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

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Claim for <strong>Compensation</strong> of Deceased Civilian Employee (SF 1153) • Ensure you • Have beneficiary employee completes the SF- provide a Direct Deposit Sign-up 1152, Beneficiary form (SF 1199A) for Unpaid <strong>Compensation</strong> • Have knowledge if Funeral Expenses have been paid for. 54
Form TSP-17 – Information Relating to Deceased Participant i • This form asks • Completed forms questions about the Deceased and need to be mailed to TSP Death the beneficiaries and additional family members. Benefits Processing Unit, Fairfax Post Office, DEDIS – P.O. Box 4450, 22038- • Must include a Fairfax, VA certified copy of 9998 death certificate 55
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 and 32: Required Documents • Social Secur
Page 33 and 34: DOCUMENTS REQUIRED • DD 214’S S
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: REPORT OF PUBLIC SAFETY OFFICER’S
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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12th Annual Federal Workers' Compensation Conference S i #39 ...

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