1. (a) Definitions and Applicability.

   1. (1) The Board shall only pay income or support loss if the victim or derivative victim was receiving documented earned income as an employee or from self-employment, as described in subdivision (d), at the time the qualifying crime occurred.

      1. (A) “Earned income” includes wages, salaries, and tips that are reflected on the victim's paystubs or tax returns, sick leave, and vacation leave. “Earned income” does not include overtime, commissions, income derived from passive investments, retirement accounts, unemployment benefits, or disability benefits. Passive investments include gross receipts derived from royalties, rents, dividends, interest, and annuities.
      2. (B) “Support loss” includes, but is not limited to, the victim's earned income or child support paid by the victim, or both.
      3. (C) Income loss includes time lost from work for medical or mental health appointments that became necessary as a direct result of the qualifying crime.
      4. (D) “Gig economy” is the economic system by which a workforce of people engage in freelance and/or independent contract work. This includes, but is not limited to, ridesharing, delivery services, on-demand labor and repair services, and the sale of crafts and personal items. A victim whose income was based on gig economy activity is considered to be self-employed.
      5. (E) “Scope of employment” means reasonably related to the kinds of tasks that the employee was employed to perform or was reasonably foreseeable to perform in light of the employer's business or the employee's job responsibilities.
      6. (F) The Board may pay income or support loss based on a documented job offer and acceptance, with a start date within 30 days of the qualifying crime.
   2. (2) All reimbursements for income or support loss shall be necessary as a direct result of the qualifying crime.

2. (b) Written Request for Income Loss.

   1. (1) Requirements for Making Income Loss Request. A request for income loss must include:

      1. (A) Date of injury;
      2. (B) Dates of disability period for which the victim is requesting income loss;
      3. (C) Name and contact information for the treating healthcare provider; and
      4. (D) The legal name of the employer, the employer's contact information, and the victim's work site at the time the qualifying crime occurred. The employer's legal name and contact information should be determined from the victim's itemized wage statement or Form W-2, Wage and Tax Statement.
      5. (E) Signature under penalty of perjury. A request for income loss that is made after the CalVCB application was submitted must be signed under penalty of perjury.
   2. (2) Six-month Renewal Requirement. A request for income loss must be renewed every six months, except when the treating provider certifies that the disability is permanent and the victim has reached the point in the healing process when they are not expected to further improve with generally accepted medical treatment.
   3. (3) State Disability Insurance and Social Security Disability Insurance. An employed victim who is disabled for one year or less must apply for State Disability Insurance (SDI) from the Employment Development Department (EDD). A self-employed victim is not required to apply for SDI. All victims whose disability lasts beyond one year must apply for Social Security Disability Insurance (SSDI) from the Social Security Administration (SSA). A victim must provide the Board with proof of the EDD or SSA claim and the response showing approval or denial of the claim, and the amount of benefits paid or to be paid.

3. (c) Disability Statements.

   1. (1) General Requirements.

      1. (A) When the victim is disabled as a direct result of the qualifying crime and unable to work, either short-term or long-term, the Board must receive a disability statement that meets all of the following criteria:

         1. (i) Signed by a licensed medical or mental health provider who treated the victim's injuries or disabilities that were a direct result of the qualifying crime (treating provider).
         2. (ii) Must contain sufficient information to verify that the disability period is a direct result of the crime-related injury, or the direct result of an exacerbation of a pre-existing condition and shall include the information identified in subdivision (c)(3).
         3. (iii) A disability statement is only valid for six months, except when the treating provider certifies that the disability is permanent and the victim has reached the point in the healing process when they are not expected to further improve with generally accepted medical treatment.

      2. (B) Requests for income loss due to time lost from work for intermittent or periodic mental health or medical appointments do not require a disability statement. Acceptable documentation for income loss due to mental health or medical appointments includes:

         1. (i) Evidence of time missed from work, which may include a timesheet that confirms time missed from work, check stubs showing the loss of income due to time missed, or a statement from the employer that demonstrates time was missed; and
         2. (ii) Documentary evidence that corresponds to the time missed from work from the medical or mental health provider showing the date and time of the appointment and that it was an appointment to treat the physical and/or emotional injuries resulting from the qualifying crime.

   2. (2) Acceptable Providers.

