Apply for Compensation
How do I apply for compensation?
Report the crime to law enforcement officials (police, naval investigative service, military police or Federal Bureau of Investigation) without undue delay.
Obtain an application by downloading the document below, or by contacting the Commission office at (808) 587-1143 or email@example.com.
Submit your application to the Commission within 18 months of the crime date. Applications will only be accepted after 18 months if there is a good cause letter from a physician or therapist.
Submit the following:
- The original signed Application Form.
- The original signed Authorization to Release Medical/Mental Health Treatment Information Form for each treatment provider.
- Proof to substantiate your claim (bills, receipts, insurance statements, and medical records).
- If you are making a claim for lost wages, completely fill out and sign the Authorization to Release Employment Information Form and submit it to your employer.
- Submit proof to substantiate your claim for lost wages (pay stubs, Income Tax returns if self-employed, and a medical disability certificate) to the Commission.
You can also download the complete application packet with all forms here:
Complete Application Packet.
How will my application be processed by the Commission?
Once we have received your application, the Commission staff will subpoena the police report and determine if you are an eligible crime victim.
You will receive a written administrative decision and order either awarding or denying compensation.
What if I disagree with the Administrative decision?
You may appeal the Commission’s decision in writing within 60 days of the mailing date of the administrative decision and order. The Commission will set a hearing for your appeal and you will have an opportunity to tell the Commission why you disagree with the decision and to present documentation.
The Commission will make a decision and provide you with a written notification of the decision.
What if I disagree with the Commission’s decision?
The Commission’s decision may be appealed to the Circuit Court of the victim’s county of residence within 30 days of the mailing date of the Commission’s decision and order. The sole ground for such an appeal is that the Commission exceeded its jurisdiction or authority.