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Chapter 6-1, Workers' Compensation Program

Chapter 6-3, Death Gratuity Payment
(April 13, 2009)

A.   References.

Statute 5 U.S.C. section 8133, note
5 U.S.C. section 8133(f)
5 U.S.C. section 8134(a)
Guidance Office of Personnel Management’s Benefits Administration Letter 96-109, October 16, 1996

Office of Personnel Management’s Benefits Administration Letter 97-104, March 5, 1997, Tax Status
Justice Management Division/Human Resources Systems and Analysis Group (HRSAG) Systems Notice #08-01
Sample Letters Sample Decision Memorandum to Head of Component Requesting Payment of a Death Gratuity Benefit
Sample Letter to Personal Representative Advising Approval of Death Gratuity Benefit Payment
Key Terms Injury
Personal Representative
Performance of Duty

B.   Policy.

  1. The Department of Justice may pay a death gratuity of $10,000 to the personal representative of an employee, whose death from an injury sustained in the line of duty, occurred on or after August 2, 1990. This includes employees who die after separation from the Department, if the death is the result of an injury sustained in the line of duty. It does not include employees whose death is determined to have resulted from willful misconduct.
  2. The $10,000 death gratuity payment is in addition to other amounts paid except that the amount must be offset by the payments listed in 5 U.S.C. § 8133, note.
  3. Components are responsible for the payment of the death gratuity from their appropriated funds.
  4. The Head of the Component (Authorizing Official) in which the decedent was employed, with the exception noted at paragraph 5, below, is authorized to approve a death gratuity payment. The Component human resources officer submits recommendations for payment to the Authorizing Official. Such recommendations include copies of the death certificate; Department of Labor’s (DOL) Office of Workers’ Compensation Program determination; Standard Form 50, Notification of Personnel Action, processing the death action; the amount of offset; and the name of the personal representative. A sample Decision Memorandum to Head of Component Requesting Payment of a Death Gratuity Benefit is attached.
  5. Where the decedent held a United States Marshal, Attorney, Senior Executive Service, or Senior Level position, the Authorizing Official is the Deputy Attorney General, with respect to organizational units reporting to him/her, or the Associate Attorney General, with respect to organizational units reporting to him/her. The decedent employee’s Component Head submits the death gratuity payment recommendation, including the documentation identified in paragraph 4, above, to the appropriate Authorizing Official.
  6. Complete and final authority approving the payment of a death gratuity, and determining, in any particular case who is the decedent's personal representative, rests with the Authorizing Official. In determining who is the decedent's personal representative, the Authorizing Official follows applicable law, including:

         a. Formal designations of executors and administrators made by the decedent, or by operation of State law; and

         b. Orders of precedence governing the payment of a Federal employee's unpaid compensation, as set forth in Title 5.

  7. The Authorizing Official may approve the death gratuity payment when presented with clear and convincing evidence that an employee, in the performance of duty, sustained an injury which resulted in the employee's death. When claims for payment which, by available evidence, do not clearly and convincingly establish entitlement to a death gratuity payment, the Component shall await the DOL determination. Attached is a sample letter informing the personal representative of the approval of the death gratuity payment.

C.  Documentation for Reports and Records.

Upon approval, the Component follows the guidance in the HRSAG System Notice 08-01, dated February 6, 2008, for processing the death gratuity payment. The cost center is the direct accounting code for the office, and sub-object class 1333.

(Sample Decision Memorandum to Head of Component Requesting Payment of a Death Gratuity Benefit)

MEMORANDUM FOR HEAD OF COMPONENT
  COMPONENT’S NAME
FROM: Name of Human Resources Officer
Human Resources Officer
District of
SUBJECT: Payment of Death Gratuity Benefit for
Jane Doe

Purpose: To authorize payment of a Death Gratuity Benefit to the personal representative of Jane Doe, HR Officer, ______ Office in accordance with 5 U.S.C. § 8133, note.

