Frequently Asked Questions

    I. Background Questions

  1. Who are the parties in this case?
  2. What claims did the United States bring against the City?
  3. What claims did the Plaintiffs-Intervenors bring against the City?
  4. What is an "unlawful disparate impact"?
  5. Now that the City has been found liable, what happens next?
  6. Will the City change the way it selects entry-level firefighters in the future as a result of this lawsuit?
  7. What kinds of individual relief may be available to remedy the City’s discrimination?
  8. Who may be able to receive individual relief?
  9. If I took Exam 6019 (first administered in 2006), am I able to receive individual relief in this lawsuit?
  10. What is the current status of the case?
  11. II. Claims Process Questions

  12. How can I join this lawsuit and receive money from the proposed settlement?
  13. Who are the Special Masters?
  14. What is the process for considering my claim?
  15. When will I receive my monetary award?
  16. How are monetary awards being calculated, and do you know the amount of my award?
  17. I submitted a claim form seeking priority hiring relief. How does the proposed settlement affect my pursuit of priority hiring relief?
  18. I submitted a claim form seeking priority hiring relief, and I’m currently participating in the priority hiring process. Is it possible to delay any portion of the priority hiring process, such as the CPAT or the medical exam, or even my appointment to the FDNY Fire Academy?
  19. I submitted a claim form seeking priority hiring relief. If I am successfully appointed to the FDNY Fire Academy, what will my starting salary be?
  20. What additional benefits are successful priority hires entitled to as a result of this lawsuit?
  21. What additional benefits are eligible Delayed-Hire Claimants entitled to as a result of this lawsuit?
  22. I am a Delayed-Hire Claimant. Why is my presumptive hire date after my actual hire date?
  23. Will my information be kept confidential?
  24. How did the May 14, 2013 decision by the United States Court of Appeals for the Second Circuit affect my claim for relief?
  25. If the Court finds that I am not eligible for priority hiring relief but I went through the firefighter hiring process, will the FDNY still hire me as a priority hire?
  26. Why was I allowed to go through the FDNY’s firefighter hiring process if I am not eligible for priority hiring relief?
  27. What if I have additional questions?
  28. III. Compensatory Damages Questions

  29. What kinds of relief may be available (in addition to priority hire, back pay, and lost fringe benefits)?
  30. If I am a black claimant, how can I submit a claim for compensatory damages?
  31. What are the next steps once I submit my claim for compensatory damages?
  32. Are compensatory damages separate from any back pay award?
  33. Are compensatory damages separate from priority hiring relief?
  34. Why are Hispanic applicants not able to claim compensatory damages?
  35. Do I have to fill out the HIPAA Authorization?
  36. If I do have to return the HIPAA Authorization, how do I fill it out?
  37. Who will be able to see my HIPAA Authorization and my medical files?





I. Background Questions

  1. Who are the parties in this case?
  2. The Plaintiff in this case is the United States of America. The Department of Justice, on behalf of the United States, is authorized to bring suit to enforce Title VII of the Civil Rights Act of 1964, as amended, 42 U.S.C. § 2000e, et seq. (“Title VII”), against state and local government employers.

    The Vulcan Society and seven individual firefighter applicants, Roger Gregg, Marcus Haywood, Candido Nuñez, Jamel Nicholson, Rusebell Wilson, Kevin Walker, and Kevin Simpkins are Plaintiffs-Intervenors in this action. The Vulcan Society is an organization of black firefighters in the Fire Department of the City of New York (“FDNY”). The Vulcan Society and the individual firefighter applicants (referred to here collectively as the “Plaintiffs-Intervenors”) intervened on behalf of themselves and all black applicants for the position of entry-level firefighter who were harmed by the employment practices challenged in this lawsuit.

    The Defendant in this case is the City of New York, a local government employer, which maintains a fire department (FDNY) and employs firefighters.

