[Code of Federal Regulations]
[Title 14, Volume 1]
[Revised as of January 1, 2003]
From the U.S. Government Printing Office via GPO Access
[CITE: 14CFR15.7]

[Page 78-79]
 
                     TITLE 14--AERONAUTICS AND SPACE
 
CHAPTER I--FEDERAL AVIATION ADMINISTRATION, DEPARTMENT OF TRANSPORTATION
 
PART 15--ADMINISTRATIVE CLAIMS UNDER FEDERAL TORT CLAIMS ACT--Table of Contents
 
                      Subpart A--General Procedures
 
Sec. 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 information:
    (1) An authenticated death certificate or other competent evidence 
showing cause of death, date of death, and age of the decedent.

[[Page 79]]

    (2) The decedent's employment or occupation at time of death, 
including monthly or yearly salary or earnings (if any), and the 
duration of last employment or occupation.
    (3) Full names, addresses, birth dates, kinship, and marital status 
of the decedent's survivors, including identification of those survivors 
who were dependent 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 burial expenses incurred by 
reason of the incident causing death or itemized receipts of payment for 
such expenses.
    (7) If damages for pain and suffering prior to death are claimed, a 
physician'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 injury 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, nature and extent of 
treatment, any degree of temporary or permanent disability, the 
prognosis, period of hospitalization, and any diminished earning 
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 another Federal 
agency. A copy of the report 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 available 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 necessity for future treatment, a 
statement of expected expenses for such treatment.
    (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 actually lost.
    (6) If a claim is made for loss of income and the claimant is self-
employed, documentary evidence showing the amount of earnings actually 
lost.
    (7) Any other evidence or information which may have a bearing on 
the responsibility 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 evidence 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 
written estimates of the cost of such repairs.
    (4) A statement listing date of purchase, purchase price, and 
salvage value, where repair is not economical.
    (5) Any other evidence or information which may have a bearing on 
either the responsibility of the United States for the injury to or loss 
of property or the damages claimed.