Death Claims

Who Can File a Death Claim

The decedent’s spouse, child, sibling or parent can file the death claim on behalf of the decedent.

• How to File a Death Claim

  To file a death claim you will need to fill out a C-62 (http://www.wcb.state.ny.us/content/main/forms/c62.pdf) and affidavit for death benefits (http://www.wcb.state.ny.us/content/main/forms/AFF-1.pdf) and file it with the Workers’ Compensation Board along with the required documents.

• When to File a Death Claim

  Although you have 2 years from the date of death to file the claim, it is important to file the claim as soon as possible.

• What Are the Benefits of a Death Claim

  If you are the spouse or a child under the age of 21 as well as a sibling or parent who was a dependent of the decedent, you are entitled to compensation. A parent or sibling that is not a dependent may also receive compensation, but it will be limited to $50,000.

  Death Claims are treated like a permanent total disability, and the surviving spouse (until he/she re-marries) and the child (until he/she reaches the age of 21) are entitled to benefits at the total rate of compensation according to the decedent’s average weekly wage the year prior to the accident and the statutory cap given at the date of accident.

  Survivors are also entitled to funeral expenses and medical expenses (if any) associated with the work-related death.

• What Should Be Your Goal When Filing a Death Claim

  When filing the claim your goal should be to establish it as quickly as possible and to settle it as quickly as possible as well so that you can take a present-date value lump-sum and invest it at a better rate of return.

• Required Documentation

  In order to file the death claim you will need:

  1) Police report

  2) Death certificate

  3) Birth certificate of decedent and survivor(s) claiming benefits

  4) Divorce decree (of decedent and/or surviving spouse if either or both were ever married before)

  5) Marriage license

  6) Funeral and hospital bills (if any)