decision regarding the claim. Once the review is complete, VVF will provide written notification regarding the outcome of the reconsideration.

If, after the reconsideration review, the claimant still disagrees with VVF’s decision, the claimant may request an Appeal Hearing, which is conducted by a Deputy Commissioner.

 

If a claimant does not agree with the Director's reconsideration decision, he or she may request an appeal to the Commission by submitting the request signed and in writing to the Virginia Victims Fund, P.O. Box 26927, Richmond, VA 23261, within forty-five (45) days of receipt of the Director’s Reconsideration decision letter. Appeal hearing requests should state reasons for dissatisfaction with the reconsideration decision.

Appeals Hearings are heard by a Deputy Commissioner of the Virginia Workers’ Compensation Commission (VWC) in a location near the address of the crime. At this stage of the appeals process, the claimant will be required to appear at a hearing and to provide evidence that refutes VVF’s findings. The claimant will be notified of the time and place of the hearing and may request VWC to issue subpoenas to compel witnesses on his or her behalf to appear and testify.

A written decision regarding the outcome of the Deputy Commissioner’s decision will follow the hearing.

 

If the claimant is not satisfied with the Deputy Commissioner’s decision, review by the Full Commission is available (Section 19.2-368.7 of the Code of Virginia).
In these cases, the following procedures should be followed:
  1. Address a written Request for Review to: Virginia Victims Fund, Post Office Box 26927, Richmond, VA 23261.
  2. The letter must be received within thirty (30) calendar days from the date of the Deputy Commissioner’s decision.
  3. The letter should state the reasons for the claimant’s dissatisfaction with the decision. Unless oral argument is requested, the case will be reviewed on the record by the Full Commission. If oral argument is requested and the Commission determines oral argument to be necessary, a Review Hearing will be scheduled in Richmond, Virginia. At the hearing, new evidence may not be presented and testimony by witnesses will not be heard. The claimant or their attorney will be permitted to state the reasons they disagree with the decision. Upon request, this hearing may be done by telephone conference call.
  4. After reviewing the record, the Full Commission may affirm or modify the Director's decision or it may determine additional evidence is needed and remand the case to a Deputy Commissioner for an Evidentiary Hearing.
  5. The Virginia Workers' Compensation Commission will issue a written Opinion stating its findings.

 

The Virginia Workers' Compensation Commission will issue a written Opinion stating its findings following the Full Commission review. If the claimant disagrees with the Opinion issued by the Commission regarding his or her claim, the Opinion may be appealed to the Virginia Court of Appeals by filing within thirty (30) days a written notice of Appeal with the Clerk of the Virginia Workers' Compensation Commission accompanied by a $500.00 Appeal bond and Notice to the Clerk of the Court of Appeals with a $50.00 filing fee.