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  3. What claims did the United States bring against the City?
  4. In May 2007, the United States filed suit against the City of New York in the United States District Court for the Eastern District of New York (case number 07-cv-2067). The United States alleged that since 1999, the City has discriminated against black and Hispanic applicants for the position of entry-level firefighter in the FDNY. Specifically, the United States challenged the City’s use of Written Exams 7029 and 2043, first administered in 1999 and 2002, respectively, in its hiring process for the position of entry-level firefighter. The United States alleged that the City’s use of these examinations had an unlawful disparate impact on black and Hispanic applicants and did not adequately determine who was or was not qualified for the job of entry-level firefighter.

    On July 22, 2009, Judge Nicholas G. Garaufis ruled that the City violated Title VII. The Court found that the City’s use of the written examinations had an unlawful disparate impact on black and Hispanic applicants and could not, as the law requires, be justified as job-related and consistent with business necessity.

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  5. What claims did the Plaintiffs-Intervenors bring against the City?
  6. In September 2007, the Court allowed the Plaintiffs-Intervenors to intervene in this case. The Plaintiffs-Intervenors joined the United States’ challenge of the two written examinations based on their disparate impact on black applicants, in addition to raising their own claim that the City intentionally discriminated against black applicants through its use of these examinations.

    In January 2010, Judge Garaufis found the City liable for intentional discrimination against black applicants under Title VII, as well as state and local human rights law and the Fourteenth Amendment to the United States Constitution. On May 14, 2013, the Second Circuit Court of Appeals issued a ruling overturning the intentional discrimination finding and sending the intentional discrimination claim to a new district court judge for trial. The Second Circuit also upheld most of the remedies ordered by Judge Garaufis, including a Court Monitor to oversee the FDNY’s hiring, and held that Judge Garaufis would maintain jurisdiction over financial and other remedies.

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  7. What is an "unlawful disparate impact"?
  8. Title VII of the Civil Rights Act of 1964 prohibits not only intentional discrimination, but also employment practices that appear to be fair in form but are discriminatory in operation. A facially neutral employment practice, such as a written examination, that disproportionately excludes individuals from employment opportunities on the basis of their membership in a protected group, such as a particular race or national origin, and cannot be shown to be related to job performance, violates Title VII. As the Equal Employment Opportunity Commission has explained,

    [An employer] can be found liable under Title VII if it uses a facially neutral practice that has the effect of disproportionately excluding members of a particular protected group. In such cases, which apply the disparate impact theory of discrimination, the individual alleging discrimination must prove ... that the challenged practice has a substantial and significant adverse effect on a protected group. If the individual can make this demonstration, the employer will be liable for discrimination unless it can show that the practice in question is job-related and consistent with business necessity. It is the employer's burden to make this showing, and a failure to provide any justification for the practice will likely result in a finding of liability. Even if an employer can demonstrate that a practice is justified, moreover, the individual will be given an opportunity to prove that there are other available practices that would also serve the employer's purposes, but with less impact on the protected group.

    http://www.eeoc.gov/eeoc/foia/letters/2000/titlevii_disparate.html

    These facially neutral practices include the use of some written tests by employers, which have, intentionally or not, screened out people of a particular race, national origin or sex who are in fact qualified. Although using written tests to screen applicants may present the appearance of objective, merit-based selection, written tests often do not actually identify applicants who will be successful at performing a particular job. If appropriate analysis finds a test to be a poor assessment of an applicant’s ability to do a job, then the test stands in the way of identifying the best qualified candidates. As a result, it is in everyone’s interest to find a better measure.

    In United States v. City of New York, Judge Garaufis found: (1) that the City’s use of two written examinations screened out black and Hispanic applicants at a significantly higher rate than white applicants; and (2) that the City’s use of these examinations did not predict which applicants would be best able to perform the job, which means that the use of these examinations was not job-related and consistent with business necessity. As a result, the Court found the City liable for disparate impact discrimination under Title VII.

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  9. Now that the City has been found liable, what happens next?
  10. The Court has directed that the claims process begin so that it can identify which individuals who took the City's unlawful exams are eligible to receive money, a firefighter job, and/or seniority. The deadline to return a claim form was June 18, 2012.

