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Jus 11.02(2)(c) (c) An accurate description of the crime, the circumstances which brought it about and the date on which the crime occurred.
Jus 11.02(2)(d) (d) The law enforcement agency to which the crime was reported and the date on which the crime was reported.
Jus 11.02(2)(e) (e) The nature and extent of the injuries the victim sustained from the crime; the name and address of any person who gave medical treatment to the victim for these injuries; the name and address of any hospital or similar institution where the victim received medical treatment for the injuries and the costs of such treatment.
Jus 11.02(2)(f) (f) The work loss the victim sustained as a result of the crime.
Jus 11.02(2)(g) (g) The amount of benefits the victim, dependent or applicant has received, or is to receive, from any collateral source for economic loss that resulted from the crime and the name of the collateral source.
Jus 11.02(2)(h) (h) Whether the claimant is the spouse, sister, brother, child or parent of the offender, the offender's relatives or accomplice or whether the applicant lives with the offender, the offender's relatives or accomplice and the relationship, if any, between the applicant, offender, offender's relatives or accomplice.
Jus 11.02(2)(i) (i) A release authorizing the department to obtain any report, document or other information it needs in its determination of the claim.
Jus 11.02(2)(j) (j) Any additional information or material the department determines is reasonably related to the application.
Jus 11.02 Note Note: A copy of the application form may be obtained at the Wisconsin department of justice at no charge.
Jus 11.02(3) (3)Incomplete applications. Whenever an application is not complete or the department otherwise lacks information required under sub. (2), the department shall request the applicant to provide the required information. If the applicant fails within 30 days to provide the information or to indicate why the information is unavailable, the applicant shall be denied an award under s. Jus 11.07 (7).
Jus 11.02 History History: Cr. Register, February, 1992, No. 434, eff. 3-1-92.
Jus 11.03 Jus 11.03 Claims investigation and decision.
Jus 11.03(1)(1)Claims determination. Claims may be investigated, verified and determined regardless of whether the alleged offender has been apprehended, prosecuted for, or convicted of, any crime based upon the same incident or has been found not guilty of such crime.
Jus 11.03(2) (2)Suspend proceedings. The department may suspend proceedings upon its own motion or that of a prosecuting attorney for a period it deems appropriate on the grounds that a prosecution for an offense arising out of the act has been commenced or is imminent.
Jus 11.03(3) (3)Written decision. The department, by the director, shall issue a written decision setting forth the granting of the award or denying the claim and the reasons, and shall furnish the applicant with a copy of the decision. The decision shall also advise the applicant of any right to a contested case hearing.
Jus 11.03(4) (4)Closed claims. A claim for compensation is closed when any of the following conditions occur:
Jus 11.03(4)(a) (a) The statutory maximums allowed under s. 949.06 (1) (d) or (2), Stats., or both, have been awarded by the department.
Jus 11.03(4)(b) (b) The 30 day time period for appealing the decision of the department has passed without a request from the applicant for a contested case hearing.
Jus 11.03(4)(c) (c) The 30 day period for appealing the decision of the hearing examiner has passed without further appeal being made by the applicant.
Jus 11.03 History History: Cr. Register, February, 1992, No. 434, eff. 3-1-92.
Jus 11.04 Jus 11.04 Economic loss. The department may make awards for unreimbursed economic losses as follows:
Jus 11.04(1) (1) Actual cost of reasonable and necessary medical treatment.
Jus 11.04(2) (2) Loss of actual earnings if the victim was employed or loss of potential earnings if the victim was not employed at the time of the crime based upon a sufficient showing by the victim that the victim incurred an actual loss of earnings. The department shall determine an award for work loss incurred as a direct result of an injury as follows:
Jus 11.04(2)(a) (a) If the victim was employed at the time of the injury, an award for work loss shall be equal to the victim's unreimbursed net salary. In this paragraph "net salary" means income less deductions for federal withholding tax, state withholding tax, and FICA tax. In this paragraph "disability period" means the length of time a victim is unable to work as a direct result of injuries caused by the crime. The disability period shall be determined by a physician.
Jus 11.04(2)(b) (b) If the victim was not employed at the time of the injury or, if as a direct result of the injury, the victim suffered a disability causing a loss of potential earnings, the award may be based upon a sufficient showing by the victim that the victim incurred an actual loss of earnings. The victim must have received an offer of employment and must have been unable to begin employment as a direct result of a disability caused by the crime.
Jus 11.04(2)(c) (c) The amount of the award under pars. (a) and (b) may be reduced by any income from substitute work actually performed by the victim or by income the victim would have earned in, [if] available, appropriate substitute work the victim was capable of performing but unreasonably failed to undertake.
Jus 11.04(2)(d) (d) If the victim was self-employed at the time of the injury, the loss of actual earnings may be determined by taking into account the net business profit reported on the previous year's federal income tax return or the current year's net business profit based on current financial records, divided by the number of weeks covered by the income tax returns or current financial records.