      1. (A) Physical Injuries. For physical injuries, the disability statement must be signed by one of the following providers: medical doctor, physician assistant, nurse practitioner, osteopath, optometrist, dentist, podiatrist, or chiropractor. A chiropractor's disability statement shall only be accepted for the period of time the chiropractor is providing treatment. Diagnosing the victim's disability must be within the scope of the treating provider's licensure.
      2. (B) Emotional Injuries. For emotional injuries with a disability period of up to six months, the disability statement must be signed by one of the following providers: licensed social worker, licensed marriage family therapist, licensed clinical psychologist, psychiatrist, physician assistant, or nurse practitioner. When the total disability period lasts beyond six months, any new disability statements submitted in support of a longer disability period must be signed by a licensed clinical psychologist or psychiatrist. Diagnosing the victim's disability must be within the scope of the treating provider's licensure.
      3. (C) Out-of-State Providers. Disability statements submitted by out-of-state health care providers are acceptable if the medical or mental health provider's licensure is comparable to the licensure of one of the authorized California medical or mental health providers as identified in subdivisions (c)(2)(A) and (c)(2)(B). Their licensure must be valid under the governing authority regulating the provider's practice in the state or country where the service is provided at the time the service was provided.

   3. (3) Content of disability statement. The Board may accept a disability statement that is on either a CalVCB approved disability statement or a treating medical or mental health provider's letterhead. The disability statement must include the following information:

      1. (A) Date of injury;
      2. (B) Current diagnosis;
      3. (C) Prognosis for recovery;
      4. (D) Extent and expected duration of the disability;
      5. (E) Certification that the disability resulted directly from the qualifying crime and no other reason;
      6. (F) Provider's professional license number or National Provider Identifier (NPI);
      7. (G) The provider's contact information; and
      8. (H) The provider's signature under penalty of perjury.

4. (d) Income Loss -- Verification Requirements.

   1. (1) Employed Victims and Derivative Victims.

      1. (A) To demonstrate eligibility for income loss for employed victims and derivative victims, they must submit one of the following documents:

         1. (i) Wage Statements. At least one month of itemized wage statements (i.e. paystubs) for the pay periods immediately preceding the disability period; or
         2. (ii) Employer Payroll Records. At least one month of employer payroll records for the pay periods immediately preceding the disability period; or
         3. (iii) Bank Records. At least one month of bank records evidencing deposits from earned income for the month immediately preceding the disability period. The deposit must reflect that it came from the victim's employer.

      2. (B) CalVCB's Verification Requirements. Following receipt of a Disability Statement and one of the three documents identified in subdivision (d)(1)(A), CalVCB staff must obtain at least one of the following to verify income loss before income loss may be paid:

         1. (i) Tax Returns. Tax returns for the tax year preceding the date the qualifying crime occurred or the tax year the qualifying crime occurred. If tax returns are used as a verification source, they must come directly from the appropriate jurisdiction's taxing authority. If CalVCB cannot obtain tax returns from the appropriate jurisdiction's taxing authority, the Board may accept tax returns directly from the victim or derivative victim as long as they provide evidence they filed the tax return. Acceptable evidence may consist of a receipt from a tax preparer, documentation showing that the victim or derivative victim received a refund or made a payment that matches the amount reflected on the tax return, or copies of receipts, cashed checks, or money orders in the amount indicated on the tax return.
         2. (ii) EDD Employment Documentation. Employment documentation from the EDD reflecting the victim's employment during the tax year preceding the date the qualifying crime occurred or the tax year the qualifying crime occurred.

         3. (iii) Employer Verification. A statement under penalty of perjury from the employer providing all of the following information:

            1. (I) Acknowledgement that the victim or derivative victim was employed by the employer;
            2. (II) The dates of employment;
            3. (III) The time missed from work as a direct result of the qualifying crime;
            4. (IV) The rate of pay; and
            5. (V) All paid leave (sick leave, vacation time, annual leave, or personal time off) utilized as a direct result of the qualifying crime.

   2. (2) Self-Employed Victims and Derivative Victims.

      1. (A) To verify eligibility for income loss for self-employed victims and derivative victims, the Board must receive:

         1. (i) Tax Returns. Tax returns for the tax year preceding the date the qualifying crime occurred or the tax year the qualifying crime occurred. If tax returns are used as a verification source, they must come directly from the appropriate jurisdiction's taxing authority. If CalVCB cannot obtain tax returns from the appropriate jurisdiction's taxing authority, the Board may accept tax returns directly from the victim or derivative victim as long as they provide evidence they filed the tax return. Acceptable evidence may consist of a receipt from a tax preparer, documentation showing that the victim or derivative victim received a refund or made a payment that matches the amount reflected on the tax return, or copies of receipts, cashed checks, or money orders in the amount indicated on the tax return.
      2. (B) Calculations Based on Annual Net Profit. To determine the amount of income loss for self-employed individuals, the Board shall calculate their income based on their annual net profit from their business. The Board shall not calculate income loss based on the annual gross income from their business. (If using IRS tax documentation, the net annual income is found on Line 31 of form Schedule C: Profit or Loss from Business.)