    The Court has issued a Relief Order which sets forth the different types of individual relief it will award as well as the criteria for determining whether an individual is eligible for an award. The Court held a fairness hearing on October 1-4, 2012, where it considered objections from individuals who might be affected by the proposed Relief Order. The Court overruled those objections when it entered the Final Relief Order.

    Individuals that submitted claim forms should have received a letter by November 16, 2012, indicating whether the United States has preliminarily determined that they are eligible for relief. Individuals intending to object to these preliminary eligibility determinations were required to do so by November 30, 2012.

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  11. Will the City change the way it selects entry-level firefighters in the future as a result of this lawsuit?
  12. The parties worked jointly under the supervision of the Court to develop Exam 2000, a new selection procedure for entry-level firefighters. The City administered Exam 2000 to applicants for the entry-level firefighter position in March and April 2012. The Court approved the City's proposed use of Exam 2000 on September 28, 2012.

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  13. What kinds of individual relief may be available to remedy the City’s discrimination?
  14. The Court will award money, firefighter jobs, and seniority to individuals who were found to be harmed by the City's discriminatory practices. You may refer to the Court's Final Relief Order for more details about the individual relief available. Check this website for updates about the relief phase of the case.

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  15. Who may be able to receive individual relief?
  16. The Court will determine whether or not an individual who applies for relief was subjected to the City’s discriminatory practices, and thus, able to receive relief. Individuals eligible for relief may include black and Hispanic applicants who took entry-level firefighter Exam 7029 (first administered in 1999), Exam 2043 (first administered in 2002), or both. This includes individuals who the City hired as entry-level firefighters (if their hiring was delayed due to the City’s discriminatory practices), as well as those the City did not hire as entry-level firefighters. For more information, please see the Final Relief Order.

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  17. If I took Exam 6019 (first administered in 2006), am I able to receive individual relief in this lawsuit?
  18. No. Individuals who did not take either Exam 7029 or Exam 2043 between 1999 and 2006 are not eligible to receive individual relief in this lawsuit. If you feel you were discriminated against because of your race or national origin as a result of taking one of the City's written examinations for entry-level firefighter, you should consult with an attorney (at your own expense) to determine your legal options or you can file a charge of discrimination with the Equal Employment Opportunity Commission. The Department of Justice and the Plaintiffs-Intervenors have not filed suit against the City with respect to any entry-level firefighter exams other than Written Exams 7029 and 2043.

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  19. What is the current status of the case?
  20. The parties to this lawsuit (the United States, the Vulcan Society and several class representatives, and the City of New York) have reached an agreement in principle to settle this case, including the total amount of money that the City of New York will pay to eligible claimants. The parties are currently working on the details of the proposed settlement. Once the details have been worked out, eligible claimants will be notified, and the Court will hold a fairness hearing to consider whether to approve the proposed settlement.

    If the Court approves the proposed settlement, claimants who were already determined by the Court to be eligible for relief will be entitled to money as a result of the settlement. The parties have proposed to settle the back pay and fringe benefits claims for approximately $98 million, which will be divided among eligible claimants in a manner yet to be determined. In addition, eligible black claimants who submitted a compensatory damages claim form by the February 18 deadline may also be offered a separate amount by the City to settle their compensatory damages claims. (See “What are the next steps once I submit my claim for compensatory damages?” for more information.)

    As of now, the parties cannot predict when claimants will receive their settlement awards or precisely how much money each claimant will receive. However, the parties anticipate that the settlement will be faster and less burdensome on claimants than if the case had not settled and continued with the litigated claims process. The parties are currently drafting a timeline for the Court’s approval and will update eligible claimants once the Court has approved the timeline.

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    II. Claims Process Questions

  21. How can I join this lawsuit and receive money from the proposed settlement?
  22. The only people who were eligible for relief were those black and Hispanic applicants who took Exam 7029 in 1999 and/or Exam 2043 in 2002 and who met the eligibility criteria set by the Court. If you did not take one of those exams, you are not eligible for relief.

