Form 1221-2

(June 1969)

UNITED STATES

DEPARTMENT OF THE INTERIOR

BUREAU OF LAND MANAGEMENT

MANUAL TRANSMITTAL SHEET

Release

1-1795

Date

2/27/2019

Subject 

H-1112-3, Loss of Human Life Handbook

1. Explanation of Material Transmitted: This handbook has been developed for ongoing agency 

use in response to the loss of human life. It will be continuously revised and updated based on 

current needs, policy, and procedures. 

2. Reports Required: BLM personnel are required to follow BLM Serious Accident 

Investigation (SAI) reporting procedures.

3. Material Superseded: None.

4. Filing Instructions: File as directed below.

REMOVE INSERT

None All or Rel. No. 1-1795

(Total: 160 Pages)

 

 

S:// Brian C. Steed

 Brian C. Steed

Deputy Director, Policy and Programs

Exercising the Authority of the Director 

 
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Table of Contents

CHAPTER I. INTRODCUTION ..........................................................................................................................I-1

CHAPTER II. AUTHORITIES ..........................................................................................................................II-1

A. Public Law 103-332 Section 312 – Reimbursement ................................................................................II-1

B. Public Law 104-208 Section 651 – Death Gratuity..................................................................................II-1

C. 31 U.S.C. Section 1345 – Use Of Appropriated Funds............................................................................II-1

D. Public Law 103-332, 5 U.S.C. Sections 8133 And 8134 – (FECA/OWCP)............................................II-1

E. 5 U.S.C Section 4503 – Agency Awards .................................................................................................II-1

F. 5 U.S.C. Section 6328 – Absence In Connection With Funerals Of Fellow Federal Law Enforcement 

Officers Or Federal Firefighters..........................................................................................................................II-2

G. 5 U.S.C. Section 8102 – Compensation For Disability Or Death Of Employee ......................................II-2

H. 5 U.S.C. Section 8133 – Compensation In Case Of Death ......................................................................II-2

I. 5 U.S.C. Section 8134 – Funeral Expenses, Transportation Of Body ..........................................................II-2

CHAPTER III. OBJECTIVES...........................................................................................................................III-1

CHAPTER IV. LOSS OF HUMAN LIFE CLASSIFICATIONS ...................................................................IV-1

A. Line-of-Duty Death................................................................................................................................IV-1

B. Death in Service .....................................................................................................................................IV-1

C. Death of Other Personnel .......................................................................................................................IV-2

CHAPTER V. PREPLANNING.......................................................................................................................... V-1

A. Training................................................................................................................................................... V-1

B. Personal Emergency Contact Information .............................................................................................. V-1

C. Designation of Beneficiary ..................................................................................................................... V-2

CHAPTER VI. ROLES AND RESPONSIBILITIES IN RESPONDING TO LOSS OF LIFE ...................VI-1

A. Responding to a LODD & Employee On-Duty Death........................................................................... VI-1

B. Roles and Responsibilities in Responding to an Employee Off-Duty Death ......................................... VI-3

CHAPTER VII. THE CIRCUMSTANCES OF DEATH SUMMARY CHART......................................... VII-1

CHAPTER VIII. LOHL RESPONSE TEAMS AND RESPONSIBILITIES..............................................VIII-1

A. Serious Incident or Fatality Response Management Team ................................................................. VIII-1

B. Overview of Associated SIOF Team Duties A ................................................................................... VIII-2

C. Investigations.................................................................................................................................... VIII-10

D. Critical Incident Stress Management ................................................................................................ VIII-14

CHAPTER IX. WORKFORCE CONSIDERATIONS ....................................................................................IX-1

A. Sick Leave/Annual/Administrative Leave .............................................................................................IX-1

B. Post-Traumatic Stress Disorder..............................................................................................................IX-1

C. Employee Assistance Program (EAP)....................................................................................................IX-1

CHAPTER X. BUSINESS PRACTICES............................................................................................................ X-1

A. Transport of Deceased Body................................................................................................................... X-1

B. Escort of Remains................................................................................................................................... X-1

C. Agency Memorial Ceremonies................................................................................................................ X-2

D. Funeral and Memorial Attendance.......................................................................................................... X-3

E. Honor Watch........................................................................................................................................... X-3

F. Travel of Family Members...................................................................................................................... X-4

G. Additional Support.................................................................................................................................. X-4
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H. BLM Funding Matrix – Serious Illness or Injury/Death ......................................................................... X-5

CHAPTER XI. SERVICES, MEMORIALS, AND CEREMONIES ..............................................................XI-1

A. Respecting The Surviving Family’s Wishes .......................................................................................... XI-1

B. Agency Administrator’s Responsibility ................................................................................................. XI-1

C. Flag Lowering Protocols........................................................................................................................ XI-3

CHAPTER XII.BENEFITS.............................................................................................................................. XII-1

A. Unpaid Compensation and Final Time Sheets ......................................................................................XII-1

B. Compensation for Missing Employees..................................................................................................XII-1

C. Survivor Benefits ..................................................................................................................................XII-2

D. Specialized Benefits..............................................................................................................................XII-4

CHAPTER XIII. REMEMBERING AND HONORING..............................................................................XIII-1

A. Temporary Commemoration............................................................................................................... XIII-1

B. Permanent Commemoration................................................................................................................ XIII-1

C. Retirement of Law Enforcement Shields ............................................................................................ XIII-1

D. State and National Memorials............................................................................................................. XIII-1

APPENDIX 1: DEFINITIONS .................................................................................................................... A1-1

APPENDIX 2 – LAW ENFORCEMENT LODD PROTOCOL..................................................................... A2-1

A. Law Enforcement Incident Notification................................................................................................ A2-1

B. Roles and Responsibilities .................................................................................................................... A2-1

C. Law Enforcement Serious Incident Review Team................................................................................ A2-5

D. Departmental Serious Incident Review Group...................................................................................... A2-7

E. OLES Honor Guard Standard Operating Procedures............................................................................ A2-7

F. OLES Serious Incident Report.............................................................................................................. A2-8

APPENDIX 3 – PROCEDURES FOR DEATH NOTIFICATION................................................................ A3-1

A. Introduction........................................................................................................................................... A3-1

B. Basic Death Notification Procedures .................................................................................................... A3-1

C. Follow-Up ............................................................................................................................................. A3-4

D. Death Notification in The Work Place.................................................................................................. A3-5

E. Death Notification in A Hospital Setting .............................................................................................. A3-5

F. General Information on How Survivors Respond To Death Notification............................................. A3-6

G. “Debriefing” For Death Notification Volunteers and Professionals ..................................................... A3-7

H. Survivor Intake Form (Fillable Form) .................................................................................................. A3-7

APPENDIX 4 – LOCAL UNIT INITIAL ACTIONS AND PREPARING FOR SERIOUS 

ACCIDENT INVESTIGATIONS .............................................................................................................. A4-1

A. Initial Actions........................................................................................................................................ A4-1

B. Notifications.......................................................................................................................................... A4-2

C. Preparing For the SAI Team ................................................................................................................. A4-2

APPENDIX 5 – UNPAID COMPENSATION, TIMESHEETS, AND QUICKTIME.................... A5-1

A. Overview............................................................................................................................................... A5-1

B. Unpaid Compensation........................................................................................................................... A5-1

C. Annual Leave Lump-Sum Payment ...................................................................................................... A5-1

D. Compensatory Time .............................................................................................................................. A5-1

E. Travel Comp Time ................................................................................................................................ A5-1

F. Time-Off Awards.................................................................................................................................. A5-2

G. Cash, Honorary and/or Informal Recognition Awards.......................................................................... A5-2

H. How to Record Date of Death on Timesheet......................................................................................... A5-2
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I. Missing In Service..................................................................................................................................... A5-2

J. References and Links ................................................................................................................................ A5-3

K. Forms .................................................................................................................................................... A5-3

APPENDIX 6 – MISSING EMPLOYEE BENEFITS ............................................................................ A6-1

A. Designation of Authority....................................................................................................................... A6-1

B. Authority ............................................................................................................................................... A6-1

C. Agency Review – Establishing Date of Death ...................................................................................... A6-1

D. Entitlements .......................................................................................................................................... A6-2

APPENDIX 7 – LODD DEATH GRATUITY PAYMENT ................................................................... A7-1

A. Overview............................................................................................................................................... A7-1

B. Eligibility .............................................................................................................................................. A7-1

C. Process .................................................................................................................................................. A7-2

D. Personal Representative ........................................................................................................................ A7-3

E. Tax Implications ................................................................................................................................... A7-4

F. Links for More Information .................................................................................................................. A7-4

G. Memorandum to Chief Financial Officer (Fillable Template) .............................................................. A7-4

H. Sample Letter to Personal Representative (Fillable Template)............................................................. A7-4

I. Application for Additional Death Gratuity Payment (Fillable Template) ................................................. A7-4

J. Letter to Personal Representative Regarding Additional Death Gratuity Payment (Fillable Template) ... A7-4

APPENDIX 8 – OFFICE OF WORKERS’ COMPENSATION LODD BENEFITS......................... A8-1

A. Overview............................................................................................................................................... A8-1

B. Claims for Death Benefits – Forms To Complete ................................................................................. A8-1

