Page 1 of 2

New Death Claim () (California)

PostPosted: Wed Mar 18, 2009 4:51 pm
by amyown
I would like some help in regards to a new Death claim. This is my first death claim and I'm trying to find out if there's any special prodecure. Im looking for the application for the death claim and any other necessary forms but cant find any. Please advice. Thanks.

Re: New Death Claim () (California)

PostPosted: Wed Mar 18, 2009 4:59 pm
by jparres
I know that workcompschool.com provides a course called "Death Benefits" in the catalog of online courses. This course gives full instructions to claims adjusters for handling death benefits, and the course is only $150. You can give the WorkCompSchool people a call too at 805-484-0333 x133 if you need some recommendations for education that will help you handle your task at hand. Good luck!

Re: New Death Claim () (California)

PostPosted: Wed Mar 18, 2009 10:54 pm
by gaiassoul1@yahoo.com
EAMS seems to have forgotten we have death claims

Use the legacy death application form and file it the same way you would file any other.

IF you want to be complete filing proofs of dependency as soon as possible is also beneficial...i.e. marriage and birth certificates for minor children or any children on the way.

If there are minor children, you will have to request appointment of guardian ad litum via the WCAB...simple petition, just why person is the best guardian ad litum so that when benefits get ready to pay you have that one squared away....

that is the starting point..can't think of anything else off the top of my head.

Re: New Death Claim () (California)

PostPosted: Thu Mar 19, 2009 9:40 am
by amyown
Is the Workers' Compensation Claim Form (DWC1 form) necessary on death claims?

Re: New Death Claim () (California)

PostPosted: Thu Mar 19, 2009 9:11 pm
by gaiassoul1@yahoo.com
It is not necessary in any claim.

It is filed to start the 90 days for denial...that is all.

So file one to be safe if it is not an accepted death.

Re: New Death Claim () (California)

PostPosted: Fri Mar 20, 2009 1:14 pm
by postscript2
I disagree. A DWC-1 should/is required for all claims. If there is no DWC-1 claim form, then there are no penalties for late payments, and per HONEYWELL, the statutue of limitations for the purposes of discovery do not toll.

Unless something changed, file it and list the cause of death.

If something has changed, please correct me.

LCS

Re: New Death Claim () (California)

PostPosted: Fri Mar 20, 2009 1:48 pm
by steve appell
Hi Post:
I suspect what Ginger is saying is the DWC1 need not be filed if the claim is already admitted because benefits are already being paid.

Per LC 5402(a).......
"Knowledge of an injury, obtained from any source, on the
part of an employer, his or her managing agent, superintendent,
foreman, or other person in authority, or knowledge of the assertion
of a claim of injury sufficient to afford opportunity to the employer
to make an investigation into the facts, is equivalent to service
under Section 5400."


As far as penalties for late payments, I am not aware of any law that requires a claim form be filed prior to awarding penalties. I believe all all that is needed is an Application to invoke jurisdiction and a DOR to get the hearing date.

Re: New Death Claim () (California) (California)

PostPosted: Fri Mar 20, 2009 11:40 pm
by postscript2
Hi Steve and Ginger:

Respectufully, I must add that although I agree with LC 5402--5401 preceeds all...

I didn't really want to post this, as it's available (obviously) to EVERYONE via WCC and the DWC...

Code: 5401
Title: Claim form; limitations
History: Amended by stats 2002, Chap 6 (AB 749)
(a) Within one working day of receiving notice or knowledge of injury under Section 5400 or 5402, which injury results in lost time beyond the employee's work shift at the time of injury or which results in medical treatment beyond first aid, the employer shall provide, personally or by first-class mail, a claim form and a notice of potential eligibility for benefits under this division to the injured employee, or in the case of death, to his or her dependents. As used in this subdivision, "first aid" means any one-time treatment, and any followup visit for the purpose of observation of minor scratches, cuts, burns, splinters, or other minor industrial injury, which do not ordinarily require medical care. This one-time treatment, and followup visit for the purpose of observation, is considered first aid even though provided by a physician or registered professional personnel. "Minor industrial injury" shall not include serious exposure to a hazardous substance as defined in subdivision (i) of Section 6302. The claim form shall request the injured employee's name and address, social security number, the time and address where the injury occurred, and the nature of and part of the body affected by the injury. Claim forms shall be available at district offices of the Employment Development Department and the division. Claim forms may be made available to the employee from any other source.

