What Happens To Workers’ Compensation Benefits When a Spouse Dies In A Work-Related Accident?

Tragically, there are work-related deaths in NC.  What if your husband or wife dies in a work accident or from an occupational disease?  In the sad event, an employee dies from injuries sustained at work, there are rules which govern the compensability for the dependents/beneficiaries of the deceased.  The State does have provisions for widows and widowers or other dependents of the person killed at work.stockfresh_8850471_woman-with-lily-flowers-and-coffin-at-funeral_sizeM-300x200

A death claim is different from the claim the injured worker had while he or she was alive.  The death claim is brought in the name of the person(s) entitled to benefits.

If death results proximately from a compensable injury or occupational disease, the deceased worker’s dependents/next of kin are entitled to certain benefits.  The death must occur within six years of the injury or occupational disease, or within two years of the final determination of disability, whichever is later.

The claimants have the burden of showing the death resulted proximately from a compensable injury or occupational disease.  Death resulting from a disease is compensable when the disease is an occupational disease or is aggravated or accelerated by causes and conditions characteristic of and particular to the worker’s job.

If the above requirements are met, then the deceased worker’s dependents/next of kin may receive benefits.  The claimant needs to file a Form 18 preferably within thirty days of the death, but no later than two years of the date of death.

The claimant must prove by the greater weight, or preponderance, of the evidence that the death was proximately caused by a compensable injury or occupational disease.  The workplace injury does not have to be the only cause of the death for the case to be compensable.  However, the workplace element needs to significantly contribute to the death.  For example, if a workplace injury or disease accelerates or aggravates a preexisting condition which then causes death, it can be covered.

The employer may require an autopsy to be sure about the actual cause of death.  The surviving spouse and next of kin must be given notice of an autopsy.  If the family refuses to give consent for an autopsy, then benefits under the Workers’ Compensation Act will end.

When an employee dies from a workplace accident and the cause of death is unknown, or the accident’s circumstances are unknown, there is a rebuttable presumption that the death is compensable.

If a person dies at work, such as from a heart attack, but the claimant cannot show the heart attack arose from an accident or some cause from work (such as the decedent was performing unusually exertional work), then the death will not be covered.

Who is a dependent?

A dependent includes a spouse, children under age 18, children born posthumously, and stepchildren who are substantially dependent on the deceased employee.

Benefits are payable for 500 weeks from the date of death.  There are two exceptions to the 500 week rule:  (1)  a child who is a minor receives benefits until age 18, even if that is for more than 500 weeks; and (2) a widow or widower who is disabled at the time of the death receives benefits until his or her death, or until he or she remarries (but for no less than 500 weeks).

The weekly amount paid is evenly distributed among the dependents.  If there is a decrease in the number of beneficiaries during the 500-week period, the full amount is redistributed among the remaining ones.

Death cases can be complicated if there are disputes as to who the proper beneficiaries are, or about the cause of death.  If your spouse has been killed in a work-related accident and you have questions, please call Grimes Teich Anderson LLP today.  There is no fee to discuss your injury case.  800-533-6845.

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