Who Canapplyfor Financial Assistance?

GuidetocompletingaFinancialAssistanceApplication(PrimaryVictim)

TheVictimsofCrimeCommissioneradministerstheFinancialAssistanceSchemetovictimsofactsofviolencecommittedintheACT.FinancialAssistancecancoveryouroutofpocketexpensesforgoodsandservicesneededtohelpyourecoverfrom aninjurycausedbyanactofviolence.

Pleaseusethisguideasyoufilloutyourfinancialassistanceapplicationasitwillprovide youwithinformationtohelpyoucompletetheform.

informationonfinancialassistanceisalsoavailableonourwebsiteat

Who canapplyfor financial assistance?

Primaryvictim-Apersonwhohasbeeninjuredasadirectresultofanactofviolencecommittedonthem byanotherperson.

Relatedvictim-Arelativeof,orpersonwhowasinarelationshipwith,apersonwhodiedasaresultofanactofviolencedonebyanotherperson.

HomicideWitness-Apersonwho waspresentwhenahomicideoccurred,ora personwhoisawitnessinacriminalproceedingrelatedtothehomicide. This is only available for applications made for acts of violence which have occurred after 1 July 2016.

FuneralAssistance-Apersonwhoisexpectedtopayfororhaspaidforthefuneralofaperson whodiedasaresultofahomicide. For acts of violence before 1 July 2016, a person will only be eligible if they are related to the primary victim.

Whatisanactofviolence?

Anactofviolenceisaviolent crimethatdirectlyresultsinthedeathoforinjurytoaperson.TobeeligibleforassistancetheactofviolencemusthavebeencommittedintheACT.

Theactofviolencemaybe:

• Murder,manslaughter,culpabledrivingcausingdeath
• Assaultoffences
• Robbery,aggravatedrobbery
• Sexualoffences
• Domesticviolenceoffences
• Stalking,kidnapping

WhatschemedoIapplyfor?

Iftheactofviolence occurredonorafter1July2016-ApplytotheVictimsofCrimeCommissionerusingtheformsfoundontheVictimSupportACTwebsite.

Iftheactofviolence occurredbefore1July2016–Apply to the Victims of Crime Commissioner using the forms found on the Victim Support ACT website.

The Victims of Crime Commissioner is now the decision maker for all applications for financial assistance.

If you have already lodged an application for financial assistance with the ACT Magistrates Court (with assistance from the ACT Government Solicitor) for an act of violence that occurred before 1 July 2016, you will not be able to lodge another application with the Victims of Crime Commissioner for the same act of violence.

Victim SupportACTcanassistyouinmakinganapplicationregardlessofwhentheactofviolenceoccurredorwhentheapplicationisbeinglodged.

Completingthe applicationform for assistance

Ifyouareapplyingasaprimaryvictimoronbehalfofaprimaryvictim thenyoushouldcompletethePrimary VictimApplicationForm.

Ifyouareapplyingasarelatedvictim orahomicidewitness(only available for acts of violence after 1 July 2016) thenyoushouldcompletetheRelatedVictim/HomicideWitnessApplicationForm.

IfyouareapplyingforafuneralassistancepaymentthenyoushouldcompletetheFuneralAssistanceApplicationForm.

Allapplicationformsareavailableonourwebsiteatorbycalling1800822272/62052066oremailingtohaveaformmailedtoyou.

Completedformsandsupportingdocumentationshouldbesenttoeither ortoACTFinancialAssistanceScheme,GPOBox158,CanberraCity,ACT2601.

CompletingthePrimary VictimApplicationform

PrimaryvictimsandpeopleapplyingonbehalfofaprimaryvictimshouldcompletethePrimaryVictimApplicationForm.

Step1.Youshouldstartbyidentifying whatyouareapplyingfor.Youmaychoose1,2,oralloftheoptions.

Animmediateneedpaymentisforurgentcostssuchascleaningthesceneofahomicide,measuresforpersonalsecurity,relocationcostsandemergencymedicalcostsandrelatedservicesthatwouldcontributetorecovery.