5. (e) Support Loss -- Verification Requirements.

   1. (1) Employed Victim's Survivors or Dependents -- Basis for Calculations.

      1. (A) Support loss for survivors or dependents who lived with the victim at the time the qualifying crime occurred is based on the victim's income.
      2. (B) Support loss for minor dependents who did not live with the victim at the time the qualifying crime occurred is based on the victim's income, child support, or both. To verify a loss of child support payments, the Board must receive a copy of the court's current child support order and evidence demonstrating receipt of payment within the last 45 days.
      3. (C) Support loss for adult dependents who did not live with the victim at the time the qualifying crime occurred is based on the victim's income. To verify dependency of an adult who did not live with the victim, the Board must receive tax returns demonstrating that the victim declared the adult as a dependent in either the tax year preceding the date the qualifying crime occurred or the tax year the qualifying crime occurred.
      4. (D) To verify an employed victim's income loss, Board staff must follow the verification requirements in subdivision (d)(1).

   2. (2) Self-Employed Victim's Survivors or Dependents -- Basis for Calculations.

      1. (A) Support loss for survivors or dependents who lived with the victim at the time the qualifying crime occurred is based on the victim's annual net income less self-employment tax.
      2. (B) Support loss for minor dependents who did not live with the victim at the time the qualifying crime occurred is based on the victim's annual net income less self-employment tax, child support, or both. To verify a loss of child support payments, the Board must receive a copy of the court's current child support order and evidence demonstrating receipt of payment within the last 45 days.
      3. (C) Support loss for adult dependents who did not live with the victim at the time the qualifying crime occurred is based on the victim's annual net income less self-employment tax. To verify dependency of an adult who did not live with the victim, the Board must receive tax returns demonstrating that the victim declared the adult as a dependent in either the tax year preceding the date the qualifying crime occurred or the tax year the qualifying crime occurred.
      4. (D) To verify a self-employed victim's income loss, Board staff must follow the verification requirements in subdivision (d)(2).
   3. (3) Derivative Victim -- Eligibility when Direct Victim Received Income Loss. If the direct victim is eligible for income loss, the Board shall not pay any derivative victims for support loss during the time period that the direct victim is being fully compensated for income loss.

6. (f) Crimes Committed While Victim was Acting in the Scope of Employment.

   1. (1) If the qualifying crime occurred at the victim's workplace or while the victim was acting in the scope of their employment, the victim or derivative victim must submit the documentation specified in subdivisions (d)(1) or (d)(2); and documentation showing that the victim filed a claim with their employer's worker's compensation carrier or the Uninsured Employer's Benefits Trust Fund (UEBTF). If the claim is resolved, the Board must receive a copy of the Compromise and Release, Stipulation and Award, Finding and Order, or Finding and Award.

   2. (2) Restrictions on Income Loss.

      1. (A) The Board shall not pay income loss for any period of time the victim receives loss of earnings through worker's compensation or the UEBTF.
      2. (B) A victim who receives compensation for lost wages through worker's compensation or the UEBTF shall be considered fully reimbursed and ineligible for income loss from the Board.
7. (g) Use of Paid Leave. A victim shall not be required to utilize paid leave (sick leave, vacation time, annual leave, or personal time off) as a reimbursement source. However, if the victim has already received full or partial compensation from paid leave or uses such leave during the period for which they have requested reimbursement for income loss, those payments will be considered a reimbursement source.
8. (h) If the documentation the Board receives is insufficient to verify income loss or support loss, Board staff may contact the victim or derivative victim's employer or treating provider for additional information.
9. (i) The Board shall not pay income loss beyond the statutory timeframes set forth in Government Code section 13957.5, regardless of whether there are gaps in the victim's total disability period, or whether the victim or derivative victim has been partially or fully compensated for their income or support loss through other reimbursement sources.

Note: Authority cited: Sections 13920 and 13974, Government Code. Reference: Sections 13957 and 13957.5, Government Code.

History

1. New section filed 6-12-2009; operative 7-12-2009 (Register 2009, No. 24).

2. Repealer and new subsection (g) filed 1-6-2011; operative 2-5-2011 (Register 2011, No. 1).

3. Amendment filed 6-28-2012; operative 7-28-2012 (Register 2012, No. 26).

4. Amendment filed 8-12-2014; operative 10-1-2014 (Register 2014, No. 33).

5. Repealer and new section and amendment of Note filed 1-13-2026; operative 4-1-2026 (Register 2026, No. 3).