Victim page

Required information:

✓ Name

✓ DOB

✓ Social security number

• NOTE: There is a box you can select if you don’t have a SSN

✓ Race/Ethnicity

✓ Marital Status

✓ Gender

• NOTE: Gender Marker X is an option, and "Prefer not to answer" is also an option.

✓ Mailing address

• NOTE: This must be an official USPS postal address. Make sure the name of your street and zip code are entered correctly. If the address is incorrect, it may prevent you from officially submitting the claim application. 

NOTE:

• Although it is not required, we recommend that you include your phone number and email here.
• You can request an interpreter here.
• If you are an advocate assisting a victim in completing this application, answer “yes” to the question, “are you the victim?”
• Undocumented crime victims can apply for compensation. OVS will not report you to ICE (Immigration and Customs Enforcement).

Updated 1/4/24

Claimant page

NOTE:
You will only complete the Claimant page if:

• You are a legal guardian of a victim who is:
  • Under 18, or
  • Physically or mentally incapable of signing the claim form
• You are filing a death claim

Someone who has the authority of a POA (Power of Attorney) should not complete this page. The POA may sign the claim on behalf of the victim. The victim’s information should be entered on the Victim page and the question “Are you the victim?” should be marked as “Yes”.

Required information on the Claimant page:

✓ Name

✓ DOB

✓ Social security number

• NOTE: There is a box you can select if you don’t have a SSN

✓ Mailing address

• NOTE: This must be an official USPS postal address. Make sure the name of your street and zip code are entered correctly. If the address is incorrect, it may prevent you from officially submitting the claim application.

✓ Relationship to the victim

NOTE:

• You can request an interpreter here.

Updated 1/4/24

Crime page

Required information:

✓ Type of claim (if victim was injured, died, lost essential personal property)

✓ Type of crime

✓ Where the crime happened

✓ Crime Report #

✓ Police or criminal justice agency crime was reported to

✓ County where crime happened

✓ Date of crime

✓ Date crime was reported

✓ Explanation if there are more than 7 days between date of crime and date it was reported

✓ Explanation if more than one year passed between date of crime and date this claim is being filed

✓ Description of crime

Answering the question, “The victim ______________ due to this crime.”

The way you answer the question, “The victim ____________ due to this crime” will determine what type of claim you will be applying for.

There are three types of OVS victim compensation claims:

• Death claims
• Essential personal property claims
• Personal injury claims

You are eligible for different kinds of reimbursements based on the type of claim you make.

Although it seems easy, knowing the correct answer to this question can be complicated. For example, even if the victim was not physically injured, they may still be eligible for a personal injury claim depending on certain factors.

For help determining what type of claim you are eligible for:

You can watch the OVS Compensation Training Series videos on “Personal Injury Claims” and “Essential Personal Property Claims” to help you understand which type of claim you should apply for. Or you can use the Victim Compensation Claim Navigator.

Once you know what type of claim you can apply for, it is important to answer the following question accurately:

       “The victim _________________ because of the crime.”

Select:

• “lost essential personal property” If you are applying for an Essential Personal Property Claim.
• "was injured” if you are applying for a Personal Injury Claim.
• “died” if you are applying for a Death Claim.

What to do if you don’t have a police report but you have another qualifying document:

• If you have a copy of your police report or other qualifying document, submit them along with your application. 
• Don't worry if you do not have documents or are not sure which document to submit. OVS will send you a letter asking for documents they will need to determine your claim. After receiving the letter, you will have 30 days to submit these documents and OVS will instruct you how to submit them. 
• OVS may also call you to ask questions related to the crime and your claim. 
• You can provide additional information in the “Describe the crime in your own words” section or on a separate document which you can attach in your claim.

Note:

• One of the biggest mistakes people make is applying for the wrong claim. Please make sure you answer the question, “The victim ___________ as a result of the crime” correctly.
• Once you select an answer for the above question, the claim type will appear on top of each of the pages. Depending on what claim you are applying for, you will have access to different pages.
• Describing the crime and explaining what happened to you again may be traumatic. Remember, you can refer to the crime report, keep your statement brief, and ask help from a victim assistance program.
• Refer to your police report or other criminal justice document to answer questions about the crime the victim has experienced.
• It is a “domestic violence crime” if the victim and the suspect:
  • Are related
  • Are married or dating
  • Were married or dating
  • Have a child in common
• Victims of Human Trafficking with a police report or OTDA/DCJS (Office of Temporary and Disability/Division of Criminal Justice Services) letter should apply for a Personal Injury claim. This is because injury is presumed.
• A hate crime is a crime motivated by bias (such as gender, race, sexual orientation, religion, age, disability, national origin, etc.). 
• If you are applying for a Personal Injury Claim, you will need to provide documents to prove the injuries you suffered and the treatment you received. 
• If you are applying for a Essential Personal Property Claim, you will need to provide original receipts of the lost or damaged property, or receipts to show the cost of replacing them. 

Updated 1/18/24

Restitution Page

Restitution, like compensation, is a way to "make the victim whole" after the crime. Restitution is payment victims receive from the person who committed the crime. Any victim of crime who has suffered injuries or has expenses as result of the crime can ask for restitution as part of the criminal case. Restitution is not the same as compensation.

NOTE: Because you cannot be paid twice for the same loss or expense, if you receive restitution after you receive victim compensation from OVS, you must pay OVS back.

Updated 1/5/24

Expenses page

Select the types of expenses you have because of this crime.

Note:

• “DV Shelter” indicates your out-of-pocket expenses related to staying at a domestic violence shelter.
• You will need original receipts to prove expenses.
• There may be a maximum amount OVS can give you for compensation.

Essential Personal Property page

Note:

• You will be asked for policy numbers, and deductibles of your homeowner/renter or auto insurance later. 
• You will be asked for original receipts for items that were lost or damaged, or receipts to replace these items.
• There may be a maximum amount that OVS can give you for compensation. The maximum award for a cash loss is $100, and the total maximum award for loss of essential personal property is $2,500.

Update 1/4/24

Insurance page

You will only be asked to complete this page if your claim is a Personal Injury Claim or Death Claim. You will not be able to access this page if you are applying for an Essential Personal Property Claim.

Required information:

✓ You are asked to identify all the insurance coverage you have:

• All forms of health insurance 
• SSDI/Disability
• Workers’ compensation
• Veteran's benefits
• Home/Renter's insurance
• Auto insurance
• Other insurance

Note:

• Every insurance question requires a YES or NO answer.
• OVS will ask for the insurance companies' names, policy/ID numbers, or deductibles later. 

Updated 1/4/24

Private Lawyer page

NOTE:

• Complete this page if an attorney is helping you file this claim or is representing you in a civil suit related to the crime.
• Do not include the names of the District Attorney or Assistant District Attorney prosecuting the criminal case.
• If you obtain monetary damages from the suspect after suing them in civil court, you must repay OVS for any compensation you received.

Representative page

You can give permission to someone to talk to OVS about your claim. This person is an “authorized representative.” An advocate, attorney, or a family member can be an authorized representative.

Note:

• OVS will only speak to authorized individuals regarding this claim.