1. Division of Federal Employees' Compensation (DFEC)....................................................................... A8-1

2. Compensation for Death ....................................................................................................................... A8-1

C. CA-810, Injury Compensation for Federal Employees Publication...................................................... A8-2

D. Survivors of “An Employee Who Dies of Injuries Incurred in Connection With the Employee’s Service 

With an Armed Force In a Contingency Operation” ........................................................................................ A8-3

E. U.S.C. Section 8102a – Death Gratuity................................................................................................. A8-3

APPENDIX 9 – EMPLOYEE RETIREMENT SYSTEMS DEATH BENEFITS ........................... A9-1

A. Overview............................................................................................................................................... A9-1

B. Benefits Payable.................................................................................................................................... A9-1

C. Other Information ................................................................................................................................. A9-1

D. Civil Service Retirement System (CSRS)............................................................................................. A9-2

E. Federal Employees Retirement System (FERS).................................................................................... A9-6

F. Applying For CSRS Or FERS Survivor Annuity Benefits.................................................................... A9-9

APPENDIX 10 – FEDERAL EMPLOYEES HEALTH BENEFITS (FEHB)................................ A10-1

A. Overview............................................................................................................................................. A10-1

B. Eligibility ............................................................................................................................................ A10-1

C. Requirements For Continuing Enrollment .......................................................................................... A10-1

D. Process ................................................................................................................................................ A10-1

E. Extension of FEHB Coverage ............................................................................................................. A10-2

F. FEHB Conversion Rights.................................................................................................................... A10-3

G. Forms .................................................................................................................................................. A10-3

H. Links For More Information ............................................................................................................... A10-4

I. Contacts................................................................................................................................................... A10-4

J. Regulations And Authorities................................................................................................................... A10-5

K. FEHB Temporary Continuation Of Coverage (TCC) ......................................................................... A10-5

L. Federal Flexible Spending Account Program (FSAFEDS)................................................................ A10-7

M. Deductible Health Plans (HDHP) High............................................................................................... A10-8

N. Federal Employees Dental And Vision Program (FEDVIP)............................................................... A10-8
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APPENDIX 11 – THRIFT SAVINGS PLAN (TSP)............................................................................. A11-1

A. Overview............................................................................................................................................. A11-1

B. Eligibility ............................................................................................................................................ A11-1

C. Process ................................................................................................................................................ A11-1

D. Forms .................................................................................................................................................. A11-2

E. Contacts............................................................................................................................................... A11-2

F. BEBS................................................................................................................................................... A11-2

G. Regulations And Authorities............................................................................................................... A11-2

APPENDIX 12 – FEDERAL EMPLOYEES GROUP LIFE INSURANCE PROGRAM (FEGLI)

............................................................................................................................................................................ A12-1

A. Overview............................................................................................................................................. A12-1

B. Eligibility ............................................................................................................................................ A12-1

C. Process ................................................................................................................................................ A12-1

D. Forms .................................................................................................................................................. A12-2

E. Links For More Information ............................................................................................................... A12-2

F. Contacts............................................................................................................................................... A12-2

G. BEBS................................................................................................................................................... A12-3

H. Regulations And Authorities............................................................................................................... A12-3

APPENDIX 13 – FIRE AND LAW ENFORCEMENT BENEFITS ................................................. A13-1

A. Law Enforcement Officers, Firefighters And First Responders.......................................................... A13-1

B. Line-Of-Duty Death Law Enforcement (Only)................................................................................... A13-2

C. Firefighters (Only) .............................................................................................................................. A13-3

APPENDIX 14 – VETERAN’S ADMINISTRATION (VA) BENEFITS ........................................ A14-1

A. Overview............................................................................................................................................. A14-1

B. Burial In A National Cemetery ........................................................................................................... A14-1

C. Burial Flags......................................................................................................................................... A14-1

D. Presidential Memorial Certificates...................................................................................................... A14-2

E. Headstones And Markers.................................................................................................................... A14-2

F. Burial And Plot Interment Allowance................................................................................................. A14-3

5=APPENDIX 15– SOCIAL SECURITY ADMINISTRATION (SSA) .......................................... A15-1

A. Overview............................................................................................................................................. A15-1

B. Eligibility ............................................................................................................................................ A15-1

C. Process ................................................................................................................................................ A15-2

D. Things That Can Affect The Amount Of Social Security Benefit Payable ......................... A15-3

E. Supplemental Security Income............................................................................................................ A15-4

F. OWCP Benefits And SSA Benefits .................................................................................................... A15-4

G. Links For More Information ............................................................................................................... A15-4

H. Forms .................................................................................................................................................. A15-5

I. Contacts................................................................................................................................................... A15-5

APPENDIX 16 – FEDERAL LONG TERM CARE INSURANCE PROGRAM (FLTCIP) ...... A16-1

A. Overview............................................................................................................................................. A16-1

B. Eligibility ............................................................................................................................................ A16-1

C. Process ................................................................................................................................................ A16-1

D. Forms .................................................................................................................................................. A16-1

E. Links For More Information ............................................................................................................... A16-1

F. Contacts............................................................................................................................................... A16-1

G. National Operations Center Branch Of Employee Benefits Services (NOC BEBS) .......................... A16-1

H. Regulations And Authorities .............................................................................................................. A16-1

APPENDIX 17 – SOURCES OF RECOGNITION............................................................................... A17-1
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A. Law Enforcement Personnel ............................................................................................................... A17-1

B. Other ................................................................................................................................................... A17-3

APPENDIX 18 – FEDERAL TRAVEL REGULATIONS PART 303-70 AGENCY 

REQUIREMENTS FOR PAYMENT OF EXPENSES CONNECTED WITH THE DEATH OF 

CERTAIN EMPLOYEES............................................................................................................................ A18-1

A. Overview............................................................................................................................................. A18-1

B. Subpart A – General Policies.............................................................................................................. A18-1

C. Subpart B – Allowances For Preparation And Transportation Of Employee Remains....................... A18-2

D. Subpart C– Escort of Employee Remains........................................................................................... A18-3

E. Subpart D – Allowances For Preparation And Transportation Of The Remains Of Immediate Family 

Members......................................................................................................................................................... A18-3

F. Subpart E – Transportation Of Employee's Baggage And Privately Owned Vehicles (POV) From Official 

Temporary Duty (TDY) Station ..................................................................................................................... A18-4

G. Subpart F – Transportation Of Immediate Family Members, Baggage, Household Goods, And Privately 

Owned Vehicles (POV).................................................................................................................................. A18-5

H. Subpart G – Transportation Of Immediate Family Members, Baggage, Household Goods, And Privately 

Owned Vehicles (POV) For Employees Assigned To Contingency Operation Or An Operation In Response To 

An Emergency Declared By The President.................................................................................................... A18-6

I. Subpart H – Transportation Of Immediate Family Members, Baggage, Household Goods, And Privately 

Owned Vehicle For Law Enforcement Assignment....................................................................................... A18-7

J. Subpart I – Policies and Procedures For Payment of Expenses............................................................... A18-8

APPENDIX 19 – TEMPLATES AND FORMS ................................................................................. A19-1

A. Survivor Intake Form (Fillable Form)................................................................................................. A19-1

B. Memorandum to Chief Financial Officer (Fillable Template) ............................................................ A19-2

C. Sample Letter to Personal Representative (Fillable Template)........................................................... A19-3

D. Application for Additional Death Gratuity Payment (Fillable Template)........................................... A19-4

E. Letter to Personal Representative Regarding Additional Death Gratuity Payment (Fillable Template)A19-

5

F. Flag Lowering (Fillable Template 1) .................................................................................................. A19-6

G. Flag Lowering (Fillable Template 2) .................................................................................................. A19-7

H. Benefits Counselor Checklist.............................................................................................................. A19-8

I. Checklist For Processing Benefits........................................................................................................... A19-9
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CHAPTER I. INTRODCUTION

RESPONSE AT-A-GLANCE

CHECKLIST FOR ESSENTIAL INCIDENT-RELATED TASKS

COMPLETED0F

1 ACTION1F2

☐

Ensure Scene Response and Preservation

See Appendix 3

☐

Activate the Death Notification Process for Family and Employees

See Appendix 3

☐

Follow BLM Serious Accident Incident Reporting Procedures

See Appendix 4

☐

Assign the Family Liaison

See SIOF Team Duties

☐ Activate a Serious Incident or Fatality (SIOF) Response Team, if Appropriate

See SIOF Team Duties

☐

Request Critical Incident Stress Management (CISM) Staff

See Requesting Support

☐ Establish Funding Source as Needed

☐ Establish Daily Briefing Schedule

☐ Draft Short Biography Material

 1 Click box to track when task is completed 

2 See Section reference links for additional details and guidance. 
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To the Reader,

This handbook has been developed for ongoing agency use in response to the loss of human life. 