Jus 11.04(2)(e) (e) If the victim failed to report earnings to federal and state revenue departments, if required to do so by law, the department may not make an award under this subsection based upon any such unreported income.
Jus 11.04(3) (3) Actual costs of ordinary, necessary and reasonable household services in an amount sufficient to ensure that the victim's duties and responsibilities are continued if the victim is a homemaker. Payment shall continue until the victim is able to resume the performance of the duties or until the cost of services reaches the maximum allowable under s. 949.06 (2), Stats., whichever is less.
Jus 11.04(4) (4) Reasonable replacement value of any clothing and bedding that is held for evidentiary purposes, not to exceed the limitations of s. 949.06 (1) (c), Stats.
Jus 11.04(5) (5) Reasonable replacement value of property, other than clothing and bedding under s. 949.06 (1) (c), Stats., that is held for evidentiary purposes and is rendered unusable as a result of crime laboratory testing, not to exceed the limitations of s. 949.06 (1) (cm), Stats.
Jus 11.04(6) (6) Reasonable funeral and burial expenses not to exceed the limitations of s. 949.06 (1) (d), Stats. The funeral and burial award may not be considered by the department under s. 949.06 (2), Stats. The costs of a reception, wake, or purchase of clothing for burial are not recoverable expenses under this section.
Jus 11.04(7) (7) Contributions of things of economic value provided by the victim to dependents but lost as a result of the victim's death and loss of financial support.
Jus 11.04(8) (8) Reasonable and necessary costs associated with securing and cleaning up a crime scene not to exceed the limitations under s. 949.06 (1) (f), Stats. In this subsection:
Jus 11.04(8)(a) (a) "Securing a crime scene" means taking immediate steps to make the crime scene free of danger and the risk of future loss.
Jus 11.04(8)(b) (b) "Cleaning up a crime scene" means removing or attempting to remove from the crime scene any stains or debris caused by the crime or the processing of the crime scene.
Jus 11.04 History History: Cr. Register, February, 1992, No. 434, eff. 3-1-92.
Jus 11.05 Jus 11.05 Awards.
Jus 11.05(1)(1)To whom payable. The department may make an award for economic loss to or for the benefit of any of the following persons:
Jus 11.05(1)(a) (a) A victim.
Jus 11.05(1)(b) (b) A dependent.
Jus 11.05(1)(c) (c) A third person other than a collateral source, who is responsible for the maintenance of the victim and who has incurred an expense as a direct result of the victim's personal injury or death.
Jus 11.05(1)(d) (d) A family member or person who lived with the victim immediately prior to the crime, as a result of the person's or family member's reaction to the death. In this subsection:
Jus 11.05(1)(d)1. 1. The victim must be a victim of s. 940.01, 940.02, 940.05, 940.06, 940.07, 940.08 or 940.09, Stats.
Jus 11.05(1)(d)2. 2. A dependent may recover both under s. 949.06 (1), Stats., and this subsection subject to the limitations of s. 949.06 (2), Stats.
Jus 11.05(2) (2)Maximum award. An award shall not exceed the economic loss to the claimant or exceed the limitations of s. 949.06 (2), Stats., plus the reasonable funeral and burial expenses under s. Jus 11.04 (6), whichever is less.
Jus 11.05(3) (3)Dependents' economic loss. In determining the amount of the award, the department shall:
Jus 11.05(3)(a) (a) Determine loss of support based on the victim's net salary at the time of death and loss of support shall be calculated equal to four times the victim's annual net salary. The department shall determine if the dependents have received or will receive proceeds from private or public insurance plans. Public insurance plans include social security benefits. The proceeds from a private or public insurance plan shall be prorated over the life expectancy of the victim and the amount of the first four years shall be deducted from the amount of the lost salary.
Jus 11.05(3)(b) (b) Calculate dependent's economic loss by determining a loss reasonably incurred after the victim's death in obtaining services in lieu of those the victim would have performed for the dependent's benefit had the victim not suffered a fatal injury. The cost of the services shall be actual, reasonable and necessary. The department may make an award on a periodic basis as the cost of lost service is incurred. The department shall periodically review the amount of the award to determine the dependent's continued right to the award.
Jus 11.05(4) (4)Collateral sources.
Jus 11.05(4)(a)(a) Any award made under this chapter shall be reduced by the amount of any payment received, or to be received, as a result of the injury or death:
Jus 11.05(4)(a)1. 1. From, or on behalf of, the person who committed the crime.
Jus 11.05(4)(a)2. 2. From insurance payments or programs, including workers compensation, unemployment compensation and social security.
Jus 11.05(4)(a)3. 3. From public funds.
Jus 11.05(4)(a)4. 4. As an emergency award under s. 949.10, Stats.
Jus 11.05(4)(a)5. 5. From one or more 3rd parties held liable for the victim's injury or death.
Jus 11.05(4)(b) (b) If the claimant fails to take advantage of a source of benefits that would have been available to the claimant or that would have reimbursed the claimant for all or a portion of an economic loss, the department shall reduce or deny an award to the extent that it would have been paid by such source of benefits. The department may waive this requirement in the interest of justice.
