1. Criminal Injuries Compensation
For Child Victims
Forms and information about filing
Criminal Injuries Compensation
for Children who are victims of crime.
This information is written to help children who are in state custody. However, these forms may
be used by any parent, or legal guardian, who is applying on behalf of any minor child who has
been a victim of abuse or other personal crime.
The following pages are adapted from the manual, “Legal Advocacy in Child Dependency and
Parental Rights Cases,” prepared by the Legal Division of the Tennessee Department of Children’s
Services.1
Victim Assistance & Advocacy Project
West Tennessee Legal Services, Inc.
1
http://www.tncourts.gov/sites/default/files/docs/lawyers_advocacy_manual.pdf, last viewed Nov. 13, 2012.

2. VICTIM’S COMPENSATION FOR CHILDREN
YOUR CHILD MAY BE ELIGIBLE!*
Criminal Injury Compensation in TN
Under TN law, victims of crimes may be eligible for monetary compensation from the state’s Criminal
Injury Compensation Fund and attorney’s fees may be paid to attorneys representing the claimant. (See
T.C.A. Title 29, Chapter 13)
• Children can be eligible for compensation both as victims of crime and as dependents of crime
victims. If the child is the actual victim, the statute of limitations does not begin to run until the child
reaches the age of 18.
PLEASE REFER TO T.C.A. Title 29, Chapter 13, TO DETERMINE IF YOUR CHILD IS ELIGIBLE FOR
VICTIM’S COMPENSATION.
If You Think Your Child is Eligible:
• File an application for Criminal Injury Compensation on behalf of your Child with the Claims
Administration of the state Treasury Department. The forms, instructions and frequently asked questions
can be found on the website: www.treasury.state.tn.us/injury
Tips for Filing a Victim’s Compensation Claim for a Child:
• The parent or legal guardian must sign the application as claimant for a minor victim, pursuant to TCA
29-13-102(b).
• If a child is in state custody and the parent or guardian is unavailable, a representative of DCS can
sign as the claimant and their social security number will not be required.
• The guardian ad litem cannot sign the application as the claimant.
• There is no requirement for conviction or adjudication of the perpetrator in order for the victim to
be eligible for compensation.
If Your Child’s Application is Approved:
• You will receive a letter from the Claims Administration containing instructions on how to
proceed once you have received your Child’s compensation check.
o This packet contains sample copies of: (1) a petition to establish a trust fund, (2) an order
to establish a trust fund, (3) a motion to encroach, and (4) an order to encroach.
• If an attorney helped you, he or she can file a claim for attorney’s fees with the Claims Administration.
*Prepared by the Legal Division of the Tennessee Department of Children’s Services.
This information sheet should not be used as a substitute for reading the statute governing criminal injury
compensation, T.C.A. Title 29, Chapter 13. If you have any questions regarding Criminal Injury
Compensation please refer to the website listed above or call the Claims Division at 615.741.2734.

3. Examples of cases where child victims have received victim’s compensation:*
Scenario 1
Child is now 12 and the the Guardian-ad-Litem (GAL) learns about disclosure of past abuse while going
through DCS file. At age 8 the child disclosed sexual abuse by two men, known only as Uncle Dave and
Uncle Ron, that happened when she was four years old. GAL files two separate victim’s compensation
claims (because there were two perpetrators) for pain and suffering. Since there is documentation in the
DCS files, victim's compensation pays the maximum award of $3,000 pain and suffering for one count of
the claims. Claims Administration states that the abuse happened at the same time and the perpetrators
acted in concert with each other since there is no documentation otherwise. So only one claim is paid for
pain and suffering due to sex abuse.
Scenario 2
Male child is placed in state custody for dependency and neglect at age 6. While in a foster home child is
raped by a teenage foster child in the same home. Child is later sexually abused on two additional
occasions by other perpetrators in different settings. GAL learns of the abuse while reviewing the file
when child is 15. GAL files 3 separate victim's compensation claims and all are paid at maximum award
of $3,000 each for pain and suffering.
Scenario 3
Child's mother is killed in child’s presence by mother’s boyfriend. GAL files claim for victim
compensation based upon the death of the mother. Child is awarded $20,000.00 for pecuniary loss.
Funeral home is paid for funeral expenses.
Scenario 4
Six year old girl is raped by her mother’s boyfriend in front of her brothers, ages 5 and 4. After the rape,
boyfriend beats the boys. GAL files claims of sexual abuse on all three children stating that the boys
were victims of sexual abuse as well as their sister because they were forced to view the rape. Victim's
compensation grants female child’s claim for $3,000.00 but denies that boys were victims of sexual abuse
- only of physical abuse. GAL appeals decision to commissioner of claims and boys are awarded $500.00
each.
Scenario 5
Female, age 17, alleges that her stepfather has raped her. Stepfather denies allegations but after going
through the Juvenile Court and criminal court process, stepfather goes on a rampage at home chasing the
stepdaughter, his biological daughter and wife through the house. Stepfather finally shoots himself in the
head and kills himself on the back porch. Victim's compensation is filed on the stepdaughter and she is
awarded $3,000 - maximum for pain and suffering of sexual abuse, plus is reimbursed for counseling not
paid for by private insurance and for time that she missed from work due to the abuse and attending
counseling.
*Prepared by the Legal Division of the Tennessee Department of Children’s Services.

