When a Claimant Dies: A 60-Second Seminar in Workers’ Compensation Claims Handling

There are times in the middle of a work comp case where the claimant unexpectedly passes away. Upon receipt of such news the claims administrator must complete several important tasks. The purpose of today’s blog is to explain the actions that must occur following news of a claimant’s death, regardless of the cause. The following tasks are to be accomplished immediately:

1. Confirm the death. If confirmed, discontinue all TD or PD payments.
2. Discontinue all medical care; cancel scheduled appointments; and discontinue services of all vendors except bill review.
3. As a courtesy advise the employer of the death. If a defense attorney was retained, then advise counsel. Depending on the situation, the defense attorney may or may not wish to immediately inform the opposing attorney.
4. Review the date of injury and compare it to the date of death. If the date of death is more than 240 weeks from the date of injury, then note in the file that should an industrial death claim be pursued, benefits are not compensable due to the statute of limitations. All too often when a death is unrelated to the industrial injury, an applicant attorney will nevertheless try to convert the death into an industrial claim by asserting the injury contributed to the claimant’s demise. By law, if any industrial contribution exists, even as little as 1%, then the entire death is compensable. Therefore, researching the 240-weeks statute of limitations is of vital importance.
5. Check obituary and funeral notices both online and in the newspaper. Keep copies for the file. An obituary often lists the cause of death and identifies family members along with a wealth of other useful information which may eventually be needed should a death claim be filed.

Unfortunately, there are times when an adjuster does not discover the claimant’s death until months later. The key is to discover the claimant’s passing as soon as possible. One method for early detection is to monitor prescription medication. If an injured worker routinely receives several medications per month, but where all refills suddenly cease, that in itself is a red flag. Perform a quick investigation to determine if the injured worker is alive. This can be achieved by simply picking up the phone and calling an unrepresented worker. The discussion is immaterial since the purpose of the call is to determine if the claimant is still alive. If the worker is represented by counsel, then a quick Google obituary search can be done to see if anything is mentioned. The adjuster can even ask a nurse or a doctor’s office to call the employee to confirm the next appointment. The caller can then advise the adjuster if they spoke to the claimant. Over the past three years we are aware of an administrator who discovered four claimants had passed away simply by monitoring the discontinuation of prescription medication and then by following up accordingly.
The attorneys here at Friedman + Bartoumian are experts in the handling of industrial death claims. We welcome partnering with clients to mitigate or defend all of death claims, whether accepted or disputed. We are here to help.