Severe Injury Payment

Victorian Bushfire Appeal Fund

Am I eligible?

You are eligible for the Severe Injury Payment if, as a result of the 2009 Victorian Bushfires:

• you have stayed overnight in hospital; and
• you have had or will require surgery or further hospital treatment.

What assistance is available?

If you are eligible for the Severe Injury Payment you will receive a lump sum of $7,500.

Payments will be made to your nominated bank account. If you do not have an account or access to your account please talk to the Victorian Bushfire Appeal Fund about alternate arrangements.

How do I claim?

To claim the Severe Injury Payment will need to complete the Severe Injury Payment Application Form (PDF, 86kb) for all members of the household you are claiming for. Each member of the household who is over the age of 18 will need to sign a Statutory Declaration and Privacy Statement. You can get additional Statutory Declarations and Privacy Statements by calling 1800 180 213 or you can copy the ones attached to this form.

To claim the Severe Injury Payment you will need to complete a new form for each individual.

What information do I need to provide?

The Government recognises the extraordinary circumstances that families are facing and will work with individuals to ensure that any necessary information can be obtained in a flexible and sensitive manner.

The Government will need to reasonably establish proof of identity, and that you were hospitalised as a result of the 2009 Victorian bushfires.

Proof of identity can include:

• passport
• drivers licence, Key Pass or other photographic identification
• marriage certificate
• birth certificate
• concession card
• Medicare card
• utility bill or bank statement.

Evidence of your hospitalisation may include:

• discharge papers
• letter/medical certificate from hospital or general practioner.

If you require assistance with providing required information please contact the Victorian Bushfire Appeal Fund on 1800 180 213.

Who can witness a Statutory Declaration?

People authorised to witness statutory declarations include lawyers, police, pharmacists, school principals, ministers of religion, bank managers, doctors, vets and Housing Services Officers.

If you require assistance with getting your statutory declaration witnesses please contact the Victorian Bushfire Appeal Fund on 1800 180 213.

How long do I have to claim?

You have until 31 December 2009 to lodge a claim for the Severe Injury Payment. Applications beyond this date will be considered on a case-by-case basis.

What if I need assistance with completing the form?

You can contact the Victorian Bushfires Appeal Fund on 1800 180 213.

A printable version of the the information on this page can be downloaded via the Severe Injury Payment Fact Sheet (PDF, 59kb)