It will be continuously revised and updated based on current needs, policy, and procedures. If 

you need assistance or have questions or comments about its contents, please contact any of the 

following team members:

Name Title Office Phone Email

Chris Glode Division Chief FA- 200 NIFC 208-387-5065 Cglode@blm.gov

Ryan Wilkins Supervisory Human Resource 

Specialist

NIFC 208-387-5522 Rwilkins@blm.gov

*Vacant Fire Safety Program Manager NIFC 208-387-5175

Thomas Sharkey Special Agent OLES WO-100 775-861-6579 Tsharkey@blm.gov

Vanessa Marquez Fire Management Specialist NV State Office 775-861-6518 Vmarquez@blm.gov

Bodie Ronk Safety and Occupational 

Health Manager

NIFC 208-387-5044 Bronk@blm.gov

* Until permanently filled, acting Fire Safety Program Manager can be contacted at this phone.
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CHAPTER II. AUTHORITIES

A. Public Law 103-332 Section 312 – Reimbursement

This authority provides for payment of up to $10,000 in reimbursement for burial costs and 

related out-of-pocket expenses for employees killed in the line of duty in agencies that 

receive appropriations under a Department of the Interior and Related Agencies 

Appropriations Act.

Public Law 103-332 Section 312

B. Public Law 104-208 Section 651 – Death Gratuity

This authority provides for payment of up to $10,000, when combined with certain other 

payments, as a death gratuity to the personal representative of an employee who is killed in 

the line of duty. The total amount paid under the authorities of Public Law 103-332, 5 

U.S.C. Section 8133.

Section 8134 (FECA/OWCP) listed above, and the death gratuity payment, may not be 

more than $10,000. The death gratuity payment is not reduced by any other amounts, 

including other benefits payable under FECA.

Public Law 104-208 Section 651

C. 31 U.S.C. Section 1345 – Use Of Appropriated Funds

Authorizes Federal agencies to use appropriated funds for travel, transportation, and 

subsistence when an employee or officer performs an official duty.

Comptroller General’s Decision, volume 70, page 200 (70 Comp. Gen. 200) sets forth that 

an officially designated representative(s) may be designated and approved in writing to 

travel to and attend the funeral as official business.

31 U.S.C. Section 1345

D. Public Law 103-332, 5 U.S.C. Sections 8133 And 8134 – (FECA/OWCP)

Availability of Department of the Interior (DOI) and related agencies appropriations to 

reimburse representatives of employees killed in line of duty – provided that: 

“Notwithstanding any other provision of law in fiscal year 1995 and thereafter, 

appropriations made available to any department or agency in a Department of the Interior 

and Related Agencies Appropriations Act shall be available to that department or agency to 

reimburse the representative (as that term is defined by applicable law) of employees killed 

in the line of duty after January 1, 1994, and in subsequent fiscal years, for burial costs and 

related out-of-pocket expenses – Provided, That the amount of such reimbursement may 

exceed the $800 limitation in 5 U.S.C. Section 8134(a): Provided further, That funds 

provided pursuant to this authority may not exceed $10,000 per employee.”

5 U.S.C. Section 8133 and 5 U.S.C. Section 8134

E. 5 U.S.C Section 4503 – Agency Awards

This title allows agency heads to incur necessary expenses for honorary recognition of an 
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employee who performed a special act or service or service within their official 

employment. These “necessary expenses” for employee award ceremonies have been 

defined by the U.S. Comptroller General in the General Accountabilities Office’s 

publication, Appropriations Law, Volume I, Chapter 4.

5 U.S.C. Section 4503

F. 5 U.S.C. Section 6328 – Absence In Connection With Funerals Of Fellow Federal Law 

Enforcement Officers Or Federal Firefighters

A Federal Law Enforcement Officer (LEO) or a Federal Firefighter may be excused from 

duty without loss of, or reduction in, pay or leave to which such officer is otherwise entitled, 

or credit for time or service, or performance or efficiency rating, to attend the funeral of a 

fellow Federal LEO or Firefighter who was killed in the line of duty.

5 U.S.C Section 6328

G. 5 U.S.C. Section 8102 – Compensation For Disability Or Death Of Employee

Under specific criterion for the type of death that occurs in the workplace, this authority 

defines who is not eligible for compensation.

The United States shall pay compensation as specified by this subchapter for the disability 

or death of an employee resulting from personal injury sustained while in performance of 

his duty, unless the injury or death is:

1. Caused by willful misconduct of the employee,

2. Caused by the employee's intention to bring about the injury or death of himself 

or of another, or

3. Approximately caused by the intoxication of the injured employee. 

5 U.S.C. Section 8102

H. 5 U.S.C. Section 8133 – Compensation In Case Of Death

If death results from an injury sustained in the performance of duty, the United States shall 

pay a monthly compensation equal to a percentage of the monthly pay of the deceased 

employee in accordance with a schedule which is further defined within the law.

Notwithstanding any funeral and burial expenses paid under Section 8134, there shall be 

paid a sum of $200 to the personal representative of a deceased employee within the 

meaning of Section 8101 (1) of this title for reimbursement of the costs of termination of the 

decedent’s status as an employee of the United States.

5 U.S.C. Section 8133

I. 5 U.S.C. Section 8134 – Funeral Expenses, Transportation Of Body

If death results from an injury sustained in the performance of duty, the United States shall 

pay, to the personal representative of the deceased or otherwise, funeral, and burial 

expenses not to exceed $800, in the discretion of the Secretary of Labor.

The body of an employee whose home is in the United States, in the discretion of the 

Secretary, may be embalmed and transported in a hermetically sealed casket to his home or 

last place of residence at the expense of the Employees’ Compensation Fund if—

1. The employee dies from—
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a. The injury while away from his home or official station or outside the 

United States, or

b. From other causes while away from his home or official station for the 

purpose of receiving medical or other services, appliances, supplies, or 

examination under this subchapter, and

2. The relatives of the employee request the return of his body. 5 U.S.C. Section 

8134
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CHAPTER III. OBJECTIVES

The objective of this handbook is to establish a reference of consistent procedures and guidelines 

through implementation of the Loss of Human Life (LOHL) Response Handbook for managing 

Bureau of Land Management (BLM) response to all incidents and accidents that result in the loss 

of life of a BLM employee. This handbook:

A. Identifies responsibilities for BLM leadership before, during, and after incidents that 

result in the death of a BLM employee by aligning BLM policies with Federal laws and 

regulations that govern agency responses.

B. Delineates the agency response to all employee deaths based on circumstance.

C. Clarifies employee benefits based on classifications of death and identifies accurate 

sources of information.

D. Establishes the requirement to create and maintain Serious Incident or Fatality (SIOF) 

Response Plans.

E. Identifies a response structure by utilizing a Serious Incident or Fatality (SIOF) Response 

Team, scaled to match the needs of the event.

F. Identifies the process for using the BLM Critical Incident Stress Management (CISM) 

Program.

G. Clarifies and identifies the proper use of business practices when expending government 

funds.
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CHAPTER IV. LOSS OF HUMAN LIFE CLASSIFICATIONS

A. Line-of-Duty Death

The term Line-of-Duty Death (LODD) means a BLM employee has died as a direct or 

proximate result of personal injury sustained in the performance of official duties. Examples 

include:

1. Death from a felonious act committed by another while the employee is on duty.

2. Death during the act of saving a life or responding to an emergency when the death is 

caused by the response actions required of the employee.

3. Death when the employee is engaged in Fire Operations or Law Enforcement 

activities while on duty.

4. Death when the employee is in an accident while on duty or in official travel status 

and the death is due to injuries sustained in the accident.

5. Death occurring from an illness due to occupational exposure.

6. An employee missing while on duty and presumed dead.

Classifying an employee death as LODD can have certain legal implications, such as death 

benefits and entitlements, particularly in the event of LODDs for Law Enforcement and Fire 

Personnel.2F

3

B. Death in Service

1. Employee On-Duty Death: The term On-Duty Death means an employee has died 

during duty hours, but the death is not the result of the performance of official duties. 

For example:

a. Death from a personal medical condition (natural causes) not related to 

official duties.

b. Death determined to be suicide.

c. Death from accidental causes during work hours due to the employee’s willful 

misconduct, intention to bring about death of oneself or another (felonious 

act), or intoxication (U.S Department of Labor, Office of Workers 

Compensation Programs (OWCP) Publication CA-810, Injury Compensation 

for Federal Employees, Chapter 3).

d. In most circumstances, an On-Duty Death will have a similar INITIAL 

response to a Line-of-Duty Death until the agency leadership or OWCP has 

made an administrative determination that it is “not in the line of duty” based 

on the circumstances surrounding the death. Certain situations, such as 

felonious acts, may be more immediately obvious, requiring limited agency 

 3 Agency action in accordance with this handbook does not constitute a determination for assurance of 

financial death benefits.
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response outside of Law Enforcement and Mental Health Professional (MHP) 

for employees.

2. Employee Off-Duty Death: The term Off-Duty Death means an employee has died 

during non-duty hours. Examples include:

a. Death from a personal medical condition.

b. Death from an accident and/or vehicle fatality.

c. Death determined to be a suicide 

C. Death of Other Personnel

The BLM response and honors provided is limited for loss of human life of partners, 

volunteers, contractors, former employees, and other Bureau personnel. Some discretion is 

afforded to the BLM Deputy Director of Operations in these circumstances. Refer to the 

Circumstances of Death Summary Chart below for appropriate response levels.
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CHAPTER V. PREPLANNING

Preparing for the death of an employee begins long before the loss of life. Pre-planning for a loss 

of human life response includes development of standard operating procedures, gathering 

information about personnel, and identification of resources. Managers and employees should 

view pre-incident planning as a continual process.

