12th Annual Federal Workers' Compensation Conference S i #39 ...

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DOCUMENTS REQUIRED • Court Papers • Required if you are appointing an executor/ administrator applying as executor or administrator of deceased person’s s estate. • Court papers appointing guardian for minor or disabled child(ren) • Required if you are applying on behalf of minor or disabled children of the deceased and guardian has been appointed by the court. 32
DOCUMENTS REQUIRED • DD 214’S SO OR • Provide if you are OTHER MILITARY DISCHARGE CERTIFICATES applying as a surviving spouse or former spouse, and • the deceased was a former employee at the time of death. Failure to attach the information may delay the processing of your claim. 33
Page 1 and 2: 12 th Annual Federal Workers’ Com
Page 3 and 4: Death Benefits under § 8133 • FE
Page 5 and 6: Agency Responsibilities • The sup
Page 7 and 8: Timely claim • Survivors must giv
Page 9 and 10: Who is eligible under § 8133? •
Page 11 and 12: NOTE If a widow or widower receivin
Page 13 and 14: How does OWCP calculate the FECA/FE
Page 15 and 16: How are these benefits claimed? •
Page 17 and 18: FECA Death Gratuity • New § 8102
Page 19 and 20: Contingency Operations • The stat
Page 21 and 22: Order of Precedence • Section 810
Page 23 and 24: Offset of other gratuities • The
Page 25 and 26: References • 5 U.S.C. § § 8101,
Page 27 and 28: PLANNING YOUR NEEDS • Who has Pas
Page 29 and 30: CONTACTING THE FAMILY • 5Copeso C
Page 31: Required Documents • Social Secur
Page 35 and 36: Standard Form 3104B • Certified e
Page 37 and 38: Survivor’s Military Service Elect
Page 39 and 40: Agency Information & Certification
Page 47 and 48: Claim for Death Benefits (FEGLI) FE
Page 49 and 50: Claim for Death Benefits (FEGLI)
Page 51 and 52: Death Benefits Payout (FEGLI) • I
Page 53 and 54: REPORT OF PUBLIC SAFETY OFFICER’S
Page 55 and 56: Form TSP-17 - Information Relating
Page 57 and 58: Veteran’s Administration • Info
Page 59 and 60: Claim for Compensation by Widow,
Page 61 and 62: Death Gratuity Payment Authority
Page 63: QUESTIONS? Contact Information Greg

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