When a workplace accident results in the death of a worker, the emotional toll on families is devastating and financial concerns can add another layer of stress to an already overwhelming situation. Under New South Wales workers compensation laws, dependents of deceased workers may be entitled to death benefits that provide crucial financial support.
This guide aims to help families understand what death benefits are available under NSW workers’ compensation legislation, who qualifies as a dependent, and how to navigate the claims process.
What Are Death Benefits in NSW Workers’ Compensation?
The NSW workers’ compensation scheme provides several types of benefits to eligible dependents of workers who have died as a result of a work-related injury or illness. These benefits are designed to provide financial support to those who were financially dependent on the deceased worker at the time of their death.
The main components of death benefits include a one-time lump sum payment, weekly compensation payments for dependent children, reimbursement for funeral expenses, and coverage for medical expenses incurred before death. These benefits are paid by the employer’s workers compensation insurer, which in many cases is icare NSW (Insurance & Care NSW), the state’s primary workers compensation insurer.
Who Can Claim Death Benefits?
Under NSW workers compensation law, death benefits are payable to the “dependants” of the deceased worker. A dependant is defined as a person who was wholly or partly dependent on the worker at the time of death. This typically includes spouses, de facto partners, and children, but may also extend to other family members who can demonstrate financial dependency.
The Workers Compensation Act recognises both total and partial dependency, and the degree of dependency affects how death benefits are distributed among multiple dependants. A totally dependent person, such as a non-working spouse or young child, relied entirely on the deceased worker’s income. A partially dependent person received some financial support from the deceased worker but also had other sources of income.
Primary consideration is given to spouses (including de facto partners) and children under 16 years of age (or under 21 if they’re full-time students). These individuals are generally presumed to be dependents without having to provide extensive proof of financial dependency.
GET HELP NOW WITH YOUR PERSONAL INJURY
Get in touch with our Personal Injury Compensation team
What Can Death Benefits Include?
Lump Sum Death Benefit
The lump sum death benefit is a tax-free, one-time payment available to the dependents of a deceased worker. The sum is paid regardless of the deceased worker’s income level or the circumstances of the work-related death.
If there are multiple dependants, the lump sum is apportioned among them according to their level of dependency. If there’s any dispute about how the payment should be divided, the Personal Injury Commission may determine the appropriate distribution. In cases with no dependants, the lump sum is typically paid to the deceased worker’s legal personal representative.
Weekly Payments for Dependent Children
In addition to the lump sum payment, weekly benefits are payable to dependent children of the deceased worker. These payments provide ongoing financial support for children who have lost a parent due to a work-related incident and continue until the child reaches 16 years of age. However, if the child is a full-time student, payments may continue until they reach 21 years of age. The payments are made directly to the child’s guardian or the child themselves if they are of appropriate age and circumstances.
It’s important to note that these weekly payments are indexed annually to account for the increased cost of living, ensuring that the support provided maintains its value over time as children grow and their needs change.
Funeral Expenses
The NSW workers’ compensation scheme covers reasonable funeral expenses when a worker dies due to a work-related injury or illness.
Funeral expenses cover costs associated with the burial or cremation of the deceased worker, including the funeral service, cemetery or crematorium fees, coffin or casket, headstone or plaque, funeral director’s professional fees, and transportation of the body. To claim these expenses, itemised invoices and receipts must be provided to the worker’s compensation insurer.
Making a Death Benefits Claim
The first step in making a death benefits claim is to notify the deceased worker’s employer of the death as soon as possible. The employer then has an obligation to notify their worker’s compensation insurer within 48 hours. However, dependents or their representatives can inform the insurer directly if necessary.
A formal claim must be lodged with the relevant insurer within 6 months of the date of death, although extensions may be granted in certain circumstances. The claim should include a death certificate, evidence of the work-related nature of the death, and documentation proving dependency status, such as marriage certificates, birth certificates for children, or proof of financial support.
It’s crucial to establish that the death was work-related, meaning it resulted from either a workplace accident or a work-related illness. Medical evidence linking the cause of death to workplace factors is often required, especially in cases involving diseases or conditions that develop over time.
Determination & Disputes in the Claims Process
Once a claim is lodged with the insurer, they have 21 days to determine whether to accept or dispute liability for the claim. During this assessment period, the insurer will review all submitted documentation and may request additional information or evidence to support the claim.
If the claim is accepted, the insurer will arrange for payment of benefits to eligible dependents according to the provisions of the Workers Compensation Act. The lump sum payment is typically processed within a month of claim acceptance, while weekly payments for dependent children commence shortly after acceptance and continue according to the eligibility criteria.
If the insurer disputes liability or disagrees about the distribution of benefits among dependents, the matter may need to be resolved through the Personal Injury Commission. This independent body can decide on disputed workers’ compensation matters, including death benefit claims.
Common Challenges in Death Benefit Claims
One of the most common challenges in death benefit claims is establishing that the death was work-related. This can be particularly difficult in cases involving diseases with multiple potential causes, such as cancers or heart conditions. Expert medical evidence is often required to establish the causal connection between work factors and the death.
Another common challenge is determining dependency status, especially for relationships outside the traditional spouse and child categories. Claimants may need to provide bank statements, tax returns, household bills, and other financial documents to demonstrate financial dependency on the deceased worker.
Insurance companies may dispute claims, questioning the work-relatedness of the death or challenging the extent of dependency claimed by family members. These disputes can lead to delays in payment and additional stress for grieving families.
How a Workers’ Compensation Lawyer Can Help
An experienced workers’ compensation lawyer can provide invaluable assistance in navigating the complexities of death benefit claims. They can help gather and present the necessary evidence to establish work-relatedness and dependency status, significantly improving the chances of a successful claim.
Legal representation is particularly important if the insurer disputes liability or if there are complications regarding the distribution of benefits among multiple dependents. A lawyer can negotiate with the insurer on your behalf and, if necessary, represent you in proceedings before the Personal Injury Commission to protect your rights.
During this emotionally challenging time, having a knowledgeable legal advocate can simplify the process for families, allowing them to focus on their emotional well-being while ensuring their financial interests are appropriately addressed. While no amount of compensation can make up for the loss of a loved one, these benefits can help provide financial stability for families as they cope with their loss.
Key Takeaways
- NSW workers' compensation death benefits include a lump sum payment, weekly payments for dependent children until age 16 (or 21 if studying full-time), and coverage for funeral expenses.
- Eligible dependents include spouses, de facto partners, children, and other family members who can demonstrate financial dependency on the deceased worker.
- Claims must be lodged within 6 months of death, requiring proof that the death was work-related and documentation of dependency status.
- Legal representation is crucial when navigating complex claims, especially when establishing work-relatedness, proving dependency, or disputing insurer decisions about liability or benefit distribution.
Eligible for Workers’ Compensation Death Benefits?
If you believe you may be entitled to death benefits through workers’ compensation, you can contact our legal team to learn more about your rights, responsibilities and potential outcomes.
The team at Burke Mead Lawyers are experts in personal injury law and compensation claims and can assist you throughout this process.
