4127.03; R.C. 4123.031; R.C. 4123.032; R.C. 4123.59; R.C. 4123.60; R.C.
4123.66; O.A.C. 4123-3-07; 4123-5-13.
Abrams, Chief Operating Officer
CP-04-04, effective 03/21/16
07/01/13; Rev; 12/11/14; 01/05/16; 03/21/16
of this policy is to ensure that BWC processes notices of death of an injured
worker (“decedent”) and requests for death benefits and/or payment of medical
and funeral expenses consistently, appropriately and in compliance with law to
dependents and those who rendered services pertaining to an injured worker’s
(the decedent’s) death.
policy applies to BWC Field Operations staff.
who asserts a right, demand or claim for workers’ compensation benefits. For
purposes of this policy, “claimant” typically refers to the surviving spouse,
other dependents or a provider that is seeking reimbursement or payment for
services pertaining to the decedent’s death (e.g., a funeral home).
A marriage relationship created by agreement and
cohabitation rather than by ceremony. Ohio law recognizes these marriages only
in Ohio prior to October 10, 1991, or if established after that date in another
state or nation that recognizes the validity of common law marriages,
consistent with the laws of that state or nation.
Benefits payable pursuant to R.C. 4123.59 and R.C. 4123.60 to a dependent of an
injured worker who has died as a result of an injury or occupational disease
received in the course of, and arising out of, the injured worker’s employment.
Dependent: A member of the family
of the decedent, or bears to the decedent the relation of surviving spouse,
lineal descendant, ancestor, or brother or sister, who relied on the decedent,
in whole or in part, for financial support.
individual who has registered for service pursuant to R.C. 5502.34, in connection
with the development, maintenance, and operation of any state or local
emergency management agency authorized by law, and who has met the minimum
requirements of R.C. 4123.031 to 4123.037, or who has been registered as an
emergency management worker pursuant to R.C. 5502.34 during a disaster or emergency.
Guardian: A person lawfully
vested with the power, and charged with the duty,
taking care of and/or managing the property and rights of another because the
person is of minor age, has a defect of understanding or self-control, or is
considered incapable of administering his or her own affairs.
BWC purposes, the legally recognized parent of a child, whether biological or adoptive.
Partial Dependent: A dependent who has
received some financial support from the decedent, such as the payment of rent
or mortgage, medical bills, groceries or utilities.
Prospective Dependent: A surviving spouse,
lineal descendant, ancestor, or brother or sister, not found to be a whole or
partial dependent, but whose circumstances clearly indicate a need for
financial support and there is evidence of an intention or commitment of the
decedent to provide such financial support.
Handling Claims: Has the same
definition as Memo 4.21 – “COEMP and Special Handling Claims” found in the BWC
Employee Handbook/Workplace Policies.
Whole Dependent: A dependent that is
presumed or found to have relied on the decedent for financial support, to a
greater degree than a partial or prospective dependent (e.g., a surviving
spouse and/or minor children are presumed wholly dependent).
It is the
policy of BWC to ensure death benefits are properly awarded to a dependent(s)
when a decedent dies as the result of a work-related injury or occupational
Applications for Death Benefits
dependent of the decedent may file an application for death benefits.
for death benefits may be initiated via:
Report of Injury, Occupational Disease or Death (FROI);
Application for Death Benefits and/or Funeral Expenses (C-5);
Application for Additional Award for Violation of Specific Safety Requirement
in a Workers’ Compensation Claim (IC-8/9);
notification ( to be followed up with a written request);
notification (to be followed up with a written request);
through the BWC website;
written communication requesting benefits.
dependent has an authorized representative (e.g., legal counsel), the dependent
must file an appropriate authorization with BWC.
authorization made by the decedent expires upon his or her death and is not
applicable to the dependent.
See the Authorized
Representatives policy for further information.
Limitations for Applying for Death Benefits With a Date of Injury Prior to
for death benefits for all workers, except emergency management workers, that
die due to a work-related injury or occupational disease must be filed within
two (2) years from the date of death.
application for death benefits for an emergency management worker employed by
the state or a political subdivision, who dies in the performance of his or her
duties as an emergency management worker, must be filed:
(1) year of the date of the death; or
emergency management worker filed an injury claim within one year of an injury,
and the emergency management worker subsequently dies from that injury, within
six (6) months after the date of death.
Limitations for Applying for Death Benefits With a Date of Death On or After
for death benefits for all workers, including emergency management workers,
employed by the state or a political subdivision, who die due to a work-related
injury must be filed within one year from the date of death.
emergency management worker filed an injury claim within one year of an injury,
and the emergency management worker subsequently dies from that injury, the
application for death benefits must be filed within six (6) months after the
date of death.
information on the statute of limitations for deaths due to occupational
disease, see the Jurisdiction policy.
for Death Benefits
eligible for death benefits:
applicant must be a dependent;
must be made within the required time frames per section IV.B.4; and
must have occurred in the course of and arising out of the decedent’s
of the decedent as an undocumented worker or public work-relief employee does not
by itself, negate the decedent’s dependents from eligibility for death
Partial and Prospective Dependents
based on the evidence in the claim, identify a dependency level as whole,
partial or prospective.
