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Code of Federal Regulations Pertaining to U.S. Department of Labor |
| Employees' Benefits |
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| Office of Workers' Compensation Programs, Department of Labor |
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| Claims for Compensation Under the Federal Employees' Compensation Act, As Amended |
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| Filing Notices and Claims; Submitting Evidence |
20 CFR 10.105 - How and when is a notice of death and claim for benefits filed?
- Section Number: 10.105
- Section Name: How and when is a notice of death and claim for benefits filed?
(a) If an employee dies from a work-related traumatic injury or an
occupational disease, any survivor may file a claim for death benefits
using Form CA-5 or CA-5b, which may be obtained from the employer or
from the Internet at www.dol.gov./esa/owcp.htm. The survivor must
provide this notice in writing and forward it to the employer.
Another person, including the employer, may do so on the survivor's
behalf. The survivor may also submit the completed Form CA-5 or CA-5b
directly to OWCP. The survivor shall disclose the SSNs of all survivors
on whose behalf claim for benefits is made in addition to the SSN of the
deceased employee. The survivor may withdraw his or her claim (but not
the notice of death) by so requesting in writing to OWCP at any time
before OWCP determines eligibility for benefits.
(b) For deaths that occur on or after September 7, 1974, a notice of
death must be filed within three years of the death. The form contains
the necessary words of claim. The requirements for timely filing are
described in Sec. 10.100(b)(1) through (3).
(c) However, in cases of death due to latent disability, the time
for filing the claim does not begin to run until the survivor is aware,
or reasonably should have been aware, of the causal relationship between
the death and the employment (see 5 U.S.C. 8122(b)).
(d) The filing of a notice of injury or occupational disease will
satisfy the time requirements for a death claim based on the same injury
or occupational disease. If an injured employee or someone acting on the
employee's behalf does not file a claim before the employee's death, the
right to claim compensation for disability other than medical expenses
ceases and does not survive.
(e) A survivor must be alive to receive any payment; there is no
vested right to such payment. A report as described in Sec. 10.414 of
this part must be filed once each year to support continuing payments of
compensation.
Notices and Claims for Injury, Disease, and Death--Employer's Actions
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