A. Training

1. You Will Not Stand Alone

Leadership And Employees Should Consider Supporting, Hosting, Or Attending 

Courses Such As “You Will Not Stand Alone” Offered Through The National 

Wildland Fire Training Program. This Course Is An Interagency Course Intended To 

Give Overall Guidelines For Assisting Employees, Families, And Other Survivors 

Of An Employee(s) Who Have Been Seriously Injured Or Died In Service Or In The 

Line Of Duty.

2. Hospital/Family Liaison

A death or serious injury may invoke a unique set of emotional challenges that must 

be processed and dealt with. Liaisons are a very important link between the agency 

and employee/employee’s family. Liaisons must be made aware of the physical, 

mental, emotional, and professional demands of the position.

The Agency Administrator should pre-identify and train the family and hospital 

liaisons before anyone needs their assistance. Individuals selected for these roles 

should have prior training and excellent interpersonal communication skills.

There is currently a course available that provides those identified as 

family/hospital/and employee liaisons the tools for pre-incident, incident, and post 

incident planning. This course defines the roles and responsibilities of liaisons, 

provides leadership with the criteria for selecting liaisons, identifies types of stress, 

and determines best practices for self-care. While this course is not officially 

recognized through a training center or organization, it can be requested through fire 

leadership in each state.

B. Personal Emergency Contact Information

It is critical that all employees provide emergency contact information in the case of a line 

of duty death, death in service (on duty/off duty), on-the-job injury, or illness to the 

employee. Employee express allows employees to voluntarily enter and update their 

emergency contact information online.

Employees should enter their emergency contact information into Employee Express under 

Miscellaneous – Emergency Contact Information. Employees should ensure that their work 

email address entered into Employee Express matches the email address listed in the DOI 

Bison Connect email directory. The home phone number, home email address, and personal 

cellphone number will be used in the BLM emergency notification.
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The Primary and Alternate Emergency Contact’s information can only be accessed by a 

designated individual in the servicing Human Resources Office (HRO), who will in turn 

only provide it to the employee’s supervisor in the event of an on-the-job injury or illness. 

This information will only be used for emergency purposes and will be maintained in 

accordance with the provisions of the Privacy Act of 1974.

Fire and Law Enforcement employees are required to review and update their emergency 

contact information annually. All other employees within the BLM are encouraged to 

review and update their emergency contact information as outlined in IM 2016-065 as 

necessary or at the beginning of each calendar year to ensure that the most current 

information is available.

C. Designation of Beneficiary

Employees are responsible for ensuring all beneficiary forms are current and up to date to 

reflect their wishes. The following designation of beneficiary forms should be reviewed for 

currency and may be found in the employee Official Personnel Folder (eOPF) of each 

respective employee:

1. SF-1152, Designation of Beneficiary for Unpaid Compensation – this form 

determines which beneficiary will receive payout for any unused annual leave 

balance or compensation time at the time of incident.

2. SF-2823, Designation of Beneficiary for Federal Employees Group Life Insurance 

(FEGLI) – this form determines which beneficiary will receive payment for any 

applicable FEGLI payment(s) at the time of the incident.

3. SF-3102, Designation of Beneficiary for Federal Employees Retirement System 

(FERS) – this form determines which beneficiary will receive retirement annuity 

payments from the Office of Personnel Management (OPM). Note, permanent and 

TERM employees only receive OPM approved retirement plan, this would not be 

applicable to temporary seasonal employees (e.g. 1039s).

4. Thrift Savings Plan (TSP) 3 Form, Designation of Beneficiary – this form determines 

which beneficiary will receive annuity payments from TSP.

Note: This form is mailed into TSP and is note retained in the employee’s eOPF.

Inaccurate or out of date information may result in processing delays and unintended 

consequences (e.g. Benefits going to a former spouse). Unless there is a legal document, 

such as a court order that designates beneficiaries otherwise from what is on file from the 

beneficiary forms, the National Operations Center (NOC), Benefits Branch will use 

information provided by the aforementioned forms contained in the employee’s eOPF to 

legally process any benefits/payments to survivors. To view the most recent beneficiary 

forms, employees should login to their eOPF.
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CHAPTER VI. ROLES AND RESPONSIBILITIES IN RESPONDING TO LOSS OF LIFE

The death of an employee may be the most difficult work-related event a manager will 

experience. The actions and decisions he or she makes in the critical first hours and days will 

have lasting impressions on survivors, employees, and community members. It is imperative that 

managers take essential actions and initiate key activities immediately.

A. Responding to a LODD & Employee On-Duty Death

1. Agency Administrator Responsibilities

a.Determine scope of incident, jurisdictions involved, and affected agencies.

b.Immediately obtain specific information regarding the fatality (who, what, 

where, and when).

c.If affected employee is not from local unit, notify respective home unit 

Agency Administrator and coordinate efforts.

d.Activate SIOF Response Plan.

e.Activate the Designated Notification Process.

f. Follow BLM Serious Accident Incident (SAI) reporting procedures.

g.Designate or identify additional Agency Administrator as needed.

h.Assign a Family Liaison from the agency or appropriate alternative.

i. Request a Critical Incident Stress Management (CISM) response if 

appropriate.

j. Request Honor Guard if appropriate.

k.Consult with budget personnel to identify funding for Loss of Human Life 

(LOHL) response actions.

l. Establish a daily internal briefing schedule with District, State, and 

National leadership.

m. Ensure after action review(s) is conducted, and document the lessons 

learned based on overall agency response to incident.

n.Prepare the 24 Hour Report and send to the State Director. If the incident 

is fire related, it needs to be routed through the Assistant Fire Director.

2. State Director Responsibilities

a.Ensure affected unit is using appropriate SIOF response.

b.Maintain contact with designated District Manager/Agency Administrator 

to determine staffing needs to support incident response and ensure 

continued daily operation.

i. If affected employee is not from the state, notify respective State 

Director to coordinate efforts.
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c.Notify BLM Deputy Director of Operations and ensure all upward 

reporting requirements are met.

d.Ensure through State Safety Manager that OSHA notification occurs 

within 8 hours.

e.Coordinate with Designated Agency Safety Health Official (DASHO) or 

Fire and Aviation (FA) Assistant Director Designee regarding the accident 

investigation/review.

f. Issue direction for statewide flag lowering within 24 hours.

g.Ensure BLM State Office personnel are available to assist the unit as 

needed.

h.Evaluate and approve administrative leave for affected personnel as 

needed.

i. Provide guidance for funeral/memorial service and memorial ceremony 

attendance.

j. Determine agency support, funding expenditures, and involvement in all 

activities associated with the response to loss of life, especially in 

situations where policy may not specifically indicate.

3. Office of Fire & Aviation

The Office of Fire and Aviation is only involved if incident involves fire program 

personnel. Coordinate with BLM Director’s Office and affected State Director(s) 

to determine high-level impacts and any need for assistance.

a.Coordinate with State and Washington offices to determine level of media 

interest and need for appropriate messages for release to the media and/or 

leadership talking points.

b.For interagency investigations, coordinate with respective agency(s) fire 

directors and/or delegating official.

c.Mobilize SAI.

d.Coordinate and schedule the initial SAI conference call with affected State 

Fire Management Officer(s) and State Office(s).

e.Sign delegation of authority letter for SAI Team

f. Activate designated notification processes.

4. The Office of Law Enforcement & Security

For more detailed information, see Appendix 2 Law Enforcement LODD 

Protocol.

a.The Special Agent-in-Charge (SAC) is responsible for notifying the Duty 

Officer, OLES.

b.The Duty Officer, OLES is responsible for notifying the Director, OLES, 

and the Department of the Interior (DOI) Operations Center.

c.The Director, OLES is responsible for notifying the Director, BLM.
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5. Washington Office

a.The BLM DASHO will notify DOI DASHO.

b.Notify non-affected BLM State Directors by the next business day, but do 

not release names before notification of family confirmed.

c.Prepare and issue direction for nationwide flag lowering within 24 hours.

d.Determine appropriate BLM WO official representation at 

funeral/memorial service.

e.The National Safety Office (NSO) notify DOI Office of Occupational 

Safety and Health that a SAI has occurred.

f. The BLM DASHO determines delegation of SAI Team. If incident 

involves fire program personnel, FA Assistant Director is delegated this 

responsibility.

g.The NSO will inform the BLM Emergency Management (EM) 

Coordinator of the accident.

h.The BLM EM Coordinator will notify the DOI Operations Center.

B. Roles and Responsibilities in Responding to an Employee Off-Duty Death 

6. Agency Administration

a.Verify death notification from family or supervisor and determine family’s 

desired level of agency involvement and support.

b.If desired by family, assign a Family Liaison.

c.Determine need for a SIOF response and implements as appropriate.

d.Implement designated notification process as appropriate.

e.Request CISM response if appropriate.

7. State Director

a.Notify BLM Deputy Director of Operations.

b.Discuss the need for official memorial attendance by state representatives 

in consultation with the Deputy Director.