    If you did take one of those exams, and if you are not already part of the lawsuit, it is too late to join now. In order to receive money from the proposed settlement, you must have already submitted a claim form seeking relief and the Court must have already decided that you are eligible for relief. If you have not submitted a claim form, the deadline to return claim forms has passed, and no additional claim forms will be considered by the Court.

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  23. Who are the Special Masters?
  24. The Special Masters are four attorneys the Court has appointed to review individual claimants’ claims to see who is eligible for different kinds of relief. Everyone who submitted an initial claim form has been assigned to a specific Special Master.

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  25. What is the process for considering my claim?
  26. The Court has made a final decision regarding the eligibility for relief of everyone who submitted a claim form. If you submitted a claim form and did not receive a Report and Recommendation from a Special Master regarding your eligibility for relief or the Court’s order on the Special Master’s eligibility recommendation, please log into your claimant portal or contact GCG.

    If you have not submitted a claim form, the deadline to return claim forms has passed, and no additional claim forms will be considered by the Court.

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  27. When will I receive my monetary award?
  28. If the Court already decided that you are eligible for relief, you will be entitled to money as a result of the proposed settlement. However, we do not yet know when money will be distributed because the parties are currently working on the details of the proposed settlement. Once the parties have worked out the details of the proposed settlement - including when and how the settlement funds will be distributed among eligible claimants - eligible claimants will be notified, and the Court will hold a fairness hearing to consider whether to approve the proposed settlement. In any case, the parties anticipate that the settlement will be faster and less burdensome on claimants than if the case had not settled.

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  29. How are monetary awards being calculated, and do you know the amount of my award?
  30. If the Court already decided that you are eligible for relief, you will be entitled to money as a result of the proposed settlement. However, we do not yet know how much you will receive because the parties are currently working on the details of the proposed settlement. Once the parties have worked out the details of the proposed settlement – including when and how the settlement will be distributed among eligible claimants – eligible claimants will be notified, and the Court will hold a fairness hearing to consider whether to approve the proposed settlement.

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  31. I submitted a claim form seeking priority hiring relief. How does the proposed settlement affect my pursuit of priority hiring relief?
  32. The parties’ proposed settlement does not affect your claim for priority hiring relief. For example, if you have already been hired as a priority hire, this settlement does not affect your employment with the FDNY. Similarly, if the Court found you eligible for priority hiring relief and you are undergoing processing for appointment with the FDNY, your processing is not affected by this settlement.

    If you have additional questions about the priority hiring process, you may contact the U.S. Department of Justice via email at fdnycase@usdoj.gov or by calling (800) 556-1950, selecting mailbox option number 7, and leaving a detailed message. Black claimants who sought priority hiring relief may also contact Levy Ratner at (212) 627-8100.

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  33. I submitted a claim form seeking priority hiring relief, and I’m currently participating in the priority hiring process. Is it possible to delay any portion of the priority hiring process, such as the CPAT or the medical exam, or even my appointment to the FDNY Fire Academy?
  34. Questions about the CPAT should be directed to the City’s Department of Citywide Administrative Services (DCAS) at testingaccommodations@dcas.nyc.gov. If you have questions or concerns about the medical exam contact the Fire Department’s Bureau of Health Services at Fire Department of New York, Chief Medical Officer, Bureau of Health Services, Room 206, 9 Metro Tech Center, Brooklyn, NY 11201. If you have any questions or concerns about your background investigation contact your investigator or call (718) 999-2179 or send an email to CID@fdny.nyc.gov.

    If you have any questions or concerns about the response you get from CID, you may contact the U.S. Department of Justice by emailing fdnycase@usdoj.gov or calling (800) 556-1950, selecting mailbox option number 7, and leaving a message.