(b) Insofar as practicable, the notice of potential eligibility for benefits required by this section and the claim form shall be a single document and shall instruct the injured employee to fully read the notice of potential eligibility. The form and content of the notice and claim form shall be prescribed by the administrative director after consultation with the Commission on Health and Safety and Workers' Compensation. The notice shall be easily understandable and available in both English and Spanish. The content shall include, but not be limited to, the following:

(1) The procedure to be used to commence proceedings for the collection of compensation for the purposes of this chapter.
(2) A description of the different types of workers' compensation benefits.
(3) What happens to the claim form after it is filed.
(4) From whom the employee can obtain medical care for the injury.
(5) The role and function of the primary treating physician.
(6) The rights of an employee to select and change the treating physician pursuant to subdivision (e) of Section 3550 and Section 4600.
(7) How to get medical care while the claim is pending.
(8) The protections against discrimination provided pursuant to Section 132.a.
(9) The following written statements:
(A) You have a right to disagree with decisions affecting your claim.
(B) You can obtain free information from an information and assistance officer of the state Division of Workers' Compensation, or you can hear recorded information and a list of local offices by calling (applicable information and assistance telephone number(s)).
(C) You can consult an attorney. Most attorneys offer one free consultation. If you decide to hire an attorney, his or her fee will be taken out of some of your benefits. For names of workers' compensation attorneys, call the State Bar of California at (telephone number of the State Bar of California's legal specialization program, or its equivalent).

(c) The completed claim form shall be filed with the employer by the injured employee, or, in the case of death, by a dependent of the injured employee, or by an agent of the employee or dependent. Except as provided in subdivision (d), a claim form is deemed filed when it is personally delivered to the employer or received by the employer by first-class or certified mail. A dated copy of the completed form shall be provided by the employer to the employer's insurer and to the employee, dependent, or agent who filed the claim form.


It is alway's been an "audit"penalty for the ER/I/C or TPA---If the DWC-1 is not provided... The fact is that it MUST be returned, regardless of LC 5402... There was much discussion about this after "Honeywell," was issued... so col[color=#FF4000]([color=#FF4040]d) The claim form shall be filed with the employer prior to the injured employee's entitlement to late payment supplements under subdivision (d) of Section 4650, or prior to the injured employee's request for a medical evaluation under Section 4060, 4061, or 4062. Filing of the claim form with the employer shall toll, for injuries occurring on or after January 1, 1994, the time limitations set forth in Sections 5405 and 5406 until the claim is denied by the employer or the injury becomes presumptively compensable pursuant to Section 5402. For purposes of this subdivision, a claim form is deemed filed when it is personally delivered to the employer or mailed to the employer by first-class or certified mail. [/color]or me "stupid," but it's a "REQUIREMENT..."[/color]
LCS

Re: New Death Claim () (California)

PostPosted: Fri Mar 20, 2009 11:50 pm
by postscript2
I apologize for not "navigating" very well on this forum... Still trying to get used to it.

But again--if you all have "information" contrary to what I posted, I'd really like to see it.

Thanks,

LCS

Re: New Death Claim () (California)

PostPosted: Sat Mar 21, 2009 12:36 am
by gaiassoul1@yahoo.com
ok, we are talking apples and oranges here...the issue was not PROVIDING a DWC-1 from an employers or insured's point of view, it was filing one from an applicant's point of view.

SO there is NO obligation to file a DWC-1, but there are disadvantages....Steve is absolutely correct as to my intent.

Honeywell just says you don't toll the 90 day presumption.

NOTHING releives you of penalties to the applicant under any statute, there is no code or case law to support this premise. The issue becomes if the applicant does not file an application for adjudication timely, then they are left without jurisdiction to collect the penalties, particularly LC 5813 and LC 5814 penalties because those have to be orcdered by a judge.

However, if penalties were not sefl-imposed per the applicable statutes, you are NEVER relieved from the audit penalties.

SO it is hard to prove something in the absence of any LC, CCR or case law to support the premise. There is none I know of, but I am always willing to learn...Honeywell does not stand for this premise for sure. SO I would suggest the opposite, if you can prove otherwise, that you provide applicable LC, CCRs or case law where a DWC-1 where an application is filed.