8. Washington Office

a.Notify the DOI when appropriate.

b.Determine appropriate BLM official representation at funeral/ memorial 

service.
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CHAPTER VII. THE CIRCUMSTANCES OF DEATH SUMMARY CHART

The Circumstances of Death Summary Chart below lists the BLM-approved actions based on the 

circumstances of death. The table focuses on agency actions based on the circumstances of the 

death, not on-the-job series, title, or profession of the employee.

CIRCUMSTANCES OF 

DEATH

SIOF RESPONSE 

MANAGEMENT 

TEAM3F

4

CISM4F

5 SAI TEAM5F6

FLAG 

LOWERING

EMPLOYEE LINE-OF-DUTY DEATH

Felonious Act Required Recommended

Law 

Enforcement 

Investigation

SD/BLM 

Director

During a Life Saving Act Required Recommended Required SD/BLM 

Di t

Fire Operations Required Recommended Required SD/BLM 

Di t

Law Enforcement Actions Required Recommended OLES 

Pt l

SD/BLM 

Di t

Accident/Occupational 

Exposure

Required Recommended Required SD/BLM 

Director

Missing and Presumed 

Dead

Required Recommended Required SD/BLM 

Director

EMPLOYEE ON DUTY DEATH

Death from other causes 

while on duty, e.g., 

medical suicide

Required Recommended Required TBD by SD

EMPLOYEE OFF-DUTY DEATH

Death from other causes 

while off duty, e.g., 

medical, suicide

Optional

Recommended 

Especially in Cases 

of Suicide

No No

DEATH OF OTHER PERSONNEL

Former or retired employee No No Not Applicable No

Partner, volunteer, or other 

bureau

No No DASHO

Determination

No

Former BLM Director or 

other dignitary

No No Not Applicable TBD by 

Deputy 

 4 Link to more information: Serious Incident or Fatality Response Management Team. 5 Link to more information: Definitions. 6 Link to more information: Definitions.
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CHAPTER VIII. LOHL RESPONSE TEAMS AND RESPONSIBILITIES

This Loss of Human Life (LOHL) section provides an overview of the roles, responsibilities, and 

duties expected from teams responding to incidents involving a serious employee incident or 

fatality.

A. Serious Incident or Fatality Response Management Team

Serious Incident or Fatality (SIOF) management teams are mobilized to respond to serious 

incidents or fatalities. Every unit will develop and maintain a SIOF Response Plan, with 

State Office and Center SIOF Response Plans supporting and providing continuity and 

standardization of the district plans. A LOHL classification requires the use of a SIOF Team 

response. In certain situations, even though a serious incident or fatality does not occur, 

SIOF Team positions may be employed as appropriate. SIOF Teams will be pre-identified 

through the SIOF Response Plan. Positions will be filled by any agency employee not 

directly affected by the incident on or off unit; however, specialized positions should have a 

background in that function.

A template and more detailed information on each of the positions along with a checklist of 

duties can be found in the companion document to the LOHL Handbook, SIOF Template.

Figure 1. Elements included in SIOF Response Plans, including positions and overview of 

associated duties.
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B. Overview of Associated SIOF Team Duties A

1. Agency Administrator

The position serves as the BLM manager who has direct line authority over 

employee activity when and where a serious accident occurs:

a.Determines the scope of the incident, identify the involved jurisdictions, and 

implement initial actions.

b.Considers need for implementing other emergency response plans (e.g., 

HAZMAT, Aircraft Crash/Rescue) and coordinate appropriately.

c.Activates SIOF Team.

d.Determines the capabilities and limitations of SIOF organization and 

requests assistance, e.g., neighboring units; or state, regional, or national 

offices.

e.Prepares and issues 24 Hour Preliminary Report.

f. Strategizes with appropriate Manager, Immediate Supervisor, Law 

Enforcement, Safety Manager, and Hospital Liaison on notification of 

survivors. Determines who, how, and when to notify family(s) and whether 

any cultural or religious requirements are needed.

g.As warranted, provides a Delegation of Authority and objectives for the 

management of the SIOF.

h.Notifies immediate supervisor and/or contractor if applicable. When off-unit 

employees are involved, contacts victim’s home duty station with as much 

information as possible.

i. Checks with Hospital Liaison/Immediate Supervisor to ensure that the 

OWCP process has been started.

j. Works with Public Affairs Officer to identify key contacts during the 

incident.

k.Contacts Critical Incident Stress Management (CISM) Team. Requests for 

Critical Incident Peer Support (CIPS) Groups should be made by the Agency 

Administrator or designee to the Appropriate Geographic Area Coordination 

Center (GACC). CIPS Groups do not provide immediate support and are 

generally most effective within 48 to 72 hours after an incident. The CISM 

Coordinator completes a situational assessment and recommendation for 

most appropriate response.

l. Ensures both short- and long-term programs are provided for affected 

employees.

m. Establishes a daily briefing schedule.

n.After notification, works with family(s) to determine who they would like to 

be their Family Liaison. Periodically monitors the Family Liaison and family 

dynamics to ensure a mutually beneficial relationship exists for both parties. 

In cases with multiple families, designates more than one Family Liaison.
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o.Ensures a briefing packet is prepared for incoming SAIS.

p.Assesses the unit employees’ emotional and physical condition resulting 

from the incident, and identifies their needs and any additional 

responsibilities that may arise as a result of the incident. If needed, requests 

assistance from other offices and/or other agencies to help fulfill routine 

duties or the additional tasks of unit staff.

q.Ensures after action review(s) is conducted and documented for the SIOF 

Team response.

2. Serious Incident Fatality Commander

Position serves as the overall coordinator for the incident:

a.Implements and supervises SIOF Response Team.

b.Reviews and accepts Delegation of Authority.

c.Establishes and facilitates daily briefings as appropriate.

d.Ensures all needed Liaisons are in place and there is an agreed set of 

expectations set between all parties.

e.Ensures coordination between SIOF Human Resources Benefits Coordinator 

and appropriate benefits offices are in place.

f. Manages Memorial Service if applicable.

g.Coordinates with CIPS Team as necessary.

h.Facilitates and participates in After Action Review of SIOF Team response 

and document findings.

i. Participates in Close-Out with Agency Administrator and provides all 

pertinent documentation and actions associated with incident.

3. Serious Incident Coordination Officer

Position serves to coordinate all incoming information and documentation to ensure 

all relevant tasks are being completed:

a.Uses checklists from SIOF Incident Organizer to track progress.

b.Keeps in contact with SIOF Team members or employees who are 

responsible for checklists to track progress toward completion.

c.Reports progress updates to SIOF Commander.

d.Gathers information on people and agencies that assisted in the incident. 

Creates a central log of offers of assistance from other organizations. Ensures 

supportive organizations are treated with respect and consideration by the 

agency and that offers of assistance are used and/or recognized to the 

greatest extent possible.

e.Ensures all SIOF Team members have completed their checklists.

f. Prepares final documentation for SIOF Commander.
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g.Participates in After Action Review(s).

h.Participates in Close-Out with SIOF Commander and provides all pertinent 

documentation and actions associated with incident.

4. Family Liaison

Position serves to facilitate communication and coordination between the 

employee’s family and the agency, ensuring that the family’s needs are met within 

agency policy:

a.Provides logistical and emotional support to the family of the deceased 

employee.

b.Anticipates, determines, and communicates resource needs for immediate 

actions, secondary actions, and follow-up.

c.Communicates family needs to agency and facilitates information exchange, 

including but not limited to Human Resources, OWCP, agency Public 

Affairs Staff, news media, medical providers, home-unit employees, and 

investigations teams such as SAI, CRP, OIG, and Law Enforcement.

d.Participates in After Action Review(s).

e.Participates in Close-Outs with Serious Incident Coordination Officer 

(SICO) and provides pertinent documentation and actions associated with 

incident.

f. Respectfully concludes Family Liaison support when the family no longer 

needs it, relaying the family’s decision to the BLM unit.

5. Public Affairs Officer

Position serves to ensure incident messaging is being released in a timely and 

accurate manner:

a.Determines scope and scale of incident related to Public Affairs, requesting 

additional Public Affairs resources as appropriate.

b.Coordinates with SIOF Commander and gathers basic information for 

employee biography. (Do Not Release until given approval from the lead 

jurisdictional agency.)

c.Assists the lead jurisdictional agency to prepare a news release for the media.

d.Reports all information to designated SICO.

e.Coordinates with Family Liaison to inform family members prior to 

releasing new information to the media and updates as appropriate.

f. Responds to inquiries from the public and media, providing accurate and 

timely information approved by the lead agency. Shares information 

approved by the lead agency or appropriate agency personnel, i.e., SAI 

Team.

g.Participates in After Action Review(s).

h.Participates in Close-Outs with SICO and provides pertinent documentation 
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and actions associated with incident.

6. Notification Team

Position serves to make the death notification to top ranking agency officials within 

the agency and to the designated next of kin family member(s) as identified by the 

deceased employee on the completed Emergency Notification Information Form or 

by the family of the fallen if notification instructions are not available.

