Occupational Injuries Benefit - Death Benefit


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Internal Guidelines used in processing claims

Table of Contents

PART 1: ENTITLEMENT
Description of Scheme
Information Leaflet
Legislation:
Administration

QUALIFYING CONDITIONS
Widow's/Widower's Pension
Orphan's Pension
Dependent Parent's Pension
Funeral Grant
Exception

DISQUALIFYING CONDITIONS
Widow's/Widower's Pension
Dependent Parent's Pension
Late Claims
Imprisonment
RATES STRUCTURE
EXTRA BENEFITS
OVERLAPPING PROVISIONS

PART 2: CLAIMS, INVESTIGATION AND DECISION PROCEDURES
Claims
Late Claims
Compensation for Loss of Purchasing Power
Documentation
Investigation of Claim
Decisions
Appeals

PART 3: PROCEDURES FOLLOWING AWARD
Payment
Duration of Payment
Absence from the State


PART 1: ENTITLEMENT

Description of Scheme

If a person dies as a result of an accident at work or a prescribed occupational disease, Death Benefit may be payable to his/her dependants.

It may also be payable to the dependants of a person who at the time of death was in receipt of a 50% or over Disablement Pension, regardless of the cause of death. This provision has been effective from 2 April 1997.

Death Benefit includes:

  • Widow's/Widower's Pension
  • Orphan's Pension
  • Dependent Parent's Pension
  • Funeral Grant

Widow's/Widower's Pension is payable to a widow/widower of a deceased person. A person (in relation to deceased) who has been divorced may qualify for this pension providing they have not remarried since the divorce.

Orphan's Pension is payable for child(ren) where the parent, step-parent or person who supported the child(ren) dies as a result of an accident at work or occupational disease.

Dependent Parent's pension is payable to the parent (or parents) of the deceased where he or she had been wholly or mainly maintained by the deceased.

Funeral Grant is paid towards the cost of funeral expenses.

The Scheme was introduced on 1 May 1967. The Widower's Pension was introduced from 2 April 1997 (replacing the Dependent Widower's Pension or Gratuity). Cover for commuter accidents commenced on 27 March 1986 and cover for Gardai commenced on 6 April 1989.

Information Leaflet

Death Benefit SW 32

Legislation:

The main provisions are contained in Chapter 13 of the Social Welfare (Consolidation) Act, 2005 and SI No 102 of 2007.

Administration

Disablement Section, Social Welfare Services Office, Ballinalee Road, Longford deals with deciding claims and the payment of Funeral Grants. Widow's Section in Social Welfare Services Office, Sligo deals with the payment of pensions once they are awarded.

QUALIFYING CONDITIONS
  • The insured person must have died as a direct result of an occupational accident or disease or must have been in receipt of a Disablement Pension of 50% or over at the time of death. [See also qualifying conditions for Injury Benefit (separate guidelines "OIB/Injury Benefit" and "OIB/Disablement Benefit" for prescribed diseases]
  • Widow's/Widower's Pension. The claimant must be a widow/widower of the deceased insured person.
  • Orphan's Pension. The child must be one whose parents are both deceased or one of the parents is deceased and the other parent has abandoned the child. If not a child or step child of the deceased, the child must have been wholly or mainly maintained by the deceased at the time of his/her death. The child must be under the age of 18 (22 if in full-time education by day at a recognised school or college). (See further details in separate guideline on " Child Dependants" )
  • Dependent Parent's Pension. The parent must at the time of death of the insured person have been wholly or mainly maintained by the deceased person. Parents include parents by adoption (under the Adoption Acts) and step-parents. The rules of Article 6 of SI 417/94 are applied when any question arises as to 'wholly or mainly maintained" (See separate guideline re " Adult Dependants" ).
  • Funeral Grant. Confirmation that funeral expenses have been paid is required. A funeral grant is payable in respect of a death occurring outside the State if the deceased, immediately before death (a) was employed in insurable (occupational injuries) employment, or (b) was entitled to and not disqualified from receiving Injury Benefit or Disablement Benefit.
  • See also the qualifying conditions for Disablement Benefit (separate guideline "OIB/Disablement Benefit").
  • Exception; Death Benefit is not payable in respect of occupational asthma where the insured person, in respect of whose death the benefit has been claimed, died more than 10 years after the date on which s/he ceased to be employed in any occupation prescribed in relation to occupational asthma.

DISQUALIFYING CONDITIONS

Widow's/Widower's Pension

A widow/widower will be disqualified from receiving the pension:

  1. on re-marriage.
  2. if and so long as he/she and any other person are cohabiting as husband and wife.
Dependent Parent's Pension

A widow or an unmarried woman will be disqualified from receiving the pension:

  1. on re-marriage
  2. if and so long as she and any person are cohabiting as husband and wife.
Late Claims

Claims made later than 3 months after the death of the insured person are disqualified, but see later paragraph in Part 2 re exceptions to this rule.