Ms. Doe’s injury occurred in her office when she struck her head on the edge of a desk on December 19, 2007. Ms. Doe entered the hospital for treatment related to the injury on December 19, 2007, and remained in the hospital until her death on January 1, 2008. Her family filed a claim for benefits with the Department of Labor, Office of Workers Compensation Program (OWCP). OWCP approved the claim on January 5, 2008.

Payments already made to Decedent's Personal Representative: The Doe family received a one-time payment from OWCP of $800 in burial expenses and a $200 administrative costs payment for a total of $1,000.

Death Benefit Gratuity Entitlements: The Death Benefit Gratuity statute provides for the payment of a death gratuity of up to $10,000 to the personal representative of an employee whose death from an injury is sustained in the line of duty occurring on, or after August 2, 1990. This $10,000 death gratuity is reduced only by those offset payments listed in 5 U.S.C. § 8133, note.

The aforementioned $800 and $200 payments already paid to the Doe family are required offset payments under the Death Benefit Gratuity statute. Therefore, the maximum amount payable by the Department to Ms. Doe's personal representative is $9,000. Once approved, the payment of the gratuity is from the Office’s Direct Appropriation, cost center xxxx, sub-object 1333, Death Gratuity Benefits.

Attached are copies of:

1. Ms. Doe's death certificate;
2. the OWCP determination in Ms. Doe's case
3. the Standard Form (SF-50), Notification of Personnel Action; and
4. copy of the decedent's will or other documentation identifying the personal representative.

RECOMMENDATION: Recommend approval of the payment of a Death Gratuity Benefit of $9,000 to the personal representative, Mr. Ralph Doe.

APPROVE: __________________

DISAPPROVE: ________________

OTHER: ____________________

Attachments

 

(Sample Letter to Personal Representative Advising Approval of Death Gratuity Benefit Payment)

Mr. Ralph Doe
1234 Elm Street
Any where, US 123456

Dear Mr. Doe:

This informs you that under the provisions of 5 U.S.C. § 8133, note, you as the personal representative for your late wife, Jane N. Doe, shall receive a death gratuity payment. I have authorized payment of the gratuity in the amount of $9,000, the maximum amount payable to you under the law because of reductions due to payments under other statutes, specifically, the amounts of $200 and $800 paid by the Office of Workers’ Compensation Program (OWCP).

For tax purposes, the death gratuity paid to you is not subject to FICA taxes for Social Security and Medicare since payment of this money is in the calendar year after Ms. Doe's death. This money is fully subject to Internal Revenue Service income tax withholding.

In order to process this payment, we need your social security number for tax reporting purposes. Please send me this information in the enclosed prepaid envelope. If you have any questions, please do not hesitate to contact xxxxx at (202).

We wish to express our condolences on your loss.

Sincerely,



Human Resources Officer

Enclosure


 

DEFINITIONS FOR DEATH GRATUITY PAYMENT

INJURY: Includes an injury by accident (traumatic injury) or a condition (disease) proximately caused by employment.

A traumatic injury is defined as a wound or other condition of the body caused by external force, including stress or strain. The injury must be identifiable by time and place of occurrence and member of the body affected; it must be caused by a specific event or incident or series of events or incidents within a single day or work shift. (DOL Publication, CA-810, Injury Compensation for Federal Employees).

An occupational disease is defined as a condition produced in the work environment over a period longer than one workday or shift. It may result from systemic infection, repeated stress or strain, exposure to toxins, poisons, or fumes, or other continuing conditions of the work environment. (DOL Publication, CA-810, Injury Compensation for Federal Employees).

PERSONAL REPRESENTATIVE: An individual formally designated executor or administrator of the employee's estate by operation of State law and/or orders of precedence governing the payment of an employee’s unpaid compensation, as set forth in Title 5.

PERFORMANCE OF DUTY: Employee engaged in assigned duties or engaged in an activity reasonably associated with the employment which may be on work premises or off premises while engaged in work activity. An employee in travel status is covered 24 hours a day for all activities incidental to the work assignment. Such activities include, but not limited to, obtaining meals, using the hotel room, and traveling between the hotel and the work site. (DOL Publication, CA-810, Injury Compensation for Federal Employees).

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Updated: September 2012
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