- (a) Pursuant to Tex. Code Crim. Proc. Art. 56.42(b), the OAG may award an additional benefit amount to be used for extraordinary pecuniary losses if personal injury to a victim is catastrophic and results in a total and permanent disability to the victim. For purposes of this benefit, extraordinary pecuniary loss means crime related expenses that exceed, or the OAG anticipates expenses to exceed, the maximum amount allowed under Tex. Code Crim. Proc. Art. 56.42(a).
(b) Once the OAG determines that a victim is catastrophically injured, the OAG may approve payment of expenses from either the victim's basic or catastrophic compensation benefits as determined appropriate by the OAG. The additional catastrophic injury benefit amount is available for the reasonable and necessary costs incurred as a result of catastrophic injury occurring on or after September 1, 1995, as follows:
- (1) A claim for additional catastrophic injury benefits arising from crimes that occurred on or after September 1, 1995, to on or before August 31, 1997, shall not exceed $25,000. A claim for the additional catastrophic injury benefits for this time period shall be applied only to lost wages and (c)(1), (2), (3), (4), and (5) below.
- (2) A claim for additional catastrophic injury benefits arising from crimes that occurred on or after September 1, 1997, to on or before August 31, 2001, shall not exceed $50,000. A claim for the additional catastrophic injury benefits for this time period shall be applied only to lost wages and (c)(1), (2), (3), (4), and (5) below.
- (3) A claim for additional catastrophic injury benefits arising from crimes that occurred on or after September 1, 2001, shall not exceed $75,000. A claim for the additional catastrophic injury benefits for this time period shall only be applied to lost wages and (c)(1), (2), (3), (4), (5), (6), (7) and (8) below.
(c) The additional catastrophic injury benefit shall be used only to replace lost wages and the following reasonable and necessary expenses incurred on the dates as follows:
- (1) "Making a home accessible" means reasonable and necessary modifications to a residence that are necessary to maintain an independent lifestyle. This includes modifying a kitchen, bedroom, or bathroom to accommodate the victim's disability resulting from the criminal injury. The legal owner of the residence must submit to the OAG verification of ownership and written permission to modify the dwelling. (Available to victims with catastrophic injuries resulting from criminally injurious conduct that occurred on or after September 1, 1995).
- (2) "Making an automobile accessible" means equipping a personal vehicle with reasonable and necessary equipment to allow the victim to control or to enter the vehicle. Modification of a vehicle is limited to one time per two year period. Eligibility for this benefit may be based on the OAG's assessment of the extent of the disability and the availability of collateral sources. (Available to victims with catastrophic injuries resulting from criminally injurious conduct that occurred on or after September 1, 1995).
- (3) Expenses for job training or vocational rehabilitation may be compensated if the service provider is licensed, certified or otherwise operating within the guidelines of the state in which services are being provided and a referral has been made by one of the health professionals treating the injuries that resulted in the disability. Services may be obtained through private or public institutions. However, all other collateral sources for these services must be utilized. Itemized bills should be submitted to CVC indicating the dates of service and the nature of the services provided. Quarterly reviews of theses conditions shall be conducted to assure continued compliance within the predicted length of rehabilitation. (Available to victims with catastrophic injuries resulting from criminally injurious conduct that occurred on or after September 1, 1995).
- (4) Training in the use of special appliances includes the training required by the victim or a non-medically trained person providing care for the victim. (Available to victims with catastrophic injuries resulting from criminally injurious conduct that occurred on or after September 1, 1995).
- (5) Home health care expenses may be paid for related services by licensed individuals or facilities upon submission by the victim or claimant to the OAG of an itemized bill for services provided. (Available to victims with catastrophic injuries resulting from criminally injurious conduct that occurred on or after September 1, 1995).
- (6) Durable medical equipment refers to those items that can withstand repeated use, are primarily used to serve a medical purpose, are generally not useful to a person in the absence of illness, injury or disease, and are appropriate for use in the victim's home. (Available to victims with catastrophic injuries resulting from criminally injurious conduct that occurred on or after September 1, 2001).
- (7) Rehabilitation technology are those therapeutic measures, deemed appropriate by the OAG, that help the victim attain maximum function and an optimal level of independence in the activities of daily living. (Available to victims with catastrophic injuries resulting from criminally injurious conduct that occurred on or after September 1, 2001).
- (8) Long-term medical expenses incurred as a result of medically indicated treatment for the catastrophic injury includes, but is not limited to, medications, supplies, surgery, and surgery related expenses necessary to sustain the highest possible quality of life following a catastrophic injury. (Available to victims with catastrophic injuries resulting from criminally injurious conduct that occurred on or after September 1, 2001).
- (d) Pursuant to Tex. Code Crim. Proc. Art. 56.42(b) only the victim may be eligible to be awarded compensation for catastrophic injury.
Source Note:The provisions of this §61.407 adopted to be effective December 15, 2002, 27 TexReg 11513; amended to be effective November 14, 2007, 32 TexReg 8117.