Notification should be done as soon as possible and with the upmost professionalism 

and empathy. This position shall not be taken lightly, as it will have lasting effects 

on the family. For best management practices in notifying families and coworkers, 

see Appendix 3 Procedures for Death Notification:

a.Confirms with coroner, through agency representative, that the involved 

employee(s) is deceased.

b.Refers to the completed Emergency Notification Information Form to 

determine the deceased employee’s wishes on next of kin notification. If not 

available, considers the following order, keeping in mind that it is the family 

representative(s), not the agency, who is responsible for making subsequent 

family notifications:

1) Spouse.

2) Adult children.

3) Parents.

4) Brothers and sisters, to include step-siblings and those acquainted 

through adoption

5) Grandparents.

6) Persons granted legal custody of the individual by a court decree or 

statutory provision.

7) Other relatives in order of relationship to the individual according 

to civil laws.

8) If no other persons are available, the county coroner or medical 

examiner will provide information on who can officially act on the 

behalf of the deceased.

c.Participates in After Action Review(s).

d.Participates in Close-Out with SICO, and provides pertinent documentation 

and actions associated with incident.

7. Law Enforcement Liaison

Position serves to provide for consistent and effective management of critical 

incidents:

a.Establishes Law Enforcement Liaison who will continue to work with local 

Law Enforcement through investigations and is the conduit for information 

back to BLM.
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b.Participates in After Action Review(s).

c.Participates in Close-Out with SICO, and provides pertinent documentation 

and actions associated with incident.

8. Hospital Liaison

Position serves to facilitate communication and coordination between the employee,

employee’s family, human resources department, the receiving medical treatment 

facility, the employee’s home unit, or the incident comp/claims specialist if the 

injury occurred on an incident. The Hospital Liaison is the point of contact for 

supervisory updates and coordinates patient transportation and/or other employee 

needs:

a.Attends to patient needs and advocate for appropriate medical care.

b.Provides logistical support with OWCP and agency forms for proper coding 

and billing.

c.Monitors progress and follow through of patient resiliency, familial 

pressures, and vocational pressures to ensure the most effective care is 

provided through the agency.

d.Participates in After Action Review(s).

e.Participates in Close-Out with SICO and provides pertinent documentation 

and actions associated with incident.

9. Medical Examiner Office Liaison

Position serves to ensure the family’s wishes are being met and agency-specific 

protocols are being followed, from fatality scene, to medical examiner’s office, to 

release of remains to family. If committed to the incident, the Honor Guard typically 

fills this role:

a.Determines which medical examiner’s office remains are being transported 

to and respond safely.

b.Identifies self as the agency’s Medical Examiner Liaison to the family and 

begins to coordinate arrangements as appropriate.

c.Coordinates with Family Liaison to determine any cultural or religious 

requirements that are necessary and provides information to the family 

regarding required autopsy protocols, i.e., Firefighter and Law Enforcement 

Autopsy Protocols and Public Safety Officers’ Benefit (PSOB) requirements.

d.Arranges for private waiting facilities for family and fellow employees to 

assemble, where possible.

e.Coordinates with the Public Affairs Officer to determine need to establish 

media staging and briefing areas, depending upon significance of the event.

f. Confirms the medical examiner’s office is aware that family has arrived and 

facilitates introduction between the family to the medical examiner.

g.Ensures appropriate transportation arrangements have been made for the 

family.
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h.Participates in After Action Review(s).

i. Participates in Close-Out with SICO and provides pertinent documentation 

and actions associated with incident.

10. Funeral Home Liaison

Position serves to coordinate with the Family Liaison and ensure the family’s wishes 

are met regarding agency presence at funeral home. If committed to the incident, the 

Honor Guard typically fills this role:

a.Coordinates with Family Liaison to determine the needs and wishes of the 

family regarding agency presence at the funeral home.

b.Ensures needs and wishes of the family are paramount to those of the 

agency.

c.Coordinates with the funeral home on what to expect from the agency.

d.Coordinates Honor Watch as needed.

e.Participates in After Action Review(s).

f. Participates in Close-Out with SICO and provide pertinent documentation 

and actions associated with incident.

11. Employee Liaison

Position serves to be the primary Point of Contact (POC) to the employees of the 

home unit of the deceased or injured. The principle task is to ensure these 

employees are informed, included, and involved:

a.Determines who the “affected” employees are.

b.Develops an accountability process to track employees and provides 

resources as needed.

c.Determines preferred method (text, email, etc.) And establishes 

communication with affected employees.

d.Participates in SIOF meetings and disseminates information as appropriate to 

the affected employees.

e.Is prepared to answer questions from employees or knows where to get 

answers.

f. Participates in After Action Review(s).

g.Participates in Close-Out with SICO and provides pertinent documentation 

and actions associated with incident.

12. Event Coordinator

Position serves to coordinate services as requested by the family and within agency 

protocols. BLM Honor Guard is typically assigned these duties; however, in the 

absence of Honor Guard these duties will need to be performed by the pre-identified 

event coordinator:
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a.Coordinates with Agency Administrator to determine scope of event, i.e., 

locations, planned transportation, points of contact, etc.

b.Ensures needs and wishes of the family regarding any and all services come 

before those of the agency.

c.Establishes Honor Watch.

d.Works in coordination with the SIOF Commander and Family Liaison to 

determine agency honors for the individual(s).

e.Meets with Family Liaison and family spokesperson to determine the needs 

and wishes of the family regarding agency presence during funeral, 

memorial, wake planning, and facilitation.

f. Determines family’s preference regarding Federal, State, and local 

personnel/dignitary presence as well as their desire for an Honor Funeral to 

be arranged for by the agency.

g.If the family chooses an agency coordinated funeral or memorial service, 

briefs the family members about the procedures involved and the potentially 

large size and scope of a public funeral.

h.Assists family in making contacts regarding arrangements, and accompanies 

them, as appropriate, to services, ceremonies, and other observances.

i. Determines if the family desires a burial in uniform. If so, coordinates with 

the Family Liaison to obtain a uniform along with all accoutrements and 

delivers them to the funeral home.

j. Ensures the employee’s immediate family, including the spouse, children, 

parents, and siblings, receive recognition and that proper placement is 

arranged for them during services.

k.Solicits volunteers to provide this service, if agency ushers are desired by the 

family.

l. Coordinates with SIOF for proper seating of dignitaries attending the funeral, 

speeches by the dignitaries, and/or other arrangements.

m. Coordinates needs and arrangements for any honor ceremonies or special 

memorials. The Funeral Liaison will help facilitate the arrangements and 

coordinate with the financial specialist to obtain approvals, flags, and other 

purchases.

n.Coordinates with local Law Enforcement to advise that many emergency 

vehicles may arrive to participate in the funeral procession. Locates facilities 

with sufficient space for staging these vehicles.

o.Obtains a suitable U.S. flag for draping the coffin. Obtains and coordinates 

an appropriate Honor Guard for events and associated honors.

p.Participates in After Action Review(s).

q.Participates in Close-Out with SICO and provides pertinent documentation 
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and actions associated with incident.

13. Human Resources Coordinator

Position serves to engage all necessary Human Resources Specialists with the family 

to ensure benefits are understood and processed in a timely manner:

a.Determines appropriate human resource contacts for local, state, and national 

offices.

b.Ensures employee’s final timesheet is completed.

c.Contacts OWCP coordinator with initial information on employee death, if 

appropriate. If applicable, obtains Claim Number once issued by OWCP.

d.Coordinates with State Human Resources Specialist for NOC Benefits and 

Retirement notification.

e.Determines any benefits/specialized benefits that may be available to 

deceased employee or family, including processing or assisting with 

processing of death gratuity payment at the local HRO.

f. Maintains continuous coordination with Family Liaison(s), Servicing NOC 

Human Resources Benefits/Retirement Specialist, and OWCP Coordinator to 

share any new status updates, concerns, or relevant information.

g.Ensures all documents related to benefits have been received by appropriate 

specialist.

h.Consolidates all documents in a benefits package for the local unit and 

family.

i. Participates in After Action Review(s).

j. Participates in Close-Out with SICO, and provides pertinent documentation 

and actions associated with incident.

14. SAI Point Of Contact (POC)

Position serves as a liaison with the SAI Team and facilitates needs of the Team to 

complete the investigation in a timely and efficient manner. Please note that the SAI 

Team itself works under a separate delegation and does not work for the SIOF but 

coordinates as necessary with this position:

a.Secures SAI Team facilities and logistical needs.

b.Establishes a preliminary list of employees involved in incident.

c.Provides briefing packet for affected unit.

d.Provides contact information of local/responding Law Enforcement.

e.Coordinates with SIOF Commander on schedule of events.

f. Participates in Close-Out with SICO and provides pertinent documentation 

and actions associated with incident.

15. Logistics Coordinator
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Position serves to logistically support the incident.

a.Scouts and secures facilities for the SIOF Team.

b.Ensures lodging, transportation, and facilities are available for the SIOF 

Team.

c.Scouts and secures potential venues to services if requested by family.

d.Establishes a relationship with each functional area as appropriate and 

maintains a clear line of communication throughout incident.

e.Participates in Close-Out with SICO, and provides pertinent documentation 

and actions associated with incident.

