Week 2: FEMA Appeals by Policy, Guide and Checklist.

For disaster related DENTAL expenses, you will need to provide one or more of the following documents.

• A verifiable statement from the dental provider(s) which verifies the date of the dental injury occurred and if the injury is disaster related.
• A verifiable itemized bill/receipt from the provider(s) including the name, address, phone number and the date of service. If prescription medication has been lost or the treating physician has prescribed prescription medication, you will need to provide a verifiable physician's statement stating your condition requires the medication, and receipts from a pharmacy showing the cost of the medication.
• Name, address, telephone number and policy number of your medical/health insurance carrier including Medicaid, Medicare and Veterans Administration Benefits. A claim must be filed with your insurance carrier before submitting it to FEMA for consideration. (FEMA cannot duplicate benefits payable from your insurance company)
• You must submit either the written denial from your insurance carrier, or the explanation of benefits statement(s) for the amount which they have covered. If you are Not covered by any health/medical insurance, please sign and date the Statement of Insurance form and return it to FEMA

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For disaster related HOME REPAIR assistance, you will need to provide one or more of the following documents, dated prior to the disaster and indicating the physical street address of the damaged dwelling.

• A written description of previously unidentified disaster related damages
• Verifiable itemized estimates from a licensed contractor(s) to show the cost for repair or replacement of disaster related structural damage.
• Store receipts for building materials.

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For disaster related DAMAGE ASSESSMENTS assistance, you will need to provide one or more of the following of the damaged dwelling.

• Preliminary Damage Assessments (PDAs): Preliminary reports are typically conducted by state, county or parish, and local municipalities to determine the baseline of FEMA assistance needed. You can report your damage to the local authorities associated with FEMA, Homeland Security, or your Emergency Preparedness and Response managers.
• Create a Substantially Damaged Report.
• Verify FEMA Remote Damage assessments with private inspection reports.
• Determine your financial needs and complete a damage assessment financial statement.

Damage Assessments

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For a denial due to INSURANCE coverage, you will need to provide one or more of the following documents. The documentation submitted must contain the address of the damaged property and show that you filed a claim for damages to your home or personal property that occurred during the federally declared disaster incident period.

• A verifiable copy of your insurance denial letter.
• A verifiable copy of an itemized insurance settlement worksheet or a Proof of Loss statement.
• A verifiable statement or letter from your insurance company stating that you have no Loss of Use coverage or that the amount of this coverage is inadequate or exhausted.

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For disaster related MEDICAL expenses, you will need to provide one or more of the following documents.

• A verifiable statement from the medical provider(s) which indicates the date the medical injury or illness occurred and if it is disaster related.
• A verifiable itemized bill/receipt from the provider(s) including the name, address, phone number and the date of service.
• If prescription medication has been lost or the treating physician has prescribed prescription medication, you will need to provide a verifiable physician's statement stating your condition requires the medication, and receipts from a pharmacy showing the cost of the medication.
• Name, address, telephone number and policy number of your medical/health insurance carrier including Medicaid, Medicare and Veterans Administration Benefits.
• If insured, you must submit either the written denial from your insurance carrier, or the explanation of benefits statement(s) for the amount they have covered.
• If you are not covered by any health/medical insurance, please sign and date the Statement of Insurance form and return it to FEMA.

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For disaster related MOVING and STORAGE expenses, you will need to provide one or more of the following documents.

• Documentation of why the moving and storage expense was necessary.
• Date(s) for the moving and storage, provide telephone number and address of the storage facility used and furnish a copy of the receipts or lease of the storage unit.
• If essential personal property was damaged or lost in a storage unit, furnish an itemized list of losses and a written statement of why and how long the essential personal property had been stored at the time of the disaster.
• Signed 009-0-3

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For proof of OCCUPANCY of the damaged dwelling you will need to provide one or more of the following documents. The documentation must be dated prior to the disaster and indicate the physical street address of the damaged dwelling. You must prove occupancy of the damaged dwelling in order to receive home repair, rental assistance, personal property or other miscellaneous items.

• Utility bill
• Merchants statement (credit card bill)
• Copy of Federal or State Tax return
• Employer's statement
• Official's statement (postmaster)
• Copy of driver's license
• Statement/letter from your landlord
• Voter's registration

If your pre-disaster residence was a mobile home, travel trailer, or if you reside in a unique area like an insular region, island, or tribal land, and you lack acceptable forms of occupancy documentation, FEMA may consider a written self-declaration as a final option. This is due to the inherent difficulties in obtaining conventional forms of documentation for these specific types of homes.

A self-declarative statement for proof of occupancy must include all of the below items:

1. The address of the disaster-damaged residence.
2. Length of time you lived in the disaster-damaged home, as your primary residence, prior to the Presidential disaster declaration.
3. Your or your co-applicant’s name and signature.

The major elements of the following statement and additional explanation:
I have made a good faith effort, in coordination with FEMA, to obtain and provide a copy of acceptable occupancy documentation. I was unable to obtain this documentation because [provide an explanation of the circumstances that prevent standard occupancy verification to include why the other document types were not available to the applicant or how the available documents do not meet FEMA's requirements]. I hereby declare under penalty of perjury that the foregoing is true and correct

Resource FEMA Verifying Home Ownership or Occupancy

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For disaster related OTHER MISCELLANEOUS expenses, you will need to provide one or more of the following documents indicating the location at the physical street address of the damaged dwelling. Miscellaneous Purchases are those services or items purchased for recovery efforts usually immediately following the disaster.

Example: dehumidifier, chainsaw, generator, wet-dry vac.

