Surviving Spouse or Relative Benefits

In my workers comp. practice I spend most of my time on the phone with insurance adjusters and defense counsel arguing about medical treatment and lost wage benefits.  But several times a year, I get a call from a different type of client – the surviving spouse or other relative of a worker who was killed on the job.

Obviously the premature death of any human being is tragic, and my words of sympathy can do little to relieve the heartache associated with the loss of a son or daughter, spouse or parent.

What I can do is assist the surviving family members collect the funds that Georgia workers’ compensation law requires the insurance company to pay.

What Benefits are Payable to Survivors of an On-the-Job Fatality?

Under Georgia law, dependents of a worker killed on the job are entitled to up to $7,500 in burial expenses.  Next, surviving dependents can collect up to 400 weeks (7 ½ years) of weekly benefit checks in a lump sum.   A surviving spouse without any dependents can collect up to $125,000, whereas a surviving spouse with dependents can collect more.

Obviously the amount of the lump sum death benefit will depend on the deceased worker’s average weekly wage.

Further, if the deceased worker did not die immediately and collected benefits, those weeks of payment will be deducted from the lump sum.

What Should I Do to Start the Process?

The surviving spouse, children and/or relatives must file a claim with the State Board of Workers’ Compensation within 1 year from the date of death.  If the insurance company voluntarily commences benefits the survivors do not have to file a claim form (although I suggest that they do so anyway).

Do I Need a Lawyer to Help Me if the Insurance Company Seems to be Cooperative?

You may not need a lawyer if your loved one’s deceased employee claim is straightforward and the insurance company pays what it is supposed to pay.  However there are several instances where problems can arise that might necessitate my involvement:

• Insurance company challenge to eligibility for benefits – the insurance company may assert that your deceased loved one was engaged in “horseplay” or other non-work authorized activity when he became involved in the accident that took his life.  In such a case, it is essential that we speak to co-workers and other witnesses quickly and conduct our own investigation.
• Insurance company challenge to coverage on the grounds that your loved one had a pre-existing condition, especially if the cause of death involves a stroke or heart attack
• Insurance company challenge to coverage on the grounds that drugs or alcohol were found in your deceased loved one’s system.
• Insurance company miscalculation of average weekly wage resulting in lower benefit amount.
• Claims by other parties who may or may not be entitled to survivor’s benefits – this type of problem may be beyond the scope of my practice but I can assist you by referring you to a domestic relations lawyer.

Obviously, settlements from a workers compensation insurance company is not going to be your main concern in the immediate aftermath of receiving bad news.  However, if you and our family are entitled to substantial financial benefits, I want you to get whatever funds are due to you.  If I can be of assistance in this regard, please email me or pick up the phone and call me at 770-351-0801.