CalVCB FAQ: Expenses
What types of expenses may be eligible for reimbursement?
CalVCB may reimburse the following expenses if they are necessary due to a crime and if there are no other sources of reimbursement available such as health insurance, worker's compensation or other benefits. Caps or limits may apply.
- Medical and medical-related expenses for the victim, including dental expenses.
- Outpatient mental health treatment or counseling.
- Funeral and burial expenses.
- Wage or income loss up to five years following the date of the crime. If the victim is permanently disabled, wage or income loss may be extended.
- Support loss for legal dependents of a deceased or injured victim.
- Up to 30 days wage loss for the parent or legal guardian of a minor victim who is hospitalized or dies as a direct result of a crime.
- Job retraining.
- Medically necessary renovation or retrofitting of a home or vehicle for a person permanently disabled as a result of the crime.
- Home security installation or improvements up to $1,000.
- In-patient psychiatric hospitalization costs under dire or exceptional circumstances.
- Relocation expenses up to $2,000 per household.
- Crime scene cleanup up to $1,000 when a crime occurs in a residence or vehicle.
- Veterinary fees, or replacement costs for a guide, signal or service dog. (GC § 13957(a)(10))
- Roundtrip mileage reimbursement from your residence to medical, dental or mental health appointments.
What expenses are not eligible for reimbursement?
CalVCB cannot reimburse applicants for the following expenses:
- Personal property losses, except medically necessary replacement of items such as eyeglasses and assistive devices.
- Expenses related to the prosecution of an alleged perpetrator.
- Compensation for "pain and suffering."
- Expenses submitted more than three years after they are incurred may not be eligible for reimbursement unless the victim is liable for the debt at the time the expense is submitted to CalVCB or has already paid the expense.
- CalVCB cannot pay any expenses incurred while a person is on parole, probation or post-release community supervision for a violent felony; incarcerated or required to register as a sex offender. This does not affect an application’s eligibility. It instead stops payment for expenses that are incurred during incarceration and felon or registered sex offender status.
What are the limits on assistance?
Assistance is limited to the amount of out-of-pocket expenses or bills incurred by or on behalf of the victim or applicant that have not been reimbursed by other sources such as insurance, and the amount of lost wages or loss of support (based on the victim's income) if that benefit is applicable.
The limits of various types of benefits are described below. For applications filed on or after January 1, 2001, the maximum amount that can be reimbursed is $63,000. For applications filed on or after January 1, 2017, the maximum amount that can be reimbursed is $70,000.
California law authorizes the Board to establish maximum rates and service limitations for reimbursement of medical and medical-related services and for mental health and counseling services. Currently, CalVCB has established the following rate limits for medical, medical-related and mental health services:
Medical and Dental Services:
- Eligible medical expenses are reimbursed:
- At the Medicare rate for services covered by Medicare
- At 75% of the billed amount for services not covered by Medicare
- At the Medicare rate for durable medical equipment (DME)
- At 80% for cosmetic surgery, prosthetics, hearing aids and eyeglasses
- Eligible dental expenses are reimbursed at 75% of the amount billed. Dentists may be able to obtain preauthorized approval for treatment. For more information visit our provider information page.
Mental Health Services:
For a complete overview of the Board's current and past rates visit our provider information page.
- Initially, an eligible victim will receive up to three mental health counseling sessions per claim.
- Providers are required to complete a Treatment Plan (TP) before the client's fourth session. The TP is to be retained in the client's file, and must be submitted to CalVCB upon request, at the time the ATP is submitted, or if treatment is less than 100% related to the qualifying crime.
- If the therapist determines additional treatment is necessary once a victim or derivative victim reaches the limits of 15, 30, or 40 sessions, an Additional Treatment Plan (ATP) must be submitted for review. If approved, a limited number of additional sessions may be authorized.
What if I have reimbursements from other sources?
CalVCB can only reimburse qualified expenses that have not or will not be paid by any other source such as health insurance, workers compensation, MediCal, or other benefits. By law, CalVCB is the "payer of last resort." If any other sources of reimbursement are available for the applicant's crime-related losses, they must be used before CalVCB payment can be made. Other reimbursement sources that may be available include, but are not limited to:
- Medical/health, dental, or vision insurance
- Public benefit programs (MediCal, unemployment insurance, or Department of Rehabilitation or other disability benefits, etc.)
- Auto insurance
- Workers' compensation benefits
- Court-ordered restitution
- Civil lawsuit recoveries
Applicants are responsible for informing CalVCB of all available reimbursement sources for their losses. Applicants must repay CalVCB for any payments for which it was later determined they were not eligible.
Does CalVCB have the right to be reimbursed if another source pays later on?
According to California law, CalVCB can only reimburse victims for crime-related expenses if there are no other sources of reimbursement. If CalVCB reimburses a victim for losses, but another source of funds becomes available because of the same criminal incident, CalVCB is entitled to be reimbursed.
To learn more about the requirements for repaying victim compensation when another source of reimbursement has become available (i.e. workers' compensation, vehicle insurance or lawsuit settlement, etc.), see CalVCB's Responsibility for Repayment of Victim Funds page.
The state is entitled to recover the amount of assistance granted to a victim out of any recovery by or on behalf of the victim from any third party liable for the victim's losses. This right is secured by a statutory lien against the recovery (Government Code § 13963). The state is also entitled to recover the amount of assistance granted out of any form of workers' compensation (Labor Code § 4903(h)). CalVCB's application includes a notice of the state's lien and recovery rights.