Compliance Corner: Tenn. Death Benefits

Gallatin, TN (WorkersCompensation.com) -- When it comes to death benefits under Tennessee workers' compensation law, who's entitled? The following breaks down who may claim benefits when a worker dies.

Persons Wholly Dependent. Under Tennessee law, the following people are conclusively presumed to be wholly dependent:

(1) A surviving spouse, unless it is shown that the surviving spouse was voluntarily living apart from the surviving spouse's spouse at the time of injury; and

(2) Children under 16 years of age.

Persons Prima Facie Dependent. Children between 16 and 18 years of age, or those 18 years of age, if physically or mentally incapacitated from earning, shall prima facie be considered dependent.

Actual Dependents. Wife, husband, child, mother, father, grandparent, sister, brother, mother-in-law, father-in-law, who were wholly supported by the deceased employee at the time of death and for a reasonable period of time immediately prior to the time of death, shall be considered actual dependents, and payment of compensation shall be made in the order named.

Partial Dependents. Any member of actual dependents who regularly derived part of the member's support from the wages of the deceased employee at the time of death and for a reasonable period of time immediately prior to the time of death shall be considered a partial dependent, and payment of compensation shall be made to the dependents in the order named.

Compensation in Death Cases. In death cases, compensation payable to dependents shall be computed on the following basis, and shall be paid to the persons entitled to compensation, without administration:

(1) Surviving Spouse and No Dependent Child. If the deceased employee leaves a surviving spouse and no dependent child, there shall be paid to the surviving spouse 66 2/3% percent of the average weekly wages of the deceased;

(2) Surviving Spouse and Children. If the deceased employee leaves a surviving spouse and one or more dependent children, there shall be paid to the surviving spouse for the benefit of the surviving spouse and the child or children, 66 2/3% of the average weekly wages of the deceased;

(3) Surviving Spouse and Children, How Paid. In all cases where compensation is payable to a surviving spouse for the benefit of the surviving spouse and dependent child or children, the court shall have the power to determine in its discretion what portion of the compensation shall be applied for the benefit of any child or children, and may order the compensation paid to a guardian;

(4) Remarriage of Surviving Spouse. Upon the remarriage of a surviving spouse, if there is no child of the deceased employee, the periodic compensation benefits shall terminate and the surviving spouse is entitled to one lump sum payment equal to 10) weeks based on 25% of the average weekly wages of the deceased employee, subject to the maximum total benefit; but if there is a child or children under 18 years of age, or over 18 years of age if physically or mentally incapacitated from earning, from the time of the remarriage, the child or children have status of orphan or orphans and draw compensation accordingly, except the compensation shall not exceed 66 2/3% of the average weekly wages of the deceased.

(5) Dependent Orphans. If the deceased employee leaves one dependent orphan, there shall be paid 66 2/3% of the average weekly wages of the deceased; if the deceased leaves two or more dependent orphans, there shall be paid 66 2/3% of the average weekly wages of the deceased;

(6) Parent or Parents. If the deceased employee leaves no surviving spouse or child entitled to any payment under this section, but should leave a parent or parents, either or both of whom are wholly dependent on the deceased, there shall be paid, if only one parent, 25% of the average weekly wages of the deceased to the parent, and if both parents, 35% of the average weekly wages of the deceased to the parents;

(7) Grandparent, Brother, Sister, Mother-in-law or Father-in-law. If the deceased leaves no surviving spouse or dependent child or parent entitled to any payment under this section, but leaves a grandparent, brother, sister, mother-in-law or father-in-law wholly dependent upon the deceased for support, there shall be paid to the dependent, if only one, 20% of the average weekly wages of the deceased, or, if more than one, 25% of the average weekly wages of the deceased, divided between them or among them share and share alike;

(8) Compensation to Dependents to Cease upon Death or Marriage. If compensation is being paid under this chapter to any dependent, the compensation shall cease, upon the death or marriage of the dependent, unless otherwise provided in this section;

(9) Partial Dependents to Receive Proportion. Partial dependents shall be entitled to receive only that proportion of the benefits provided for actual dependents that the average amount of the wages regularly contributed by the deceased to the partial dependent at the time of, and for a reasonable time immediately prior to, the injury, bore to the total income of the dependent during the same time;

(10) Maximum and Minimum Compensation. The compensation payable in case of death to persons wholly dependent shall be subject to the maximum weekly benefit and minimum weekly benefit; provided, that if at the time of injury the employee receives wages of less than the minimum weekly benefit, the compensation shall be the full amount of the wages a week, but in no event shall the compensation payable under this provision be less than the minimum weekly benefit. The compensation payable to partial dependents shall be subject to the same maximum and minimum specified in Tennessee statutes; provided, that if the income loss of the partial dependents by the death is less than the minimum weekly benefit, then the dependents shall receive the full amount of the income loss. This compensation shall be paid during dependency not to exceed the maximum total benefit, payments to be paid at the intervals when the wage was payable, as nearly as may be;