Imprisonment

A person is disqualified from receiving Death Benefit for any period during which that person is undergoing penal servitude, imprisonment or detention in legal custody subject to the following exceptions contained in Art. 12 of S.I. 102 of 2007:

  1. where a funeral grant is in payment
  2. where the person is detained on charge of a criminal offence and the charge is subsequently withdrawn or the person is acquitted and immediately before the detention, s/he was entitled to disablement benefit
  3. where imprisonment is undergone as an alternative to the payment of a fine

Increases for qualified adults and qualified children are payable in the following circumstances:

  1. increases for qualified adults and qualified children are payable to an appointed person
  2. where the detention of the claimant is in an institution for the treatment of mental and infectious diseases
    OR
    if the claimant was in receipt of disablement benefit immediately before being detained;
  3. increase for a qualified adult is payable if s/he is detained on charge of a criminal offence and the charge is subsequently withdrawn or the qualified adult is acquitted of the offence;
  4. increase for a qualified child is not payable where the child is detained in a mental hospital.

Where a payment is due to a person who is in prison or legal custody, the payment may be made to a person appointed by the Minister to receive it on behalf of the claimant or payment may be suspended until the claimant's release. If the latter, the provision regarding payment having to be obtained within 6 months of the date due will not apply.

RATES STRUCTURE

The current rates of Benefit are published in the SW 19 Booklet.

Widow's/Widower's Pension is made up of a personal rate and increases for a qualified child. IQC is payable up to age 18, or if the qualified child is in full-time education by day at any university, college, school or other educational establishment, up to the end of the academic year of the year in which he or she reaches age 22. (See also separate guideline re " Child Dependants" )

A Widowed Parents grant is payable to newly widowed persons with children following a bereavement after 1 December, 1999.

Dependent Parent's Pension may be paid to both parents if the dependency conditions are fulfilled by both. It is payable at two different rates:

The maximum rate is payable where the deceased was at death a widower, a widow or a single person:

  1. In any case where the parent is the father and was, at the death of the deceased, permanently incapable of self-support because of mental or physical infirmity,
  2. In any case where the parent is the mother, if she is a widow, or subsequently becomes a widow, OR
  3. In any case where the parent is the mother but not a widow and the pension at maximum rate is not payable to her husband.

The lower rate only is payable where the deceased was married, and in all other cases than those described above.

An increase is payable at age 66 - see Rates Booklet.

Orphan's pension is payable at a fixed rate per child. It is payable up to age 18, or if the orphan is in full-time education by day at any university, college, school or other educational establishment, up to the end of the academic year of the year in which he or she reaches age 22.

Funeral Grant is paid as a once off lump sum payment. If a Bereavement Grant (See separate guideline " Bereavement Grant" ) has already been paid in respect of the deceased the amount paid is deducted from the Funeral Grant.

EXTRA BENEFITS

Fuel Allowance (See "National Fuel Scheme" guideline for conditions.)
SWA (See separate guideline on " Supplementary Welfare Allowance" )

If over age 66:

  • Living Alone Increase
  • * Free Travel.
  • * Free Electricity,
  • * Free Television Licence,
  • * Free Natural Gas/Bottled Gas Refill Allowance,
  • * Free Telephone Allowance.

* (See Free Schemes guideline for conditions.)

OVERLAPPING PROVISIONS

Persons in receipt of Death Benefit by way of Widow's/Widower's Pension or Dependent Parent's Pension can also be paid the following at half the personal rate for a period of 390 days provided they satisfy the conditions of the schemes:

  • Adoptive Benefit
  • Illness Benefit
  • Health and Safety Benefit,
  • Injury Benefit
  • Maternity Benefit
  • Incapacity Supplement
  • Jobseeker's Benefit

If Illness Benefit or Incapacity Supplement was in payment on 5 April 1990 with Death Benefit by way of Widow's/Widower's Pension or Dependent Parent's Pension it may continue in payment until the end of the period of incapacity for work.

A person in receipt of Death Benefit by way of Orphan's Pension may also be paid one of the following provided s/he satisfies the conditions of the scheme:

  • Adoptive Benefit
  • Death Benefit by way of Widow's/Widower's Pension or Dependent Parent's Pension.
  • Deserted Wife's Benefit
  • Illness Benefit
  • Health and Safety Benefit
  • Injury Benefit
  • Maternity Benefit
  • One-Parent Family Payment
  • Incapacity Supplement
  • Jobseeker's Benefit
  • Widow's or Widower's (Contributory) Pension
  • Widow's or Widower's (Non-contributory) Pension

PART 2: CLAIMS, INVESTIGATION AND DECISION PROCEDURES

Claims

The onus is on the person to apply if s/he believes s/he is entitled to benefit under the scheme. The Death Benefit under the Occupational Injuries Scheme Claim form OB 61 should be completed in full and signed by the claimant.