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  35. I submitted a claim form seeking priority hiring relief. If I am successfully appointed to the FDNY Fire Academy, what will my starting salary be?
  36. If you are ultimately hired as a priority hire and begin the FDNY Fire Academy, you will receive a higher salary, as if you had been hired from your original exam. If you took Exam 7029, you will receive the salary of someone who was hired on February 2, 2003. If you took Exam 2043, you will receive the salary of someone hired on June 11, 2006.

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  37. What additional benefits are successful priority hires entitled to as a result of this lawsuit?
  38. If you are ultimately hired as a priority hire and begin the FDNY Fire Academy, you will receive retroactive seniority. For a definition of retroactive seniority and what it covers, please see pages 14 – 15 of the Final Relief Order. You will also receive retroactive pension benefits.

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  39. What additional benefits are eligible Delayed-Hire Claimants entitled to as a result of this lawsuit?
  40. If you are ultimately determined to be eligible for relief as a Delayed-Hire Claimant, you will receive retroactive seniority and retroactive pension benefits, if you made the employee contributions to the Pension Fund.

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  41. I am a Delayed-Hire Claimant. Why is my presumptive hire date after my actual hire date?
  42. The presumptive hire date for each exam is the median date of hire for all firefighters appointed from each exam. For Exam 7029, the median hire date was February 2, 2003, and for Exam 2043, the median hire date was June 11, 2006. The Court determined that all those hired after the median hire date would receive retroactive seniority dating back to February 2, 2003 for those who took Exam 7029 and June 11, 2006 for those who took Exam 2043. Delayed-Hire Claimants who were hired before the median hire date will not receive retroactive seniority, but they will of course not lose any seniority. In other words, those whose hires were delayed the most will receive retroactive seniority back to the median or presumptive hire date, but the presumptive hire date has no effect on your seniority if you were hired before February 3, 2003 for Exam 7029 or June 11, 2006 for Exam 2043. The presumptive hire date also has no effect on your eligibility for back pay or on back pay calculations.

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  43. Will my information be kept confidential?
  44. All information submitted through this website will be maintained and utilized in accordance with applicable federal law, including the Privacy Act of 1974, 5 U.S.C. § 552a, et seq. To the extent any information submitted is protected by the Privacy Act, that information would not be used or disclosed except as permitted under the Privacy Act. No one will file your social security number in any public document.

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  45. How did the May 14, 2013 decision by the United States Court of Appeals for the Second Circuit affect my claim for relief?
  46. It did not affect your claim for relief. On May 14, 2013, the United States Second Circuit Court of Appeals issued a decision on an appeal that the City filed regarding issues that do not have any impact on the availability of awards for back pay, lost fringe benefits, non-economic damages, retroactive seniority, and firefighter job offers for eligible claimants. The Second Circuit’s decision primarily dealt with Judge Garaufis’s Injunctive Relief Order, and the Second Circuit affirmed the appointment of a Court Monitor and most of the other provisions of the Injunctive Relief Order. The Second Circuit reversed two findings: (1) that the City intentionally discriminated against black applicants, and (2) that former Fire Commissioner Nicholas Scoppetta was immune from being sued for intentional race discrimination. The Second Circuit determined that the intentional discrimination claims against the City and Commissioner Scoppetta must be decided at a trial, which may take place this fall. The Second Circuit’s decision has no effect on the relief to be awarded to claimants according to the Final Relief Order. So, eligible claimants can still expect to receive cash awards and, if they are qualified, firefighter job offers.

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  47. If the Court finds that I am not eligible for priority hiring relief but I went through the firefighter hiring process, will the FDNY still hire me as a priority hire?
  48. No. In order to be hired as a priority hire, you must (1) be found eligible for priority hiring relief by the Court, and (2) successfully make it through the FDNY’s firefighter hiring process. Only claimants who the Court determined are eligible for priority hiring relief and who pass every step in the FDNY’s hiring process can be hired by the FDNY as priority hires.

    If the Court determined that you are not eligible for priority hiring relief, the only way you could become an entry-level FDNY firefighter is if you applied and were hired through one of the FDNY’s regular hiring processes (e.g., if you took Exam 2000 in early 2012 as part of the FDNY’s open-competitive hiring process or, if you are a current FDNY EMT and took Exam 2500 in early 2012 as part of the FDNY’s promotional hiring process).

