Butler v Suffolk County Supplemental Documentation Form

You may use this form to upload additional documentation related to your Tier 1 Injury Award or Tier 2 Injury Award Claim. If you did not claim a Tier 1 or Tier 2 Injury Award on your initial Claim Form, and instead claimed only the Per Diem Award, you do not need to submit any documentation or medical records.

If you submitted all of your relevant medical documentation with your initial Claim Form, you do not need to submit anything further. Submission of additional documentation is optional.

This form is intended to be used by Class Members who have previously submitted a Claim Form. You may submit your Claim Form online by clicking here. Supplemental documentation should be submitted as soon as possible and should only be submitted after a class member has already submitted a Claim Form. As a reminder, a Claim Form must be submitted by December 3, 2025.

A Class Member ID is required to access this online form. Class Member IDs were included on the postcard Notices mailed to Class Members. You must use the Class Member ID you used when filing your Claim Form.

If you do not remember your Class Member ID, you may (i) call the toll-free telephone number, (833)420-3826, or (ii) use the Contact Form on the Settlement Website to obtain it.

In lieu of submitting supplemental information or medical records regarding your claim through this webpage, you may also submit supplemental information and medical records regarding your claim by U.S. Mail to the following address:

Claims Administrator – 83221

c/o Kroll Settlement Administration LLC

P.O. Box 225391

New York, NY 10150-5391

Please include your Class Member ID in your supplemental submission. If you do not know your Class Member ID, you can call (833) 420-3826 or contact the Class Administrator using the online Contact Form.

Please only send copies of documents and not originals as documents received by mail will not be returned.