4. IN THE JUVENILE COURT OF ___________________________ COUNTY, TENNESSEE
IN THE MATTER OF: )
)
_______________________________ ) DOCKET NO:
)
A CHILD UNDER THE AGE OF 18 YEARS )
===========================================================================
PETITION TO ESTABLISH TRUST FOR BENEFIT OF THE MINOR CHILD
===========================================================================
Comes now the Petitioner, ____________________________________________________, (name and
relationship to the child) and would move this Honorable Court to establish a trust for the benefit of the
above captioned minor child.
The Petitioner would state that the sum to be placed in the Juvenile Court Clerk’s Office is
$_______________ and that this money represents a Criminal Injuries Compensation Claim awarded by
the Tennessee Claims Commission (or the Division of Claims Administration) to be used for the benefit
of the minor child.
The Petitioner respectfully requests that this sum be deposited by the clerk in an interest bearing
account and that this sum or any part thereof be turned over to the minor child upon his/her reaching the
age of majority or by further orders of this Court.
The child’s social security number is ______________________. The child’s date of birth is
____________________ and the child’s present address is
___________________________________________________________________________________.
Respectfully submitted,
_______________________
Petitioner
_________________
Address and phone number

5. OATH
STATE OF TENNESSEE, COUNTY OF _____________________________
I, ____________________________________, being duly sworn according to law, make oath that the
facts stated in the foregoing Petition are true and correct to the best of my knowledge, information, and
belief.
_______________________________________
Petitioner
Sworn to and subscribed before me this__________ day of____________________ , 20_____.
___________________________________________
Notary Public
My Commission Expires: ________________________________

6. IN THE JUVENILE COURT OF ___________________________ COUNTY, TENNESSEE
IN THE MATTER OF: )
)
_______________________________ ) DOCKET NO:
)
A CHILD UNDER THE AGE OF 18 YEARS )
==========================================================================
ORDER ESTABLISHING TRUST FOR THE BENEFIT OF THE MINOR CHILD
========================================================================== I
It appearing to the Court that a Petition has been filed to establish a trust for the minor child and
that the same was filed with the Court on ___________(date) and the sum of $_________ was tendered to
the Juvenile Court Clerk on______________(date).
It is therefore ORDERED, ADJUDGED AND DECREED that a trust in the amount of
$_____________ shall be established for the benefit of the above captioned minor child.
It is further ORDERED, ADJUDGED, AND DECREED that these sums shall be placed in an interest
bearing account by the Juvenile Court Clerk and that the account shall be placed at __________________
(name of local bank) and that said sum shall be held in trust for the benefit of the minor child.
It is further ORDERED, ADJUDGED, AND DECREED that said sums or any part thereof shall
be turned over to the minor child at the time he/she reaches majority and that a motion to encroach this
Trust must be filed with this Court by an appropriate individual in the event it becomes necessary to
obtain these funds or any part thereof before the child reaches majority.
Entered on this the ______day of _____________, 20__.
__________________________________
JUDGE
CERTIFICATE OF SERVICE
I hereby certify that a true and exact copy of this Order was forwarded by U.S. Mail, postage
prepaid, to the following persons on this the____________ day of ____________, _______________ :
________________________________________________________________________________
________________________________________________________________________________
[List the names and addresses of each attorney/person/party noticed.]

7. IN THE JUVENILE COURT OF ___________________________ COUNTY, TENNESSEE
IN THE MATTER OF: )
)
_______________________________ ) DOCKET NO:
)
A CHILD UNDER THE AGE OF 18 YEARS )
=====================================================================
MOTION TO ENCROACH
=====================================================================
Comes now the Petitioner,_______________________________(name and relationship to child)
and would move this Honorable Court to encroach upon the corpus of the trust being held in the Juvenile
Court Clerk’s Office for the benefit of the minor child.
Petitioner would state that there is currently the sum of $_____________ being held in the
Juvenile Court Clerk’s Office for the benefit of the minor child and there is a current need for the amount
of $____________. The specific need(s) for which funds are sought is as follows:
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
____________________________________________________________________________________
Respectfully Submitted,
_____________________________________
(name of person submitting)
_____________________________________
(address)
CERTIFICATE OF SERVICE
I hereby certify that a true and exact copy of this Motion was forwarded by U.S. Mail, postage
prepaid, to the following persons on this the____________ day of ____________, _______________ :
______________________________________________________________________________
[List the names and addresses of each attorney/person/party noticed.]
This motion shall be heard on the ______day of ________________, 20____

8. IN THE JUVENILE COURT OF ___________________________ COUNTY, TENNESSEE
IN THE MATTER OF: )
)
_______________________________ ) DOCKET NO:
)
A CHILD UNDER THE AGE OF 18 YEARS )
=====================================================================
ORDER TO ENCROACH
=====================================================================
This cause came to be heard before the Honorable _________________, Judge for the Juvenile
Court of _________________County, Tennessee on the ______day of ____, 20__ upon the Motion to
Encroach filed by _____________________.
After hearing testimony from the Movant and considering the record as a whole, it was the opinion of the
Court that the Motion to Encroach should be granted /not granted.
It is therefore ORDERED, ADJUDGED AND DECREED that this cause be dismissed.
OR
It is therefore ORDERED, ADJUDGED AND DECREED that the Petition be granted and that
the sum of $_________ be awarded to_______________________________________ (custodian, health
care provider, school or other appropriate payee), to be used for the following purposes:
The Clerk shall disburse the funds accordingly.
Entered on this the _____day of _______________20__.
____________________________________________
JUDGE
CERTIFICATE OF SERVICE
I hereby certify that a true and exact copy of this Order was forwarded by U.S. Mail, postage prepaid, to
the following persons on this the____________ day of ____________, _______________ :
[List the names and addresses of each attorney/person/party noticed.]
________________________________________________
(Signature)