A Funeral Grant claim can be made by the husband/wife, next of kin of the deceased, personal representative of deceased, or by the person who paid the funeral expenses.

The person should state his/her Personal Public Service Number (PPS No.) and the deceased's PPS No. A new PPS No. will be allocated to the claimant if s/he has no PPS No.

The claimant should forward relevant documentation as indicated below. However, this may be sent on after the initial claim is made rather than delaying the claim in order to obtain it.

An acknowledgement of receipt is issued in respect of each claim. The claim reference is quoted and the claimant is asked to quote same in any future contact with the Department with regard to Death Benefit claim.

Late Claims

The claim should be made within 3 months of the death of the insured person. A person is disqualified for payment of a pension for any period prior to the date of claim.

However, where a person can prove to the satisfaction of a Deciding Officer or Appeals Officer that entitlement existed and that there was good cause for delay in making a claim, payment of a pension may be made for a period up to 6 months before the date of claim.

Further backdating of payment may also be possible on an extra-statutory basis in respect of late claims made prior to 25 May 2000 and, where late claims made on or after 25 May 2000 are concerned, in accordance with the provisions of Statutory Instrument 159 of 2000.

The primary legislative provisions governing claims and late claims are set out in Section 241 of the Social Welfare Consolidation Act 2005.

The main regulatory provisions with regard to claims are Legislation contained in Chapter 1 of Part 7 of the Social Welfare (Consolidated Claims, Payments and Control) Regulations (S.I. No. 142 of 2007) as amended (see in particular SI 55 of 1998, SI 159 of 2000 and SI 160 of 2000).

The payment of a funeral grant is not time limited.

See " CLAIMS AND LATE CLAIMS" guideline for further information on late claims and all the circumstances in which backdated payments or allowances may be made.

Compensation for Loss of Purchasing Power

Compensation for loss of purchasing power may be paid where there is an inordinate delay, attributable to the Department, in deciding a claim which results in the claimant receiving an amount of arrears that is worth less because of inflation.

See " CLAIMS AND LATE CLAIMS" guideline for information on the circumstances where compensation for loss of purchasing power is payable and how it is calculated.

Documentation

The claimant for Death Benefit is responsible for the production of certificates, documents, information and evidence required, including Death Certificate, Birth Certificates, Marriage Certificate (if applicable), funeral receipts, etc.

Benefit cannot be paid until all the necessary documentation is received.

Investigation of Claim

See under Disablement Benefit guideline. If a person had been in receipt of a Disablement Pension of 50% or over, these investigations will have already been completed. If the deceased had not been on such a pension the relevant details of the accident/disease, including death certificate are forwarded to the Department's Medical Advisor for advice in relation to the cause of death.

Decisions

Claims are decided by Deciding Officers appointed by the Minister under Section 246 of the Social Welfare (Consolidation) Act, 1993. A notification of the decision is issued to the claimant and when claims are disallowed or allowed at reduced rates the claimant is given an explanation of the reason for the disallowance or partial award.

Appeals

A person who is refused Death Benefit or who is awarded a reduced rate of payment may appeal the decision to an Appeals Officer.

PART 3: PROCEDURES FOLLOWING AWARD

Payment

Funeral Grant is paid by cheque. Payments of Pensions are arranged by Pensions Services Office, Sligo. See also separate guidelines on Widow's/Widower's Contributory Pensions and Orphan's Pension in relation to payment. The Orphan's Pension is usually paid to the guardian of the orphan but it may be paid at the discretion of the Minister to some other person for the benefit of the orphan.

Duration of Payment

Widow's/Widower's Pension is payable for life unless the person is awarded another benefit which is not payable in conjunction with Widow's/Widower's Pension or the widow/widower is disqualified for any of the reasons listed above.

Orphan's Pension continues for an orphan up to age 18 or until age 22 if s/he is in full-time education by day at a recognised school or college.

Dependent Parent's Pension is payable for life as long as the parent continues to satisfy the qualifying conditions and does not qualify for any other Social Welfare payment and is not disqualified for any of the reason's listed above.

  • Absence from the State
  • Death Benefit is payable when a person is absent from the State.
  • Maintenance
  • Lost book action
  • Certification of on-going entitlement
  • Review
  • Suspension of payment

See separate guidelines on Widow's/Widower's Contributory Pension and Orphan's Pension for these headings.


Last modified:06/10/2008