When the death of an employee is the result of an industrial injury or occupational disease, the employee's dependents may file an application for death benefits. To be considered a "dependent", a person must be a member of the family of the deceased employee, and bear to the employee the relation of surviving spouse, lineal descendant, ancestor, or brother or sister. An application signed by a person claiming to be a dependent, as described herein, shall be accepted for filing and shall be sufficient to initiate proceedings for workers' compensation benefits and to obtain a ruling on the validity of the claim. If there are no dependents, the application may be filed by the estate of the deceased employee, the attending physician, the funeral director, by a volunteer paying the funeral bill, by a person who authorized the burial and funeral expenses or by the employer, for services rendered because of the injury or occupational disease causing the employee's death.
Five Year Review (FYR) Dates: 4/8/2019 and 07/01/2024
Promulgated Under: 119.03
Statutory Authority: 4121.12, 4121.13, 4121.30, 4121.31
Rule Amplifies: 4121.121, 4123.05, 4123.59
Prior Effective Dates: 10/17/1968, 01/16/1978, 10/04/2004, 04/01/2014