following are presumed to be wholly dependent:
with the decedent at the time of death; or
separately from the decedent due to the decedent’s aggression;
A child of
the decedent living with the decedent at the time of death and for whom the
decedent was contributing more than 50% of the child’s financial support, or
for whose maintenance the decedent was legally responsible; and the child is:
age of 18;
(18) years old but less than twenty-five (25) years old and pursuing a
full-time educational program while enrolled in an accredited educational
institution and program; or
(18) years old or older and physically or mentally incapacitated from earning.
dependency may be demonstrated by producing evidence that the decedent was
paying a portion of the dependent’s living expenses.
dependency may be demonstrated by producing evidence that the decedent paid a
portion of the dependent’s living expenses in the past or had made a commitment
to pay future living expenses.
surviving natural parent(s) with whom the decedent was living at the time of
death, if not determined to be a whole or partial dependent(s), shall be
presumed to be a prospective dependent and entitled to a minimum award of
surviving spouse separated from the decedent for reasons other than aggression
is not presumed to be a whole dependent, but may otherwise be determined
to be a whole, partial, or prospective dependent if adequate evidence is
provided showing the surviving spouse received financial support from the
be a combination of whole, partial and prospective dependents in a claim.
Benefit Rates and Apportionment
rate for a whole dependent is 66 2/3% of the decedent’s average weekly wage
rate shall not exceed the statewide average weekly wage for the year of death;
rate shall not be less than 50% of the statewide average weekly wage (SAWW) for
the year of death.
rate for a partial dependent is 66 2/3% of the decedent’s AWW; but:
rate shall not exceed the SAWW for the year of death; and
no minimum weekly rate.
benefit for a prospective dependent is based on the amount of support that was
received or expected to be received from the decedent; and
for all prospective dependents (excluding natural parents deemed prospective
dependents) shall not exceed a total amount of $3,000.
parents determined to be prospective dependents shall receive a minimum total
award of $3,000.
and Reapportioning Death Benefits Among Dependents
are two or more whole and/or partial dependents eligible for death benefits,
BWC will apportion the amount of the benefit among the whole and or partial
dependents equitably, considering the circumstances of each particular case.
is at least one whole dependent, the one benefit, as calculated based on the
whole dependent, shall be apportioned among the whole and/or partial
benefits to any prospective dependent(s) does not factor into the benefits paid
or apportioned among whole and/or partial dependents.
to natural parents living with the decedent at the time of death that are
determined to be prospective dependents shall be equally apportioned.
is more than one prospective dependent (excluding natural parents) the award to
the prospective dependents will be apportioned among the prospective dependents
as BWC determines equitable.
benefits will be reapportioned when:
were awarded and apportioned to one or more dependents and subsequently an additional
dependent is identified and awarded benefits; or
eligibility status of a dependent changes. Events that change eligibility
status include, but are not limited to:
of the surviving spouse;
reaches the age of 18;
A child at
least 18 years old but less than 25 years old starts or stops attending an
accredited educational institution and program full-time;
attending an accredited educational institution and program reaches the age of
dependent is incarcerated or released from incarceration in a state or federal
correctional institution for a conviction of any state or federal criminal law.
See the Incarceration policy for further information.
and Medical Expenses
addition to the death benefits discussed above, application may be made for
reimbursement of, or payment for:
nurse, hospital services, and medicine related to the decedent’s work-related
injury or occupational disease; and
expenses up to a maximum of $5,500.
individual or provider that incurred the expense and making the application
must provide supporting documentation such as an invoice or receipt.
addition to funeral expenses, BWC may pay for related exceptional
transportation costs; e.g., returning the body of the decedent when the death
occurs outside the area where the decedent lived.
deduct from a dependent’s death benefits any family support that the dependent
is ordered to pay, consistent with the Family Support Orders and Attorney
Fees Paid Pursuant to Deductions of Child Support from Lump Sum Payments
potential dependent may be entitled to death benefits, even if the decedent’s
claim was settled.
dependents of the decedent may seek to settle death benefit claims, consistent
with the Lump Sum Settlement policy.
Requests for lump sum
advancements shall be processed consistent with the Lump Sum Advancement
Documentation and Contact Requirements
dependents are required to immediately notify BWC when there is any change in
his/her dependency status (e.g., surviving spouse remarries, child stops
attending a full-time educational program).
also verify the continuing eligibility of a dependent through an annual contact
letter. All dependents are required to:
letter acknowledging and verifying the information provided in the letter; and
signed letter and any required documentation to BWC within a stated period of
time. A scanned or faxed copy of the signed letter will fulfill the signature
addition to an annual contact letter, a dependent/student receiving benefits is
required to submit to BWC, every educational period (e.g., semester, quarter):
continued enrollment in a full-time educational program (e.g., class
participation in, and completion of the previous educational period for which
benefits were received (e.g., a grade report).
require additional documentation from a dependent at any time to verify
continuing eligibility status, as is reasonably necessary.
failure of a dependent to respond to an annual contact letter or submit the
required documentation, including the documentation required from a student
each educational period, may result in the withholding and possible termination
of the dependent’s benefits.
BWC staff may refer to
the corresponding procedure for this policy entitled “Procedure for Death
Claims” for further guidance.