Emergencymedicalcostsandrelatedserviceswillonlybeconsideredanimmediateneedpaymentiftheapplicantdoesnothavethefinancialabilitytopayforthetreatmentorservice.Otherwiseitcanbeappliedforasaneconomiclosspayment.

Aneconomiclosspaymentisforthecostofcounsellingorotherpsychologicalsupport,expenses(otherthanlegalcosts)incurredinmakingtheapplication,medicalanddentalexpenses,travelexpenses,justicerelatedexpenses,lossofearnings,expensesincurredbytheparentorcarerofaprimaryvictimandlossofordamagetopersonalitems.

Arecognitionpaymentisapaymenttoacknowledgetheharm andtraumasufferedbyprimaryvictimsofanactofviolenceorrelatedvictimsofhomicide.Thispaymentisbasedontheactofviolencethevictim wasinjuredbywithincreasesforcertainaggravatingfactors.

A special assistance payment is a payment to acknowledge the harm and trauma suffered by primary victims of an act of violence or a related victim and is only payable for acts of violence before to 1 July 2016. This payment is based on the act of violence the victim was injured by and provides the person must have suffered an extremely serious injury that results in a permanent impairment, loss or disfigurement.

For acts of violence before 1 July 2016, you may only apply for a recognition payment or a special assistance payment, not both.

Step2.Youarethenaskedif youhavepreviouslylodgedanapplicationforfinancialassistance.Thisincludesanypreviousapplicationslodged with the Victims of Crime Commissioner or the Magistrates Court (with assistance from the ACT Government Solicitor) whetherornottheyhavebeenwithdrawn,finalisedorarestillbeingassessed.

Step3.Youmustindicatewhetheryouhaveeverreceivedanoticestatingthat youarerequiredtorepayanamountofmoneytotheFinancialAssistanceScheme.Youmayhavereceivedthisnoticeaseitherarecoverynoticeorarepaymentnotice.

Arecoverynoticeisanoticegiventooffenderswhohavebeenconvictedorfoundguiltyofanactofviolencewherethevictimhasreceivedfinancialassistance.Thenoticeseekstorecoversomeoralloftheamountpaidtothevictim.

Arepaymentnoticeisanoticegiventoapersonwhohasbeenawardedfinancialassistanceandsubsequentlyreceivesanamountofmoneyfrom anothersourcethatcoversthesameharm orlossasthefinancialassistanceawarded.Thenoticeseekstorecoversomeoralloftheamountpaidtothevictim.

If youhavereceivedeitherofthesenoticesandthereisstillmoneyowingthenyoumustindicatetheamountstillowing.

SECTION1-PrimaryVictim’sdetails

Section1asksforpersonalinformationofthepersonwantingassistance(theprimaryvictim)whowasinjuredthroughtheactofviolence.If youarecompletingtheapplicationonsomeone’sbehalfthenitwillbetheirdetailsthatyouenterhere.Section1mustbecompletedfortheapplicationtobeassessed.

SECTION2-Detailsofapersonapplyingonbehalfoftheprimaryvictim

Section2asksforthedetailsofapersonwhoisapplyingonaprimaryvictim’sbehalf.If youareapplyingonyourownbehalfthen youdonotneedtocompletethissection.

Therearetwocircumstancesinwhichyoucanapplyonsomeone’sbehalf.

Asaformallyappointedperson

Forprimaryvictimsunder18yearsofage,aparent/guardianorlawyercanapplyonbehalfofthechild.AnymoneyawardedmaybeplacedwiththePublicTrusteetobeheldintrust.

Foradultswithanimpairedcapacity,alegallyappointedguardian,apersonappointedunderanenduringpowerofattorneyoralawyercanapplyonbehalfoftheprimaryvictim.

Formallyappointedpeoplemustprovideacopyofrelevantdocumentationtoverifytheauthority.

