90 

14 CFR Ch. I (1–1–19 Edition) 

§ 15.7 

§ 15.7

Administrative claims; evidence 

and information to be submitted. 

(a) 

Death. 

In support of a claim based 

on death, the claimant may be required 
to submit the following evidence or in-
formation: 

(1) An authenticated death certifi-

cate or other competent evidence show-
ing cause of death, date of death, and 
age of the decedent. 

(2) The decedent’s employment or oc-

cupation at time of death, including 
monthly or yearly salary or earnings 
(if any), and the duration of last em-
ployment or occupation. 

(3) Full names, addresses, birth dates, 

kinship, and marital status of the dece-
dent’s survivors, including identifica-
tion of those survivors who were de-
pendent for support upon the decedent 
at the time of death. 

(4) Degree of support afforded by the 

decedent to each survivor dependent 
upon decedent for support at the time 
of death. 

(5) Decedent’s general, physical, and 

mental conditions before death. 

(6) Itemized bills for medical and bur-

ial expenses incurred by reason of the 
incident causing death or itemized re-
ceipts of payment for such expenses. 

(7) If damages for pain and suffering 

prior to death are claimed, a physi-
cian’s detailed statement specifying 
the injuries suffered, duration of pain 
and suffering, any drugs administered 
for pain, and the decedent’s physical 
condition in the interval between in-
jury and death. 

(8) Any other evidence or information 

which may have a bearing on either the 
responsibility of the United States for 
the death or the amount of damages 
claimed. 

(b) 

Personal injury. 

In support of a 

claim for personal injury, including 
pain and suffering, the claimant may 
be required to submit the following 
evidence or information: 

(1) A written report by the attending 

physician or dentist setting forth the 
nature and extent of the injuries, na-
ture and extent of treatment, any de-
gree of temporary or permanent dis-
ability, the prognosis, period of hos-
pitalization, and any diminished earn-
ing capacity. 

(2) In addition to the report required 

by paragraph (b)(1) of this section, the 

claimant may be required to submit to 
a physical or mental examination by a 
physician employed by the FAA or an-
other Federal agency. A copy of the re-
port of the examining physician is 
made available to the claimant upon 
the claimant’s written request if the 
claimant has, upon request, furnished 
the report required by paragraph (b)(1), 
and has made or agrees to make avail-
able to the FAA any other physician’s 
reports previously or thereafter made 
on the physical or mental condition 
which is the subject matter of the 
claim. 

(3) Itemized bills for medical, dental, 

and hospital expenses incurred or 
itemized receipts of payment for such 
expenses. 

(4) If the prognosis reveals the neces-

sity for future treatment, a statement 
of expected expenses for such treat-
ment. 

(5) If a claim is made for loss of time 

from employment, a written statement 
from the claimant’s employer showing 
actual time lost from employment, 
whether the claimant is a full or part- 
time employee, and wages or salary ac-
tually lost. 

(6) If a claim is made for loss of in-

come and the claimant is self-em-
ployed, documentary evidence showing 
the amount of earnings actually lost. 

(7) Any other evidence or information 

which may have a bearing on the re-
sponsibility of the United States for 
the personal injury or the damages 
claimed. 

(c) 

Property damage. 

In support of a 

claim for injury to or loss of property, 
real or personal, the claimant may be 
required to submit the following evi-
dence or information: 

(1) Proof of ownership of the property 

interest which is the subject of the 
claim. 

(2) A detailed statement of the 

amount claimed with respect to each 
item of property. 

(3) An itemized receipt of payment 

for necessary repairs or itemized writ-
ten estimates of the cost of such re-
pairs. 

(4) A statement listing date of pur-

chase, purchase price, and salvage 
value, where repair is not economical. 

(5) Any other evidence or information 

which may have a bearing on either the 

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