Understanding the Forms
The settlement process requires regular submission of forms to claim your benefits. These forms can be confusing, especially for claimants who are ill, elderly, or managing complex medical situations. This page explains each form in plain language.
GEN4 — Cost of Care Claim Form
What it's for
The GEN4 form is used to claim Cost of Care benefits under Article 4.04 of the Settlement Agreement. This covers hourly caregiving — the time a family member or caregiver spends helping you with daily activities because of your Hepatitis C-related conditions.
Key details
- Maximum: Up to $50,000 per year
- Rate: Currently $20 per hour for family caregiving
- Frequency: Submit monthly, by the 2nd of the following month
- Physician prescription: You need a physician's letter prescribing the number of hours of care per week. This letter should describe your conditions and explain why you need the care.
Tips from experience
- Submit on time. The Administrator's rule is that if the form is not received by the 2nd of the month, payment may be held to the following month.
- Keep a copy of every form you submit.
- If your care needs change, get an updated prescription from your physician before the Administrator asks for one.
- Track the number of days in each month — February payments will be lower because there are fewer days, not because your benefits were reduced.
GEN3 — Out-of-Pocket Expenses and Uninsured Medications
What it's for
The GEN3 form covers out-of-pocket medical expenses that are not covered by your provincial health plan or private insurance. This includes:
- Prescription medications not covered by provincial formularies
- Cannabis (if prescribed by a physician)
- Medical equipment (if prescribed by a qualified health professional)
- Travel costs for medical appointments
- Other health-related expenses
Key details
- Include receipts for every expense
- If you have a prescription (e.g., for cannabis), include a copy the first time and reference it in subsequent submissions
- If a benefit you have been receiving for years is suddenly challenged or suspended, ask the Administrator to cite the specific provision of the Settlement Agreement that authorizes the change
Loss of Income Application
What it's for
If your Hepatitis C infection caused you to lose income — because you became too ill to work, lost your career, or had your earning capacity reduced — you can apply for Loss of Income compensation under Articles 4.02 and 4.03.
What you need
- Notices of Assessment (NOAs) from CRA for your highest-earning years
- Evidence of pre-disability income — tax returns, employment records, business records, professional credentials
- Medical evidence establishing the date you became disabled
- For years with zero income: If you did not file tax returns because you had no income, explain this clearly. You cannot produce documents that do not exist. A pension chart or disability benefits record showing zero income is supporting evidence.
Important
Loss of Income claims are complex and can involve significant amounts. The formula uses the average of your three highest consecutive years of earnings, capped at $300,000 per year. If you have a Loss of Income claim, consider seeking professional help — either from us or from a lawyer experienced in settlement fund claims.
The Administrator has a duty to process your LOI claim and issue a decision. If your claim has been sitting without a decision, demand one in writing. Without a decision, you cannot appeal to a Referee. Without an appeal, the fund never has to pay.
General Tips for All Forms
- Always keep copies. Every form, every receipt, every letter.
- Submit by email whenever possible, so you have a timestamp and delivery record.
- Follow up in writing if you do not receive acknowledgment within 10 business days.
- Never send originals. Send copies. Keep the originals.
- If something is denied, get it in writing. A written denial is your ticket to the Referee. A verbal "no" is worth nothing.
- Ask questions in writing. Phone calls leave no record. Emails do.