Jus 11.05(5) (5)Awards to minor dependents. The department may award benefits to the parent of a minor dependent child, the child's guardian or to such person, or trustee, for the minor dependent child's use as may be found to be best calculated to serve the interest of the child or for the support and maintenance of a minor dependent child or children.
Jus 11.05(6) (6)Awards to providers. The department may pay any portion of an award directly to the provider of any service which is the basis for that portion of the award.
Jus 11.05(7) (7)Awards not subject to attachment. No award made under this chapter may be subject to execution, attachment, garnishment or other process, except that an award for economic loss is not exempt from a claim of a creditor to the extent that the creditor provided products, services or accommodations, the costs of which are included in the award.
Jus 11.05(8) (8)Actual loss. The department may not make an award when the department determines in a particular case that the claimant would not ordinarily have been required to pay for the services but for ch. 949, Stats.
Jus 11.05(9) (9)Dependents. If 2 or more dependents are entitled to the award as a result of the death of a victim, the department shall apportion the award among the dependents. The department may apportion the award among the dependents in equal amounts.
Jus 11.05(10) (10)Probate award. The department may apportion an award for a victim's economic loss in a manner which the department determines to be just or in the best interest of the applicant.
Jus 11.05(11) (11)Periodic awards. In the case of the death of the victim or in the case of a protracted loss of earnings, the department may make periodic awards. The department shall periodically verify whether the claimant is entitled to continue to receive such payments.
Jus 11.05 History History: Cr. Register, February, 1992, No. 434, eff. 3-1-92.
Jus 11.06 Jus 11.06 Mental health treatment.
Jus 11.06(1) (1)Eligible providers. Eligible providers of mental health treatment under this chapter include:
Jus 11.06(1)(a) (a) A licensed physician who has completed a residency in psychiatry.
Jus 11.06(1)(b) (b) A licensed psychologist who is listed or eligible to be listed in the National Register of Health Service Providers in Psychology.
Jus 11.06(1)(c) (c) A person with a masters degree who is certified eligible as a psychotherapy provider under the Wisconsin medical assistance program, if providing services under the supervision of a licensed psychologist or psychiatrist certified as a psychotherapy provider under the Wisconsin medical assistance program.
Jus 11.06(1)(d) (d) A crisis counselor employed by a recognized crisis counseling agency who works under the supervision of a licensed psychologist or psychiatrist certified as a psychotherapy provider under the Wisconsin medical assistance program.
Jus 11.06(2) (2)Eligible services. Eligible types of mental health treatment under this chapter include:
Jus 11.06(2)(a) (a) Inpatient psychiatric services when prescribed by a physician and when provided within the psychiatric unit of a general hospital or a psychiatric facility.
Jus 11.06(2)(b) (b) Outpatient psychotherapy services when provided by a psychiatrist, licensed psychologist, or an eligible masters level provider who meets the supervision requirements.
Jus 11.06(2)(c) (c) Crisis intervention services when provided under the aegis of a community facility recognized by the county unified services board or as a component of services provided in a general hospital when such services are provided under the supervision of the psychiatrist or licensed psychologist.
Jus 11.06(3) (3)Limitations on eligible services. Limitations on eligible services include:
Jus 11.06(3)(a) (a) Collateral interviews are limited to the non-offending family members.
Jus 11.06(3)(b) (b) Group psychotherapy sessions are limited to those in which not more than 10 individuals receive psychotherapy services together from an eligible provider.
Jus 11.06(3)(c) (c) Court appearances or evaluations are not eligible services.
Jus 11.06(4) (4)Authorization process. The department shall require eligible providers of services to submit an authorization request which shall include the following information:
Jus 11.06(4)(a) (a) The name, address, and medical assistance or identification number of the provider conducting the diagnostic examination and performing the psychotherapy services.
Jus 11.06(4)(b) (b) A detailed summary of the problems for which the victim is seeking mental health treatment.
Jus 11.06(4)(c) (c) A detailed summary of the diagnostic examination, including the severity of the victim's mental illness, medically significant emotional or social dysfunctions, the medical necessity for treatment and the suggested outcome of treatment.
Jus 11.06(4)(d) (d) A statement of the estimated frequency of treatment sessions and the estimated cost of treatment.
Jus 11.06(4)(e) (e) A statement of the relationship between the crime and the need for treatment.
Jus 11.06(4)(f) (f) A statement of the victim's psychological condition during the 6 months prior to the crime.
Jus 11.06(5) (5)Review process.
Jus 11.06(5)(a)(a) Department claims specialists shall review authorization requests for mental health claims. The department may appoint persons who meet the same minimum requirements that providers are expected to meet to review authorization requests.
Jus 11.06(5)(b) (b) The department shall review the progress of the treatment periodically as the department determines it is reasonable to do so. Progress reports shall describe the victim's current symptoms, problem changes in symptoms since the last report, progress made toward each treatment goal, a list of impediments to progress, and a plan to address impediments.
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