(11) Orphans and Other Children. In computing and paying compensation to orphans or other children, in all cases, only those under 18 years of age, or those over 18 years of age who are physically or mentally incapacitated from earning, shall be included, the former to receive compensation only during the time they are under 18 years of age, the latter only for the time they are so incapacitated. If the dependent is attending a recognized educational institution or completing secondary education or a program leading to an equivalent credential, or enrolled in a recognized institution that provides postsecondary or career or technical education, then benefits shall be paid until 22 years of age;

(12) Actual Dependents. Actual dependents shall be entitled to take compensation until 66 2/3% of the monthly wages of the deceased during the time specified in this chapter have been exhausted, but the total compensation to be paid to all actual dependents of a deceased employee shall not exceed in the aggregate the maximum weekly benefit;

Dependency Status Not Affected by Certain Assistance Payments. Sums distributed under the Employment Security Law, the Old-Age Assistance Law, the Aid to Dependent Children Law, Aid to Blind Law, the federal Social Security Act, or any other public assistance distributed by the United States government, the state, or any county or municipality of the state, shall not be considered income within the meaning of this law and shall not affect the status or compensation of any person entitled to benefits as provided in this chapter.

Aliens or those outside the U.S. If compensation is payable due to the death of an employee under this chapter, and the decedent leaves an alien dependent or dependents residing outside of the United States, a workers' compensation mediator is authorized to conduct alternative dispute resolution proceedings to attempt to resolve the issues; provided, that a representative or representatives of the employer and a duly authorized representative or representatives of the consul or other representative of the foreign country in which the dependent or dependents reside are present. If the parties reach a settlement agreement, the administrator or administrator's designee is authorized to approve the settlement, and the order of the administrator or the administrator's designee shall be entitled to the same standing as a judgment of a court of record for all purposes. If the parties are unable to reach an agreement, the employer or employee's representative may seek relief following the issuance of a dispute certification notice.

Consular officers. The administrator, or administrator's designee, or the court shall order payment of any compensation due from the employer to be made to the duly accredited consular officer of the country where the beneficiaries are citizens. The consular officer or the consular officer's representative shall be fully authorized and empowered by this law to settle all claims for compensation and to receive the compensation for distribution to the persons entitled to the compensation.

The distribution of funds in cases described in subdivision shall be made only upon the order of the administrator, the administrator's designee, or the court that heard the matter. If required to do so by the administrator, the administrator's designee, or the court, the consular officer or the consular officer's representative shall execute a good and sufficient bond to be approved by the administrator, the administrator's designee, or the court, conditioned upon the faithful accounting of the moneys so received by the consular officer or the consular officer's representative. Before the bond is discharged, a verified statement of receipts and disbursements of the moneys shall be made and filed with the administrator or the court, as appropriate.

The consular officer or the consular officer's representative shall, before receiving the first payment of the compensation, and at reasonable times thereafter, upon the request of the employer, furnish to the employer a sworn statement containing a list of the dependents with the name, age, residence, extent of dependency and relation to the deceased of each dependent.

Periodic review. If a dependent, as established by order, judgment, or decree, is determined to be entitled to death benefits, then the employer or insurer may periodically require the dependent to provide information relevant to whether the dependent continues to qualify for benefits. After receipt of the request for information, the dependent shall provide the requested information relevant to dependency within 15 days of the date of the request.

If the dependent fails to provide the requested information relevant to dependency, then the employer or insurer may suspend benefits. If benefits are suspended, then the employer or insurer shall notify the department by filing a notice of change or termination of benefits within 15 days of the first omitted payment of compensation.

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If the dependent provides the requested information relevant to dependency within any period of suspension of benefits and the employer or insurer does not dispute the dependent's eligibility for benefits, then within 15 days of the receipt of such information, the employer or insurer shall restore periodic benefits and shall remit to the dependent any periodic benefits that were withheld during any period of suspension of benefits.

If the dependent provides information indicating the dependent no longer qualifies for benefits under this chapter based on changes in the dependent's circumstances that have occurred since the time of the initial order, judgment, or decree, then the employer or insurer may terminate benefits. If benefits are terminated, then the employer or insurer shall notify the department by filing a notice of change or termination of benefits within 15 days of the first omitted payment of compensation.

If benefits are suspended or terminated, then the dependent may file a petition for benefit determination.

A person who provides false or misleading information in response to a request for information relevant to dependency commits a fraudulent insurance act, which is punishable as theft.

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