Asaninformallyappointedperson

Amemberoftheprimaryvictim’ssupportnetworkcanapplyonbehalfofaprimaryvictim whoisunabletoapplyontheirown.Anexamplewouldincludeaprimaryvictimwhoisoverseasanddoesnothaveaccesstoacomputer.Anymoneyawardedwillbepaiddirectlytotheprimaryvictim.Aprimaryvictimwillhavetoprovidewrittenconsentforapersontoapplyontheirbehalfwithoutlegalauthority.

Pleasenote:Ifyouareonlyhelpingtheapplicanttocompletetheirapplication – for exampleyouareasupportworkerorfamilymemberassistingwithlanguage,readingorwritingdifficulties – your detailsarenotrequiredinSection2andtheapplicant(primaryvictim)mustbetheonetosignSection9(Declarationandagreementtoconditions)andSection10(Consentform).

SECTION3-Detailsoftheactofviolence

Section3oftheapplicationasksforsomedetailsabouttheactofviolence.Thereisspacetoputthedatetheactofviolenceoccurredonoradaterange.

Whenchoosingthenatureoftheactofviolence,youshouldpick theonethatmostcloselymatchestheactofviolence.Ifthere wereseveralactsofviolencethenyoushouldpick oneandmentionanyothersinthetextboxwhereitaskstobrieflydescribewhathappened.Ifyouareunsureoftheactofviolencetypethenchooseotheranddescribewhathappenedinthetextbox.

Pleasenote:attempt,conspiracyorthreattocommitanyoftheseactsofviolenceareincludedintheactualactofviolencetype.

Pleaseindicateifyouareawarewhetheranyonewaschargedwiththeactofviolence,andifsowhether youknowthename(s).

Pleasenote:Apersonisnoteligibleforfinancialassistanceiftheycommittedtheactofviolence,conspired withthepersonwhocommittedtheactofviolence,wasinvolvedinaseriouscrimeatthetimeof,andwhichledto,theactofviolenceorunreasonablyfailedtogiveassistancetopoliceinrelationtotheactof violence.

SECTION4-Reportingtheactofviolence

Section4asksaboutwhotheactofviolencewasreportedto.Ingeneral,theactofviolencemusthavebeenreportedtopolicetobeeligibleforfinancialassistance.Therearecertainexceptionsforparticularvulnerablevictims.

FillinPartAif you,orsomeoneelse,reportedtheactofviolencetopolice.Fillinasmuchdetailaspossible. You do not need to supply a copy of the police report as this will be requested from ACT Police by the FAS team.

FillinthePartBif youticked’no’inPartAbecausetheactofviolencewasnotreportedtopolice.Youneedtoexplainwhytheactofviolencewasnotreportedtopoliceandwhetheryoureportedtheactofviolencetosomeoneotherthanthepolice.Youshouldincludeasmanypeople/agenciesthatyoureportedtoandtheircontactdetailsasyoucan.Itis likelythattheywillbecontactedtoprovideevidenceofthereportbeingmade.Inordertodothisyouwillhavetogiveyourconsentforthemtosharethisinformation.Pleasespeaktotheindividual/agencyaboutwhatconsenttheywillrequire.

Youmaynotbeeligibleforfinancialassistanceif youhavenotreportedcorrectlyorthereisnotareasonableexcuseforareporttopolicenotbeingmade.

Pleasenote:if youareapersonwhofitsintoavulnerablecategorywithanexceptiontoreportingtopoliceyoumusthavereportedtoaspecificcombinationofeitheraDoctor/Psychologist/SocialWorker/Counsellor,agovernmentagency,oraspecificnon-governmentagency(e.g.DomesticViolenceCrisisServiceorCanberraRapeCrisisCentre).

SECTION5-Injury

Section5asksabouttheinjurythatyousustainedasadirectresultoftheactofviolence.Tobeeligibleforfinancialassistanceyoumusthavesufferedeitheraphysicalorpsychological(includingmentalillnessormentaldisorder)injury.Thisincludestheaggravation,accelerationorrecurrenceofaninjuryordisease(includingthecontractionofadisease).