16. Finance Coordinator

Position serves to provide guidance throughout the incident on the appropriate use of 

procurement practices and to provide purchasing support:

a.Establishes a relationship with designated procurement personnel designated 

by the Agency Administrator and maintains a clear line of communication 

throughout incident.

b.Coordinates with appropriate agency budgeting personnel to establish 

appropriate funding authority and communicates to all incident personnel.

c.Determines and advises on best business policies and procedures in relation 

to incident.

d.Tracks and documents all associated expenditures.

e.Participates in After Action Review(s).

f. Participates in Close-Out with SICO and provides pertinent documentation 

and actions associated with incident.

17. CISM Liaison

Position serves to coordinate with the SIOF Commander as necessary with respect to 

the CISM response. This person will be assigned by the CISM Coordinator to the 

SIOF. Please note that the Peer Support Group itself reports directly to the Agency 

Administrator. It does not report directly to the SIOF but coordinates as necessary:

a.Coordinates with SIOF Commander as appropriate.

C. Investigations

The BLM follows the protocol in Departmental Manual (DM) 485 and the Interagency 

Serious Accident Investigation Guide for fire related and non-fire related accidents. For 

serious accidents, the BLM DASHO has authority to determine when an accident requires a 

National Safety Investigation Team. This authority has been delegated to the AD, Fire and 

Aviation for fire-related serious accidents.

A Serious Accident Investigation (SAI) collects and interprets information to help agencies 

understand how and why the accident occurred and to recommend corrective actions that 

change or establish agency policy or mitigate hazards in an effort to prevent future similar 
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accidents. Interagency SAIS are particularly important in that they influence organizational 

and operational change across multiple agencies.

The objective of accident investigation is accident prevention and learning. Information 

from SAIS will only be used by the agencies for accident prevention purposes, not to assign 

blame or serve as the basis for disciplinary action. This is in accordance with Executive 

Order 12196 paragraph 1-201[f] and 29 CFR 1904.36 and CFR 1960, all of which apply 

specifically to Federal employees. Agencies outside the Department of the Interior (DOI) 

should refer to their agency-specific regulations.

1. Serious Accidents

A serious accident is an unplanned event or series of events that resulted in death, 

injury, occupational illness, or damage to or loss of equipment or property. A serious 

accident involves any one or more of the following:

a. One or more fatalities.

b. Three of more personnel who are inpatient hospitalized, for other than 

observation, as a direct result of or in support of operations.

c. Property or equipment damage of $250,000 or more.

d. Consequences that the DASHO or designated agency official judges to 

warrant a SAI.

2. Immediate Actions Needed For Fatality

The following actions should be taken immediately when an employee has died in 

the line of duty and from an accident:

e. Local unit will make efforts to preserve the accident scene for accident 

investigation. Nothing should be removed or disturbed until the scene can be 

reviewed by the SAI Team. If preservation is not possible due to location (i.e., 

traffic accident), the scene should be thoroughly photographed so this 

information can be provided to the SAI Team.

f. Local unit will instruct witnesses not to discuss details of the incident with 

one another until they have been debriefed. Witnesses may prepare notes of 

their recollections of accident details and retain them for reference.

g. National Safety Office or the Fire and Aviation Directorate Safety Manager 

will verify that the BLM Director and DASHO have been informed of the 

accident.

h. Local unit should refer to Appendix 4 for a checklist of Local Unit Initial 

Actions for SAIS and begin to collect information needed by the SAI Team.

i. Local unit should refer to Appendix 4 for a template to prepare a 24 Hour 

Preliminary Report of the accident to send to the DASHO or its designee.

3. Law Enforcement Control Of Accident Scene

Law Enforcement assumes control of accident scenes until the nature of the accident 

is determined. The jurisdictional Law Enforcement agency will release the accident 

scene to local Agency Administrator once the incident is determined to be a 
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workplace accident with no criminal activity suspected.

4. Aviation Accidents

The National Transportation Safety Board (NTSB) has the responsibility to 

investigate all aviation accidents except for military (49 CFR Parts 830 and 831, 

Public Law 106-181, and Federal Management Regulation 102- 33.185). OAS Chief 

of Aviation Safety is typically invited by the NTSB to be a party to the investigation. 

NTSB is still the controlling authority. Policy, including responsibilities and 

procedures concerning DOI aircraft mishaps, are contained in Office of Aviation 

Services (OAS) Departmental Manual 352DM3.

Two Bureau positions may be established to assist the DOI Investigation Team: 1) 

as a selected member of the Investigation Team working directly for the OAS Safety 

Investigator-In-Charge (IIC), or 2) as the Bureau- designated On-Site Liaison to 

coordinate with the OAS Safety Investigator-In-Charge. (Note: In many cases, the 

Bureau will provide only one representative to the Investigation Team, and that 

individual will perform only as a Liaison or as both a Team Member and a Liaison.) 

OAS Chief of Aviation Safety, as the Department’s representative to the NTSB, will 

determine who will participate. The NTSB IIC will then either accept or deny the 

individuals proposed by the Chief, or OAS IIC.

a. The BLM Investigation Team Member:

1) Must be requested by OAS to be an Investigation Team Member.

2) Will be appointed by the BLM Aviation Division Chief (FA-500).

3) Will normally be BLM NAO Safety Advisor, staff member, or SAM.

4) Must not have a personal interest in the mishap.

5) Will work directly with the OAS Safety Investigator-In-Charge (IIC).

6) Is bound by confidentiality regarding all aspects of the investigation and 

preliminary findings and conclusions.

7) Will at no time express opinions of their own or recite opinions of others 

on the Team.

b. The BLM Liaison:

1) Will be appointed by the BLM Aviation Division Chief (FA-500).

2) Will provide on-site coordination and support to the OAS Safety IIC for 

personnel, resources, transportation, office space, communications, etc.

3) Will coordinate and facilitate in and out-briefings with local BLM 

management.

4) Will serve as Liaison between the Investigation Team and local BLM 

management, BLM specialists, and/or Incident Management Team.

5) Will provide the IIC with technical expertise and Bureau organizational 

information.
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6) Will make arrangements for interviews, site visits, document review, etc.

7) Will not conduct interviews or investigative actions unless requested by 

the IIC.

8) Will be bound by confidentiality regarding all aspects of the investigation 

and preliminary findings and conclusions.

9) Will at no time express opinions of their own or recite opinions of others 

on the Team.

10) Must not have a personal interest in the mishap.

5. Law Enforcement Serious Incident Review Team

The death or serious injury of a BLM LEO while in the performance of or on 

account of official duties is considered a Category 1 – Serious Incident and requires 

investigation. (For additional investigation details, see Appendix 2 Enforcement 

LODD Protocol.)

a. Chief, Office of Professional Responsibility

Upon notification of the occurrence of any such incident, the Chief, Office of 

Professional Responsibility (OPR) will immediately assign an officer to 

investigate the incident or to liaise with the lead investigative agency. The 

investigating officer will operate under the direction of the Chief, OPR.

6. Federal Wildland Fire Interagency Investigations

For Federal wildland fire serious accidents involving the U.S. Department of the 

Interior (DOI) and the U.S. Department of Agriculture (DOA), a Memorandum of 

Understanding (MOU) between the two Departments establishes the basis for 

interagency investigation of serious wildland fire-related accidents. It also provides 

information on policy, procedures and timeframes. The MOU states, “Interagency 

investigation teams will include personnel from both Departments.”

a. Serious Wildland Fire Accident

This is an unplanned event or series of events that resulted in death, injury, 

occupational illness, or damage to or loss of equipment or property. For 

wildland fire operations, a serious accident involves any one or more of the 

following:

1) One or more fatalities.

2) Three or more personnel who are inpatient hospitalized as a direct 

result of or in support of wildland fire operations.

3) Property or equipment damage of $250,000 or more.

4) Consequences that the DASHO judges to warrant a SAI.

7. Collateral Investigations

Other agencies such as Law Enforcement, Federal Occupational Safety and Health 

Administration (OSHA), State OSHA, National Institute for Occupational Safety 

and Health (NIOSH), and the Office of Inspector General (OIG) may have a 

jurisdictional responsibility to conduct their own investigations. These investigations 
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are independent and can run concurrently while SAIS are being conducted. Team 

leaders should continue their inquiries and establish a cooperative relationship with 

these other agencies.

D. Critical Incident Stress Management

Critical Incident Stress Management (CISM)6 F

7 is the selection and implementation of the 

most appropriate crisis intervention tactics to best respond to the needs of the situation at 

hand. CISM includes a wide range of activities, including pre-incident education (PIE), 

planning and preparedness, acute crisis intervention, and post-incident follow-up. The 

purpose of CISM is to mitigate the impact of an event, accelerate the recovery process, and 

assess the need for additional or alternative services. Crisis intervention services, which is 

one component of an overall CISM program, is provided through trained and carefully 

selected Peer supporters and licensed Mental Health Professionals (MHPS) who specialize 

in trauma. In the BLM, the standard of care for crisis intervention is delivered through 

Critical Incident Peer Support (CIPS) Groups.

The utilization of CIPS Groups to deliver CISM services has evolved over the last decade. 

The CIPS Group concept has demonstrated its effectiveness as a tool to reduce human 

distress when applied by trained, qualified specialists, including Peers and licensed Mental 

Health Professionals (MHPS) under appropriate circumstances and established Boundaries 

of Competence and Standard of Care.

