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.
R. Abrams, Chief Operating Officer
07/01/13; Rev; 12/11/14; 01/05/16; 03/21/16
purpose 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.
An 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
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
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).
A. 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 disease.
B. Filing Applications for
1. A dependent of the
decedent may file an application for death benefits.
2. Applications for death
benefits may be initiated via:
a. A First Report of
Injury, Occupational Disease or Death (FROI);
b. An Application for Death
Benefits and/or Funeral Expenses (C-5);
c. An Application for Additional
Award for Violation of Specific Safety Requirement in a Workers’ Compensation
d. A Motion (C-86);
e. Telephone notification
( to be followed up with a written request);
person notification (to be followed up with a written request);
g. Online through the BWC website;
h. Email notification; or
other written communication requesting benefits.
3. If the dependent has an
authorized representative (e.g., legal counsel), the dependent must file an
appropriate authorization with BWC.
a. Any authorization made
by the decedent expires upon his or her death and is not applicable to the
b. See the Authorized
Representatives policy for further information.
4. Statute of Limitations
for Applying for Death Benefits With a Date of Injury Prior to 09/29/2017::
a. Applications 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.
b. An 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:
one (1) year of the date of the death; or
ii. If the 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.
5. Statute of Limitations
for Applying for Death Benefits With a Date of Death On or After 09/29/2017:
a. Applications 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.
b. If the 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.
c. For information on the
statute of limitations for deaths due to occupational disease, see the Jurisdiction
C. Eligibility for Death Benefits
1. To be eligible for death
a. The applicant must be a
b. Application must be
made within the required time frames per section IV.B.4; and
c. The death must have
occurred in the course of and arising out of the decedent’s employment.
2. The status 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 benefits.
D. Whole, Partial and
1. BWC will, based on the
evidence in the claim, identify a dependency level as whole, partial or
2. The following are
presumed to be wholly dependent:
a. The surviving spouse:
with the decedent at the time of death; or
ii. Living separately from
the decedent due to the decedent’s aggression;
b. 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:
the age of 18;
ii. Eighteen (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
iii. Eighteen (18) years old
or older and physically or mentally incapacitated from earning.
3. Partial dependency may
be demonstrated by producing evidence that the decedent was paying a portion of
the dependent’s living expenses.
4. Prospective 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.
a. A 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 $3,000.
b. A 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 decedent.
5. There may be a
combination of whole, partial and prospective dependents in a claim.
E. Death Benefit Rates and
1. The weekly rate for a
whole dependent is 66 2/3% of the decedent’s average weekly wage (AWW); but:
a. The weekly rate shall
not exceed the statewide average weekly wage for the year of death; and
b. The weekly rate shall
not be less than 50% of the statewide average weekly wage (SAWW) for the year
2. The weekly rate for a
partial dependent is 66 2/3% of the decedent’s AWW; but:
a. The weekly rate shall
not exceed the SAWW for the year of death; and
b. There is no minimum
3. The benefit for a
prospective dependent is based on the amount of support that was received or
expected to be received from the decedent; and
a. The award for all
prospective dependents (excluding natural parents deemed prospective
dependents) shall not exceed a total amount of $3,000.
b. Natural parents
determined to be prospective dependents shall receive a minimum total award of $3,000.
4. Apportioning and
Reapportioning Death Benefits Among Dependents
a. When there 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.
there 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
ii. Payment of benefits to
any prospective dependent(s) does not factor into the benefits paid or
apportioned among whole and/or partial dependents.
b. An award to natural
parents living with the decedent at the time of death that are determined to be
prospective dependents shall be equally apportioned.
c. If there 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.
d. Death benefits will be
were awarded and apportioned to one or more dependents and subsequently an
additional dependent is identified and awarded benefits; or
ii. The eligibility status of
a dependent changes. Events that change eligibility status include, but are not
a) Remarriage of the surviving
b) A child reaches the age
c) 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;
d) A child attending an
accredited educational institution and program reaches the age of 25;
e) A dependent dies;
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.
F. Funeral and Medical Expenses
1. In addition to the death
benefits discussed above, application may be made for reimbursement of, or
a. Medical, nurse,
hospital services, and medicine related to the decedent’s work-related injury
or occupational disease; and
b. Funeral expenses up to
a maximum of $5,500.
2. The individual or
provider that incurred the expense and making the application must provide
supporting documentation such as an invoice or receipt.
3. In 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.
G. BWC shall 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 policy.
1. A potential dependent may
be entitled to death benefits, even if the decedent’s claim was settled.
2. The dependents of the decedent
may seek to settle death benefit claims, consistent with the Lump Sum
Requests for lump sum
advancements shall be processed consistent with the Lump Sum Advancement
Documentation and Contact Requirements
1. All 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).
2. BWC shall also verify
the continuing eligibility of a dependent through an annual contact letter. All
dependents are required to:
a. Sign the letter
acknowledging and verifying the information provided in the letter; and
b. Return the 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
3. In addition to an
annual contact letter, a dependent/student receiving benefits is required to
submit to BWC, every educational period (e.g., semester, quarter):
a. Proof of continued
enrollment in a full-time educational program (e.g., class registration); and
b. Proof of participation
in, and completion of the previous educational period for which benefits were
received (e.g., a grade report).
4. BWC may require
additional documentation from a dependent at any time to verify continuing
eligibility status, as is reasonably necessary.
5. The 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.