12 Va. Admin. Code § 30-240-30

Current through Register Vol. 41, No. 1, August 26, 2024

Section 12VAC30-240-30 - Claims for compensation

A. Any individual who meets the eligibility criteria or his lawfully authorized representative, if applicable, may submit a claim for compensation.

B. Claimants shall submit applications with proof of identity and proof that the eligibility criteria are met. When an application is submitted for an individual who died on or after February 1, 2015, the application shall include a certified copy of a state-issued death certificate.

C. Claimants shall submit required documentation for proof of identity.

1. To establish proof of identity, a copy of one or more of the following documents preferably bearing a photographic image of the claimant's face and signature shall be submitted with the application form:

a. A state-issued or United States territory-issued driver's license.

b. A government-issued identification card.

c. A United States passport.

d. A foreign passport with a United States visa, Form I-94 Arrival/Departure Record, or Form I-94W Nonimmigrant Visa Waiver Arrival/Departure Record.

e. A United States military card, active or retired member.

f. A United States military dependent's identification card.

g. A Native American tribal document issued by a tribe recognized by the United States government.

2. If a claimant's current legal name is different from the name at the time of sterilization, the claimant shall provide documentation to prove that he is the same individual who is named on the sterilization records. Proof may be:

a. A marriage license;

b. A divorce decree;

c. A death certificate;

d. An adoption record;

e. A court order approving a legal change of name; or

f. Other legal document indicating an official name change.

3. Claimants may submit additional documents to establish proof of identity. The department may deem in its discretion that one or more documents other than those listed in subdivisions 1 and 2 of this subsection are sufficient to prove a claimant's identity with satisfactory reliability.

4. At the department's discretion, a crossmatch with a federal or state government data system may be used to establish a claimant's identity.

D. To establish proof of involuntary sterilization pursuant to the Act, a copy of one or more of the following shall be submitted with the application:

1. Letter notifying a parent, guardian, or a lawfully authorized representative that the involuntary sterilization procedure was performed on the claimant.

2. Progress notes from the claimant's hospital record documenting that the involuntary sterilization procedure was performed on the claimant.

3. Case summary from the claimant's hospital record documenting that the involuntary sterilization procedure was performed on the claimant.

4. Physician's order for involuntary sterilization from the claimant's hospital record.

5. Operative record of involuntary sterilization from the claimant's hospital record.

6. Involuntary sterilization record summary from the claimant's hospital record.

7. Nurses' notes documenting post-operative care was provided to the individual claimant after involuntary sterilization of the claimant.

8. Other documents that show that the involuntary sterilization procedure was performed on the claimant pursuant to the Act.

E. Any person submitting a claim on behalf of a claimant shall provide documentation that he is the claimant's lawfully authorized representative.

F. All applications shall be notarized by a notary public.

G. The department shall not accept more than one application in a single mailing.

H. Applications shall be submitted to the department through the United States Postal Service. The department shall not accept any application that is submitted in any other manner including by any shipping company, electronically, delivered by courier service, or in person.

I. The department shall send a notice that the application was received to the claimant or his lawfully authorized representative in writing within seven calendar days of receipt of the application.

12 Va. Admin. Code § 30-240-30

Derived From Virginia Register Volume 33, Issue 15, eff. 5/4/2017.

Statutory Authority: § 37.2-203 of the Code of Virginia.