Iftheinjuryoccursasadirectresultofasexualordomesticviolenceoffence,itcaninclude;

• unplannedpregnancy
• areducedsenseofself-worth
• reducedcapacitytoparticipateinsexualactivity
• asenseofviolation
• increasedfearorfeelingsofinsecurity

Pleasenote:Youwillneedtoprovideevidenceofyourinjury.If youhaveanymedical reports/hospitalrecordsthenyoushouldattachthemtoyour application.IfyouwouldliketheVictimsofCrimeCommissionertoassistyoutoaccessyourmedical/hospitalrecordsthenyoushouldcompleteSection10(Consentform).

SECTION6-Financial AssistanceforanImmediateNeedpayment

CompleteSection6ifyouhaveexpensesthatyouhaveincurred,orarelikelytoincur,foranimmediateneedthatisrelatedtotheactofviolence.

Theexpensesmustbenecessarytopromotetherecovery,preventfurtherharmand/orlimitfurtherthreatstothesafetyoftheprimaryvictim.

OnlyparticularexpensesareabletobeappliedforasanImmediateNeedpayment.

• Cleaningthesceneofhomicide includespaymenttoacleaningcompany.Themaximumamountthatcanbeawardedis$5,000.
• Measuresforpersonalsecurityofavictimforexampleinstallingsecuritywindow screensorchanginglocks.Themaximumamountthatcanbeawardedis$4,000.
• Relocationforpersonalsecurityofavictimincludesreasonablemovingcostswhichwillaidinthepersonalsecurityofthevictim.Themaximumamountthatcanbeawardedis$4,000.
• Emergencymedicalcostsandrelatedservicesincludesmedicalandrelatedcoststhatareadirectresultoftheactofviolence,areurgentandtheapplicantdoesnothavethefinancialabilitytopayforthetreatmentorservice.Themaximumthatcanbeawardedis$10,000.Medicalcostsandrelatedservicescanbeappliedforasaneconomiclosspaymentwheretheyarenoturgentand/ortheapplicanthasthefinancialabilitytopayforthetreatmentorserviceupfront.

ThetotalamountthatcanbeawardedoverallasImmediateNeedpaymentsis$10,000.

Youwillneedtoprovideproofoftheexpenseswithreceiptsorinvoices.Inadditiontotheexpensecategoryyouareaskedtoprovidethedetailsoftheserviceproviderandtheexpense,andtheamount youareclaiming.Anypaymentstowardstheexpensefromanotherparty,suchasMedicarerebates,privatehealthinsurance,worker’scompensationorgovernmentassistancewillbedeductedfromtheamountifitisawarded.

Thereisspacetoprovideseveralexpenseclaimsontheapplicationform,howeverifyourequirefurtherspaceforadditionalexpenses youcanaddthematSection11(Notes).

ApaymentofanImmediateNeedexpensecanbepaidtoyou,directlytotheproviderofthegoodsorservices,orsomeoneelsewhopaidtheexpenseonyourbehalf.

Pleasenote:IfyoureceiveanImmediateNeedpaymentandarelaterdeemedtobeineligibleforfinancialassistanceyouwillberequiredtorepaytheamount.

SECTION7-Financial AssistanceforEconomicLoss

Completesection7ifyouhaveexpensesthatyouhaveincurred,orarelikelytoincur,foraneconomiclossthatisrelatedtotheactofviolence.Theexpensesmustberelatedtohelpingyourecoveryfromtheactofviolence.

Onlyparticularexpensesareabletobeappliedforasaneconomiclosspayment.

Youcanclaimexpensesthathavealreadybeenpaid,someonehaspaidon yourbehalf,orexpenseswhichyouthinkyoumayincurinthefuture(evenif youhavenotyetreceivedthetreatmentorusedtheservice).Youmustbeabletoprovidereceipts,invoices,accountsorotherproofofexpenses.Pleaseattachthesedocuments(orcopiesofthem)toyourapplication.Theassessorwillcontact youandaskformoredetailsoranyfurtherproofrequiredfortheexpensesyouareclaiming.

ExpensesforcounsellingorotherpsychologicalsupportisonlyavailableiftheapplicantwasnotabletoaccessappropriateservicesunderthevictimservicesschemeprovidedbyVictimSupportACT.

Expenses,otherthanlegalcosts,incurredinmakingtheapplicationisavailableforcostsassociatedwithaccessingrecordsorevidencerelevanttotheapplicationsuchasmedicalrecordsorpolicereports.Thisdoesnotcoverlegalfees.

Medicalanddentalexpensesincludesmedicalanddentalcoststhatareadirectresultoftheactofviolence.Youmayberequiredtoprovideinformationfrom yourhealthpractitionerdescribingyourinjuriesandrecommendedtreatmentasaresultoftheactofviolence.

TravelExpensesareavailablefortravelrelatingtoappointmentsortreatmentformedicalpurposes.Thiscanincludepublictransportorreimbursementforpetrolused.

Justicerelatedexpensesareexpensesrelatingtoattendingjusticeproceedingsand may includetravelandaccommodation.TheseexpenseswillnotbecoveredwheretheprimaryvictimisrequiredasawitnessinproceedingsasthiswillbecoveredbytheDirectorofPublicProsecutionsortheAustralianFederalPolice.Themaximumthatcanbeawardedforjusticerelatedexpensesis$5,000.

Reasonableexpensesincurredbytheparentorcareroftheprimaryvictimincludesanexpensethatisincurredorlikelytobeincurredbytheparentorcarerofaprimaryvictim asaresultoftheactofviolence.Forexample,travelexpensestoaccompanytheprimaryvictimtointerstatemedicalappointments.Thisamountisdeductedfromthetotalamountthattheprimaryvictimiseligiblefor.

OtherexpensesareforexceptionalcircumstancesthattheVictimsofCrimeCommissionerdecidesshouldbeprovidedtoaidintheprimaryvictim’srecovery.

Lossofordamagetopersonalitemsisforprimaryvictimsonly.Primaryvictimsmaybeentitledtofinancialassistanceforanitem tobefixedorreplacedifitwasdamagedasadirectresultoftheactofviolenceandwouldassistintheprimaryvictim’srecovery.

Youarethenaskedtoidentifywhether youareclaiminglossofearnings.

Lossofactualearningsincludestheactuallossofearningswheretheprimaryvictim wasabsentfromwork.

Aparentorcarerofaprimaryvictimmayapplyforlossofearningsfortimeawayfromwork spentcaringfortheprimaryvictim.

Evidencemustbeprovidedtoshowthedates youwereaway, yoursalary,andinsomecircumstances,evidencefromadoctor.You mustalso be able to show that you and/or your parent or carer have used all your personal leave / annual leave entitlements from your employer before being apply to apply for a loss of actual earnings.

Themaximumthatcanbeawardedforlossofearningsis$30,000.

If youwereself-employedyouwillneedtoprovidesomeformofevidencethatshowswhatdaysyouwereabsentfromwork,suchasmedicalrecords.Youwillalsoneedtoprovideevidenceofyoursalarysuchastaxationdocumentsorstatementsfromyouraccountant.

Pleasenote:Anyleaveentitlement(includingpersonal/sickleaveorannual/holidayleave)mustbeusedupbeforelossofearningscanbeawarded. You will need to provide evidence to show your own leave entitlements have been exhausted.

Thetotalmaximumamountthatcanbeclaimedforeconomiclossis$50,000whichisthetotalmaximumamountthataprimaryvictimcanreceiveforallcombinedpaymentsforanapplication.Thismeansif youareawarded

$50,000undereconomiclossthenyouwillnotbeeligibleforanymorepayments(includingimmediateneedsandrecognitionpayments).

SECTION8-Moneyreceivedfromothersources

Section8asksyoutoidentifywhetheryouhavereceived,orintendtomakeaclaimfor,moneyfrom othersourcesinrelationtotheactofviolence.Thisincludes,butisnotlimitedto,anawardofdamagesorareparationorder,Medicarebenefits,workerscompensation,acivilorothercourtclaim,incomeprotectioninsuranceoraCentrelinkpayment.

