Important Facts to Know about Workers’ Compensation Survivor Benefits

Page 1

Important Facts to Know about Workers’ Compensation Survivor Benefits

Workers’ comp benefits are paid on the basis of a medical record analysis. If the employee dies, dependents are eligible for survivor benefits.

Medical Record Review 8596 E. 101st Street, Suite H Tulsa, OK 74133


As a benefit program, workers’ compensation provides the much-needed financial support to injured workers and their families. This insurance covers medical bills and lost wages during the time the employee is off work. Benefits are paid only after a detailed enquiry into the workplace incident that resulted in the injury or illness and based on a comprehensive medical record analysis. To make sure that the right medical facts are extracted from the medical documentation, attorneys utilize dedicated medical review services. Medical facts are crucial to workers’ compensation determination and employers and insurers have to be very careful when studying the claim. Apart from paying benefits to injured employees, the program also pays death benefits to survivors if the employee dies as a result of the injury or illness. The workers’ compensation program provisions vary with every state, insurer and policy. Let us look at some important facts in this regard.  Survivor benefits are paid to eligible dependents after a work-related death of an employee. Typically, the amount payable is 500 weeks of workers’ compensation benefits at the employee’s workers’ compensation rate. There must at least be one qualified dependent and multiple dependents must share in any amount allowed as compensation. 

A spouse must prove that he/she was dependent on the deceased worker. He/she may be found to be entirely or partially dependent based on various factors such as whether they are receiving income from some other source; how much the deceased worker contributed to the surviving spouse and so on. A spouse found to be partially dependent will receive 500 weeks of compensation at a reduced rate.

Children below the age of 16 are considered completely dependent and are entitled to 500 weeks of workers’ compensation. Children over the age of 16 may be required to prove factual dependence. A child above the age of 6 who is physically or mentally incapable of earning and has been living with the parent at the time of death may be considered wholly dependent and entitled to 500 weeks of workers’ compensation. After that period, the child may be entitled to continuing benefits until age 21 under certain circumstances.

Elderly live-in relatives and dependent parents may also be eligible for survivor benefits.

www.mosmedicalrecordreview.com

918-221-7791


Some U.S. states have specific eligibility requirements for survivors. For instance, children may have to be born in wedlock or a partner must have been legally married to the deceased spouse to be eligible.

If there are no eligible dependents, the benefits may go to the deceased’s estate in most states.

 The state usually determines the minimum value of benefit payments. In New York, the amount is equal to two-thirds of the deceased worker’s average weekly wage before the accident. In Oregon, the dependents and spouse each receive a fixed amount determined by the state.  Death benefits may be paid in instalments or as a lump sum. When paid in instalments, there are limits on how long those payments will continue. In most states, surviving spouses receive benefits until their own death or remarriage. Children typically receive benefits until they turn 18, and in some cases until they complete postsecondary education or vocational training. In some other states, the benefits will stop after a certain number of weeks or a certain maximum dollar amount has been reached irrespective of the child’s age or the surviving spouse’s remarriage. As providers of medical review services for workers’ compensation lawyers, we know that rules related to workers’ comp death benefits are complex and vary from one state to another. It is important therefore for applicants to consult a good attorney. The attorney will help prove that the applicant is a true dependent. Moreover, the attorney can also explain how the state’s laws would apply in the applicant’s case and how to protect his/her rights.

www.mosmedicalrecordreview.com

918-221-7791


Turn static files into dynamic content formats.

Create a flipbook
Issuu converts static files into: digital portfolios, online yearbooks, online catalogs, digital photo albums and more. Sign up and create your flipbook.