• Documentation outlining what "Other" expenses you have incurred as a result of the disaster
• Documentation of why these expenses were required
• Verifiable estimates or itemized bills signed by the person providing the services
• Verification of occupancy at the damaged dwelling

Additional appeal information for ONA Other Miscellaneous

• Information and details regarding "Other Miscellaneous" appeals.

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For proof of OWNERSHIP of the damaged dwelling, you will need to provide one or more of the following documents. The documentation submitted must be dated prior to the disaster and indicate the physical street address of the damaged dwelling. You must prove ownership of the damaged dwelling in order to receive structural repair assistance.

• Deed or Official Record - original deed or deed of trust to the property
• Verification of Structural Insurance Coverage
• Mortgage Payment Statement/Book - mortgage payment statement/book, late notice or foreclosure notice
• Tax receipts or a property tax bill
• Title - the actual escrow or title document for the purchase of the dwelling
• Real Estate Proviso - an amendment to the title or to the deed that documents rent-free ownership which has been filed at the county courthouse
• Land Installment contract / Contract for deed
• Homeowners insurance documentation
• Manufactured home certificate or title
• Letter prepared after the disaster from a mobile home park owner or manager or public official that meets FEMA requirements
• Home purchase contracts (e.g. Bill of Sale, Bond for Title, Land Installment Contract, etc.)
• Quitclaim Deed - sometimes referred to as the quick claim deed, this document conveys all ownership rights to another co-owner of a property, this document must be recorded at the courthouse to be valid
• Death Certificate/Will - if the home is titled or deeded to a deceased relative, a will naming the applicant as the heir to the property and verification of death would satisfy as proof of ownership
• Court documents
• Maintenance receipts - major maintenance receipts which pre-date the incident period
• NOTE: Lease/Purchase, or a Rent to Own agreement, does not serve as proof of ownership.

If you own a home, live in an insular area, island, or tribal land or in a travel trailer or mobile home, and do not have any acceptable forms of ownership, FEMA will accept a written self-declarative statement as proof of ownership as a last resort.

A self-declarative statement for proof of ownership must include all of the below items:

• The address of the disaster-damaged residence.
• Length of time you lived in the disaster-damaged home, as your primary residence, prior to the Presidential disaster declaration.
• Your or your co-applicant’s name and signature.

The major elements of the following statement and additional explanation:

"I have made a good faith effort, in coordination with FEMA, to obtain and provide a copy of acceptable ownership documentation. I do meet FEMA's definition of an owner-occupant because I am either [(A) the legal owner of the home. (B) pay no rent, but am responsible for the payment of taxes or maintenance for the residence, or (C) hold lifetime occupancy rights]. I was unable to obtain this documentation because [provide an explanation of the circumstances that prevent standard ownership verification of the appropriate owner-occupant category]. I hereby declare under penalty of perjury that the foregoing is true and correct."

If you own and live in a home that was passed down via heirship and do not have any acceptable forms of ownership, FEMA, as a last resort, will accept a written self-declarative statement as proof of ownership.
A self-declarative statement for proof of ownership passed down via heirship must include all of the below items:

• The address of the disaster-damaged residence.
• Length of time you lived in the disaster-damaged home, as your primary residence, prior to the Presidential disaster declaration.
• Your or your co-applicant’s name and signature.
• A copy of the decedent’s death certification.

The major elements of the following statement and additional explanation:
"I have made a good faith effort, in coordination with FEMA, to obtain and provide a copy of acceptable ownership documentation. I was unable to obtain this documentation because [provide an explanation of the circumstances that prevent standard ownership verification]."
AND, the major elements of the following statement:
"As the nearest relative of the deceased in the line of succession, my ownership includes all the rights and obligations of the deceased. The decedent's name is ________________, and they died on ________________. I understand I must submit the death certificate along with this declaration. I hereby declare under penalty of perjury that the foregoing is true and correct."

Resource FEMA Verifying Home Ownership or Occupancy

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For disaster related PERSONAL PROPERTY loss, you will need to provide one or more of the following documents identifying the property located at the physical street address of the damaged dwelling.

• A service dealership or repairman receipt, estimate or statement of disaster related damage to appliances or furniture
• Merchandise receipts to show replacement of damaged property
• If applicable, a verifiable landlord's statement of the damages to the dwelling to show justification for personal property loss

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For disaster related TRANSPORTATION loss, you will need to provide one or more of the following documents.

• Copy of title for damaged vehicle(s)
• Copy of current registration card for damaged vehicle(s)
• List of all owned vehicle(s) with the year, make and model and a brief description of the damages and whether or not all or any of the vehicles are drivable
• Verification of vehicle(s) expenses, a verifiable estimate or bill from a licensed mechanic verifying the repair cost and verifying that the damage is disaster related, include the name of the mechanic and company name, address and telephone number
• Verification of comprehensive insurance coverage settlement or statement from you stating insurance coverage does not exist
• Verification of liability insurance coverage or statement from you stating insurance coverage does not exist
• Signed 009-0-3

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For disaster related Disaster Unemployment Assistance you should appeal for disqualification and termination of your benefits if not true.

An individual can be disqualified for DUA benefits or DUA benefits can be terminated if any of the following occur:

1. The individual becomes employed and the earnings exceed the weekly benefit amount allowed under the state’s law;
2. The individual refuses to accept suitable employment without good cause;
3. The individual refuses to accept a referral to suitable employment without good cause;
4. The individual is not able or available for work (unless the inability is due to an injury caused as a direct result of the disaster);
5. The individual is not available for work, unless the unavailability is due to the individual’s preparations to resume self-employment; or
6. The individual is no longer unemployed as a direct result of the disaster.

APPEALS
Any denial of DUA benefits may be appealed. Individuals must file the appeal within 60 days of the date the determination was issued.

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