If youanswer yes toanyofthese,pleaseprovidedetailssuchaswhotheclaim iswith, whatthestatusis(e.g.haveyouputinaclaimyet,whenisitduetobeassessed)andwhattheoutcomewas(includingtheamountawarded).

Pleasenote:Youmustdeclareif youmaybeeligibletoreceiveanyofthesesourcesevenifyouhavenotyetlodgedtheclaimorreceivedthepayment.

Ifyouareawardedfinancialassistanceandthenreceivemoneyfromanothersourceyouwillberequiredtorepaymoneytothefinancialassistancescheme.

SECTION9—Declarationandagreementtoconditions

Thissectioniswhere youdeclarethateverythingthatyouhaveprovidedintheformistrueandcorrect.Yourapplicationwillnotbeassessedunlessthedeclarationhasbeenmadeandthetermsandconditionshavebeenagreedto.

Youmustalsosigntheformfortheassessmenttooccur.Ifyouarefillinginyourform onlinethenyoumusttype your

nameinthetextbox.

Thissectionmustbecompletedbythepersonapplyingforassistanceunlessthepersonapplyingontheirbehalfhasaformalauthoritytodoso(e.g.legalguardian,parent).

Ifthepersoncompletingtheformisdoingsoonsomeone’sbehalfandhasaformalauthoritytodosothentheyshouldcompletethissection and provide copies of supporting documentation in relation to the formal authority.

Pleasenote:Ifyouprovideanyinformationthat youknowtobefalseormisleadingonyourapplicationformyoumayberequiredtorepayallofthemoneyprovidedtoyouandcouldfacecriminalcharges.

BycompletingthissectionyouareacknowledgingthattheVictimsofCrimeCommissionerisauthorisedtoseekandobtaininformationtoverifyanyoftheinformationyouprovideandtoaskforproofof youridentity.

SECTION10—Consentform

Thissectionshouldbecompletedif you wouldliketheVictimsofCrimeCommissionertoobtainmedicalrecordsonyourbehalf.Youareentitledtoobtainanyinformationrequiredforyourapplicationonyourownhoweverif youwould liketheVictimsofCrimeCommissionertoassist with obtaining thisinformationonyourbehalfthenyourpermissionwillneedtobeprovided.

InordertogivetheVictimsofCrimeCommissionerpermissiontoobtainmedicalrecordsonyourbehalfyouwill needtoprovideyournameandaddressandwhattheactofviolencewas andwhatdateitwascommittedon.Thisissothatthehealthprofessional/agencycanprovidethecorrectinformationforthecorrectactofviolence.

YoumaylistasmanyHealthProfessionals/Agenciesasyouwouldlike.ThismayincludeyourGP,ahospital,acounsellor,apsychologist,agovernmentagencyoranon-governmentsupportagency.Wherepossible,youwillneedtoincludeanaddressandphonenumberforeachHealthProfessional/Agencylisted.

ThedisclaimerattheendofthissectionistomakeyouawarethattheVictimsofCrimeCommissionerhasnocontroloverwhatinformationtheHealthProfessional/Agencyprovides.Whereinformationisreceivedthatisnotrelevanttoyourapplicationitwilleitherbereturnedordestroyed.

TheVictimsofCrimeCommissionerwillnotdiscussorprovideanymedicalrecordstoanyoneunlessrequiredbylaw.

Pleasenote:Wearenotabletoprovideyouwithcopiesofanyinformationweobtainonyourbehalfastheinformationbelongstotherecordholder.If you wouldlikecopiesofthisinformationyouwillneedtoobtainitdirectlyfromthesource.

SECTION11-Notes

Youshouldusethisspacetoprovideanyadditionalinformationthatyouwereunabletoprovideanywhereelseontheform.Youmayalsoattachadditionalpagesifthereisinsufficientspace.