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  49. Why was I allowed to go through the FDNY’s firefighter hiring process if I am not eligible for priority hiring relief?
  50. In order to be hired as a priority hire, you must (1) be found eligible for priority hiring relief by the Court, and (2) successfully make it through the FDNY’s firefighter hiring process. If you were preliminarily determined by the United States to be ineligible for priority hiring relief, you were informed that you could only be hired as a priority hire if the United States was incorrect, but you were permitted to participate in the hiring process in order to preserve your claim for priority hiring relief.

    Because the Court did not make its eligibility determinations until after the FDNY’s hiring process began, some claimants who the Court ultimately determined were not eligible for priority hiring relief went through the FDNY’s hiring process. Even if you passed every step in the FDNY’s hiring process, if you were determined by the Court to be ineligible for priority hiring relief, you cannot be hired as a priority hire.

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  51. What if I have additional questions?
  52. If you have questions about the status of your claim for relief, please contact the Claims Administrator by telephone: toll free: (866) 297-7120 or by email at questions@FDNYlitigation.com

    If you have additional questions, call the Department of Justice at (800) 556-1950, select mailbox option number 7, and leave a message.

    If you have questions regarding the Plaintiffs-Intervenors’ claims, call the Plaintiffs-Intervenors at (212) 627-8100.

    Please do not contact the court for information about this case. Court personnel will not be able to answer any questions about your eligibility for relief or the process of obtaining relief.

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    III. Compensatory Damages Questions

  53. What kinds of relief may be available (in addition to priority hire, back pay, and lost fringe benefits)?
  54. If you are a black claimant and are found eligible for relief in this case, you may also be eligible for a monetary award for harms that resulted from your not being appointed as an FDNY firefighter. The Court has ordered that compensatory damages (also known as noneconomic damages) be awarded to black claimants who can show that they have suffered any of the following as the result of the City’s failure to hire them as a firefighter:

    1. Concrete emotional harm, potentially including depression, sleeplessness, anxiety, humiliation or shame;
    2. Inconvenience, such as being unemployed for some time or having to take a particularly inconvenient job or combination of jobs;
    3. No longer being able to take part in an activity or activities that they previously enjoyed before experiencing the City’s discrimination;
    4. Damage to their personal or professional reputation that has affected their future earning capacity;
    5. Certain other injuries that arose from the City’s denial of the firefighter job based upon a black applicant’s test score.

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  55. If I am a black claimant, how can I submit a claim for compensatory damages?
  56. The Claims Administrator will mail all black claimants detailed instructions on how to submit a claim for compensatory damages, along with a medical release form (if applicable) questions from the City (the City’s “discovery requests”). Those instructions will include all deadlines for filing. Further information will be posted here as soon as it is available.

    You may also contact a lawyer for help with your claims. For assistance at no cost to claimants, delayed-hire claimants (black applicants who were eventually hired by the FDNY) may seek representation from the Center for Constitutional Rights, and non-hire claimants (black applicants who were never hired by the FDNY) may seek representation from Levy Ratner, P.C.

    1. Levy Ratner: (212) 627-8100 x269/ firefighter@levyratner.com
    2. Center for Constitutional Rights: (212) 614-6494/ firefighter@ccrjustice.org
    3. More information is available at www.fdnycase.com/compensatory-damages.

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  57. What are the next steps once I submit my claim for compensatory damages?
  58. If you submitted a Compensatory Damages Claim Form, the City will be making you a monetary offer to resolve your claim. If you are represented by an attorney, the offer from the City will be sent to your attorney. These offers may not be made for several weeks, and they will be mailed as well as uploaded to your Claimant Portal. The City’s offer will explain how much time you have to respond to the offer and other instructions for responding.

