In addition to workers' compensation benefits for workers for their job-related injuries and illnesses, if such maladies ultimately result in death, certain survivors have the right to receive death benefits through their states' workers' compensation systems. If you are the family member or dependent of an employee who died from an injury or sickness incurred in the course of his or her employment, a workers' compensation attorney at Pitts & Zanaty, L.L.C. in Anniston, AL, can advise you about workers' compensation death benefits.
The right to workers' compensation death benefits is usually created by state law and details of the program vary among the states. Therefore, it is crucial to understand the law in your particular jurisdiction. This article will summarize the typical features of death benefits in most states.
Beneficiaries of workers' compensation death benefits
In most states, the designation of appropriate beneficiaries of workers' compensation death benefits looks at two main relationships:
- Dependents
- Members of the deceased's family or household
Death benefits are designed to provide monetary support for those people who will suffer most from the worker's death. Naturally, those dependent upon the worker for financial support will be negatively impacted by the death. Some states differentiate between those wholly and those partially dependent, with preference for naming the completely dependent people beneficiaries over those only partially dependent. In some states, partially dependent individuals receive reduced awards.
Sometimes certain family members, such as spouses and children, are presumed to be dependent without having to provide proof. However, if there has been a severance of the marital relationship, such as a voluntary separation with financial independence, a surviving spouse may not be assumed dependent.
Many states look at family relationships or household makeup. For example, sometimes states prescribe lists of familial relationships eligible for death benefits. Where states look to household membership, unmarried cohabiting partners, in-laws, stepchildren or stepparents, or even unrelated persons may qualify for death benefits, so long as they were living in shared households with the deceased workers, especially where financial dependence was present.
Generally, states are liberal in determining who should be named a beneficiary, consistent with the benevolent nature of the benefit.
Type and amount of workers' compensation death benefits
Beneficiaries receive benefits to cover funeral and burial expenses capped at certain levels varying widely from state to state. The other component of the death benefit is a monetary amount compensating for lost wages that is usually a percentage of weekly wages.
The length of time a beneficiary receives death benefits varies widely by jurisdiction. Depending on the state, a surviving spouse may receive benefits until his or her own death, for a set number of weeks, until remarriage or until another intimate relationship. A child usually receives death benefits until reaching the age of majority. Other types of dependents usually receive benefits for life or until they become financially independent.
Other requirements of workers' compensation death benefits
For the right to death benefits to accrue, some states require that the work-related death occur within a particular length of time after the work injury, after the last treatment for the work injury or after some other occurrence. Some states require continuous disability from injury to death.
Finally, although the cause of death must be a job-related injury or disease, usually the cause of death does not have to be exclusively that injury or sickness, as long as it contributes significantly to the death.
Pending claims or accrued benefits
A living employee's workers' compensation benefits are considered separate and distinct from the death benefits generated later for beneficiaries. When accrued regular workers' compensation benefits are due a worker at the time of death, most states provide either that these accrued benefits pass through the estate of the deceased or to dependents. A death benefit award is a separate claim.
Speak to a workers' compensation lawyer
If you are the surviving spouse, child, relative, dependent or household member of someone who died from a work-related injury or disease, you may have a claim for workers' compensation death benefits. Do not delay in obtaining legal advice and filing an application; your state probably has time limits for applying. A workers' compensation lawyer at Pitts & Zanaty, L.L.C. in Anniston, AL, can answer your questions.
DISCLAIMER: This site and any information contained herein are intended for informational purposes only and should not be construed as legal advice. Seek competent legal counsel for advice on any legal matter.
Frequently Asked Questions
To take the uncertainty out of the circumstances following a work-related injury or industrial illness, the workers' compensation system provides a reliable procedure for resolving resulting problems. Broadly, if an injury or illness occurs in the course of employment, regardless of whether the employer was negligent or otherwise at fault, the worker receives benefits that may include wage replacement, medical coverage or other assistance. In exchange, the employee is not allowed to sue the employer for the injury and the employer must carry insurance or otherwise legally provide a means to cover workers' compensation expenses. Most employers are subject to the workers' compensation system, but some states exempt smaller employers, and most federal workers and certain national industries are covered instead by comparable federal programs.
Virtually all types of work-related physical injury and industrial illness are covered by workers' compensation. Very commonly covered conditions include repetitive-stress injuries (RSIs) like carpal-tunnel syndrome (CTS), back injuries, traumatic injuries, wounds or bodily reactions to substances. Many states also cover mental or emotional harm, but the standards for psychological coverage vary greatly from state to state. Pre-existing conditions are generally not covered unless aggravated at work.
Available benefits vary from state to state, but usually include compensation for medical expenses and disability benefits to replace wages, at least in part. States use various methods for calculating benefit amounts, such as schedules or formulas that may take into account the severity and type of injury and amount of lost wages. Some states offer other types of benefits, such as vocational rehabilitation. Death benefits are available to surviving dependents of workers who die from occupational injury or disease.
State laws require one of three payment methods or a combination thereof. Employers may need to carry workers' compensation insurance; employers may self-insure by setting up a fund sufficient to cover outgoing benefits; or the state may administer its own fund into which employers are required to pay.
Of course, you should first obtain necessary emergency treatment. Second, give notice of the injury or disease to your employer as soon as possible. State laws vary about what type of notice is sufficient, whether a designated person needs to receive it, how soon it must be given and if there is a deadline. Also, some states require notice to other parties, such as the state workers' compensation agency, local court or workers' compensation insurer. Third, file your workers' compensation claim with the state agency in a timely manner. Consult a knowledgeable workers' compensation attorney as early in the process as possible for advice about how to proceed every step of the way.
Whether you can choose your own doctor depends on your state's law. Most states allow emergency treatment without concern for consultation with the employer or insurer. Beyond an emergency, the choice of treating physician may belong to the employee, the employer, the workers' compensation insurance carrier or the state. Sometimes the employee can choose from a list of providers compiled by the employer, insurer or state agency. Your state law may also control how to change providers or other situations, such as obtaining a second opinion.
Each state has a procedure for appeal of a denied claim. Normally the first review is by the state workers' compensation agency, where there may be more than one level of claim re-evaluation and a hearing is usually held. Typically if the agency ultimately affirms the claim denial, the employee can appeal to the state court system, where there may also be more than one level of appeal. Representation by an attorney is helpful at any stage of appeal, particularly at any hearing and in court.
If you are harmed in the course of employment, you are entitled to workers' compensation, regardless of the cause. You may be able to sue a third party that caused the injury, such as the manufacturer, distributor or seller of faulty equipment that caused the injury. If a co-worker caused the injury, most states do not allow you to sue your colleague, but some do. If you recover from a third party, your employer or its insurer may be eligible for workers' compensation reimbursement or they may be able to join the suit.
