GQ Corner
Q. The carrier and claimant were proceeding through the dispute resolution process on issues of MMI and impairment rating when we received notice that the claimant passed away. It is unclear at this time whether his attorney or any beneficiaries will claim that the death resulted from the compensable injury. Do I need to take any action at this time?
A. Yes. In this scenario, you must adhere to the procedures outlined in Rule 132.17 relating to the denial, dispute, and payment of death benefits. This includes conducting a prompt investigation as to the cause of death and circumstances surrounding it so that you may determine whether it is compensable. It further includes filing PLN-12 forms to officially notify each potential beneficiary of his or her possible claim of entitlement to death benefits. If your investigation yields a conclusion that the death is not compensable, you should timely file a PLN-1 to dispute a compensable death claim. Additionally, you should file a PLN-11 in connection with the prior compensable injury claim to dispute that the compensable injury extends to the death or to any unrelated diagnoses or conditions contributing thereto. These actions insulate the carrier from an argument of waiver in the event that the beneficiary or beneficiaries ultimately claim and pursue entitlement to death benefits.
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