    If you do not accept the City’s offer, the City will take discovery related to your claim (meaning you will be required to provide documents to the City to support your claim for damages, and the City may question you and the other witnesses you identified, if any). You might also be required to present your case at a hearing in front of a Special Master.

    If you fail to respond to the City’s settlement offer and also fail to cooperate with the discovery process, the City will ask the Court to dismiss your claim for compensatory damages.

    The deadline for submitting Compensatory Damages Claim Forms has passed. No more claim forms will be accepted.

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  59. Are compensatory damages separate from any back pay award?
  60. Yes. You may be eligible for back pay even if you do not file a claim for compensatory damages. Your eligibility for back pay is not affected by whether you file a claim for compensatory damages.

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  61. Are compensatory damages separate from priority hiring relief?
  62. Yes. Your eligibility for priority hiring relief is not affected by whether you file a claim for compensatory damages. You may be eligible for priority hire even if you do not file a claim for compensatory damages. Filing a claim for compensatory damages does not make you ineligible for priority hire.

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  63. Why are Hispanic applicants not able to claim compensatory damages?
  64. This case began with the United States Department of Justice filing a complaint against New York City, alleging that the City's use of certain firefighter exams disproportionately excluded black and Hispanic applicants from the FDNY. Compensatory damages are not available under the claims brought by the United States. The Vulcan Society - the association of black firefighters within the FDNY - and three individual applicants (called the “intervenors”) later joined the case on behalf of black applicants. The intervenors joined the DOJ's original claims, and also made specific requests of their own, including compensatory damages. No group similar to the Vulcan Society joined the case on behalf of Hispanic applicants. As a result, compensatory damages are available only for black applicants.

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  65. Do I have to fill out the HIPAA Authorization?
  66. There is no need to fill out or return the HIPAA Authorization form unless you are making a claim for compensatory damages and you saw a health care provider (a doctor, therapist, etc.) for treatment for your emotional distress or other injury related to the fact that you were not hired as a firefighter or your hiring was delayed.

    You do not need to complete a HIPAA Authorization as part of your Medical Expenses and Health Insurance (Fringe Benefits) Claim. The HIPAA Authorization is only for compensatory damages.

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  67. If I do have to return the HIPAA Authorization, how do I fill it out?
    • At the top of the form, fill in your name, date of birth, social security number and address. You are the patient.
    • Box 7, list the name and address of the doctor that you saw related to your injury. You are giving that doctor/therapist permission to give your patient records to the City.
    • Box 8, write: New York City Law Department, 100 Church St., New York, NY 10007, ATTN: Yuval Rubinstein. Your patient information will be released to the City as part of your compensatory damages claim.
    • Box 9(a): check the first box and list the dates of treatment for any injuries related to your compensatory damages claim. If the injury that you believe was caused by the City’s discrimination required you to undergo Alcohol/Drug Treatment, Mental Health Treatment, or HIV-Related Treatment, initial one or more of those lines in 9(a).
    • Box 9(b): If you would like your medical provider to be able to discuss your treatment with the City, you can check and initial box 9(b). List the name of your provider (your doctor, therapist, etc.) and list the City of New York again. You do NOT have to check 9(b) in order to make a claim for compensatory damages!
    • Box 10: Check “At request of individual.”
    • Box 11: Fill in the date when you no longer want the City to be able to access your records. We suggest using December 31, 2014.
    • Boxes 12 and 13: As long as you are signing the form yourself, you can ignore Boxes 12 and 13.
    • Be sure to sign and date the form at the bottom of the page.

    If you were treated by more than one medical provider for injuries related to your compensatory damages claim, you should submit a separate HIPAA Authorization for each provider.

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  68. Who will be able to see my HIPAA Authorization and my medical files?
  69. The HIPAA Authorization, and any documents that that are produced by your health care provider(s) will be uploaded to the GCG web site and can be seen by the parties in this case (the City of New York, the United States Department of Justice, the Plaintiffs-Intervenors, and the Special Masters). All parties in the case have agreed to treat this information as confidential and not to use it for any purpose other than to evaluate your claim.

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