The intent of the BLM CISM program is to support work-related incidents primarily for 

individuals and groups who work in the area of Fire and Aviation. The program may also 

assist other disciplines as needed.

1. Requesting Critical Incident Support

One risk of crisis intervention is “premature intervention”, which may interfere with 

the natural recovery mechanisms of some people. CISM processes generally start no 

sooner than 48-72 hours after an incident. It is important to allow time for affected 

individuals to disengage operationally and re-connect with family or friends. Once 

this occurs, individuals are typically emotionally ready to benefit from Peer Support.

Early psychological intervention should be based on recognition of need, not strictly 

the occurrence of an event. The BLM does not assemble or maintain CISM Teams, 

and CIPS Groups are not “on-call.” They are assembled at the time of request and 

are comprised of personnel selected to match the backgrounds and experience of 

those involved in the critical incident, i.e., hotshots, helitack, engines, and 

dispatchers.

a. Fire

The Agency Administrator or designee should request CISM through normal 

dispatch channels. The respective Coordination Center (GACC) will make 

contact with the appropriate CISM Coordinator.

 7 For additional CISM information: https://gacc.nifc.gov/cism/index.html
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Not all Geographic areas have formal CISM programs; therefore, the GACC 

will contact the National CISM Coordinator who will facilitate assessment 

and criteria for appropriate response and coordination with the affected 

unit(s). The National CISM Program Manager will facilitate the ordering 

process through the National Dispatch Coordination System. CISM personnel 

(CIPS Groups, etc.) Are to be ordered in the Resource Ordering and Statusing 

System (ROSS) as a mnemonic Technical Specialist (THSP), not with 

overhead mnemonics such as Critical Incident Stress Debriefing (CISD).

b. Non-Fire

State Directors should make requests for CISM services directly to the Deputy 

Director, Fire and Aviation. The National CISM Program Manager will work 

directly with the unit affected and determine the most appropriate level of 

response and facilitate ordering of CISM personnel. Most GACC’s do not use 

the National dispatch coordination system for non-fire events. Notification 

will be made to the State Duty Officer for both fire and non- fire requests 

whenever CISM activities are occurring in their State.
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2. Mobilization Process And Responsibilities

a. Agency Administrator

1) Is responsible for identifying an event as a Critical Incident.

2) Requests Peer Support (CISM) to the appropriate Geographic Area 

Coordination Center (GACC):

i. Provided with a general overview of the situation, GACC works 

with the Geographic Area CISM Coordinator to determine the 

number and types of positions needed.

ii. GACC works with the CISM Coordinator to order support group 

members via the roster function in ROSS. (Note that Critical 

Incident Peer Support Group personnel are to be ordered as THSP 

and not CISD.)

3) Provides the CISM Coordinator with information about the incident. The 

Agency Administrator is responsible for providing a budget code for 

expenses associated with CIPS Group response.

4) Manages information about the Critical Incident, including:

i. Acknowledging to employees that an incident has occurred and 

providing them factual information.

ii. Providing a consistent message to all groups concerning the 

incident.

Critical Incident Agency Administrator or designee 

Contacts Geographic Area Coordination 

Center (GACC)

GACC Contacts CISM Coordinator

CISM Coordinator assesses situation 

and recommends appropriate response 

including date/times and reporting 

location(s)

CISM Coordinator 

Contacts Peer 

Support Group 

Leader, assembles 

Peer Support 

Group and assigns 

a Mental Health 

Professional

CISM Coordinator contacts Agency 

Administrator or designee

CISM Coordinator provides GACC 

with names, dates/times and reporting 

location(s)

GACC creates a “Support Order” and 

fills the request via “Roster” in ROSS so 

not to impact the affected dispatch 

center
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iii. Addressing any employee concerns or rumors that may be 

circulating.

iv. Sharing information about what to expect.

5) Provides support to employees who have experienced trauma, knowing 

they respond best to information, structure, and instructions on what to 

expect next. This includes:

v. Finding out what employees are planning to do with their time 

once they leave work and providing accountability partners.

vi. Coordinating with staff to identify those employees most affected 

by the traumatic event and offering them a quiet place to be, while 

not forcing them to be isolated if they’d prefer to stay with their 

co-workers.

vii. See addition information on reactions after a critical incident 

located on the CISM webpage

6) Provides information to the CIPS Group. This includes making time to 

provide a briefing for the CIPS Group Leader upon arrival.

7) Meets immediate support needs and follows up with staff affected by a 

critical incident or other form of potentially traumatic situation. How and 

when follow-up occurs should always be proportionate to the individual 

situation and the level of distress the employee shows.

b. Local Dispatch Center

1) On behalf of the Agency Administrator, may be responsible for contacting 

the appropriate Great Basin Coordination Center to request Critical 

Incident Stress Management (CISM) Peer Support.

i. Please Note: A resource order should not be placed until the CISM 

Coordinator has received information about the incident from the 

Agency Administrator or designee. The CISM Coordinator will assess 

the situation; determine the appropriate intervention strategy; 

determine dates, times, and locations; and assemble the CIPS Group. 

The CISM Coordinator will provide the information to appropriate 

GACC, who will then request an order from the local unit. The GACC 

will fill the order via Roster in ROSS.

c. Geographic Area Coordination Center

1) Contacts the CISM Coordinator and provides contact information to the 

Agency Administrator or designee from the unit that is responsible for the 

incident.

2) Once the CISM Coordinator has provided the GACC dates and times 

needed and the reporting location(s), the GACC will pass the information 

to the local dispatch center and ask them to create a Resource Order for a 

“CISM Team” in ROSS and place it with the GACC.
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d. CISM Coordinator

The Geographic Area CISM Coordinator is trained and certified crisis 

intervention specialist who has been certified by the International Critical 

Incident Stress Foundation (ICISF) and has been trained and certified in 

strategic response to crisis as well as other crisis intervention practices. The 

CISM Coordinator has been selected by the Geographic Area Coordinating 

Group to provide situational assessment for Agency Administrators, 

Managers, and others to help determine the appropriate response. The CISM 

Coordinator will assist in determining the timing and type of support needed 

for the incident. Tactics are applied at the right time, in the right place, and 

under the right circumstances. The CISM Coordinator will also provide a 

Critical Incident Peer Support (CIPS) Group, which includes the expertise and 

screening requirements of a licensed Mental Health Professional (clinician) 

who is experienced and trained in trauma:

1) In consultation with the Agency Administrator, determines the most 

appropriate crisis intervention strategy (CISM, EAP, etc.).

2) As leaders, they are held to a high standard and must demonstrate respect 

and integrity for what crisis intervention is and is not.

3) If a CIPS Group is needed, identifies CIPS Group Leader, based on nature 

of the incident, affected personnel, time frames, and availability.

4) Determines the number and type of Peer Supporters to respond with the 

CIPS Group.

5) Maintains a roster of licensed and qualified Trauma Specialists 

(clinicians).

6) Maintains an active roster of trained and qualified Group Leaders and Peer 

Supporters.

7) Coordinates with Serious Incident or Fatality (SIOF) and SAI leader and 

provides CIPS Group Leader information.

8) Assigns CISM Liaison, if needed, to SIOF or SAI.

e. CIPS Group Leader Responsibility

1) Oversees the implementation of the elements of the established program. 

These elements include a set Standard of Care and established Boundaries 

of Competence requirements as established by the BLM.

2) Required to keep confidences, be committed to the program, adhere to 

established limits and protocols, stay aware of their boundaries, and seek 

guidance and assistance when appropriate.

3) As a leader, is held to a high standard and must demonstrate respect and 

integrity for what crisis intervention is and is not.

4) Functions as the Liaison between the local unit and the Peer Support 

Group if a dedicated CISM Liaison has not been assigned.
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5) Provides the Team Members with reporting times, lodging, and meeting 

locations.

6) Coordinates with the MHP in determining the appropriate crisis 

intervention tactics to be applied with specific individuals and groups.

7) Allocates Peer Supporters based on background and culture.

8) Coordinates with the group(s) daily when the groups are in multiple 

locations.

9) Provides Incident Business Management duties, such as approving time, 

monitoring work/rest, and driving hours.

10) Keeps the Coordinator/Liaison informed to the status of the assignment 

through daily call(s).

11) Demobilizes resources and provides travel information to 

coordinator/point of contact and dispatch center.

12) Conducts Post-Action Strategic Assessment for all CISM personnel prior 

to demobilization to identify and mitigate emotional distress that may be 

occurring during and after the CISM response. This is often referred to as 

compassion fatigue.

f. Peer Supporter

A Peer is an employee with a professional history, often having historic 

recognition for a background and experience in a “culture” willing to assist or 

support others in times of crisis. Peers come from all different aspects of the 

agency, e.g., Wildland Fire Community; Dispatch, Aviation, and Direct 

Suppression Crews or Modules; Engines and Fire and Aviation Managers; 

Law Enforcement, etc. The best Peers are typically individuals who share 

common backgrounds of those they support:

1) Assists the CIPS Group and MHP in providing crisis management 

briefings, defusings, debriefings, one- on-one support, and information 

sharing as directed.

2) Assists the CIPS Group Leader and MHP in setting up and organizing 

formal meetings (location, seating, refreshments, assemblage of resource 

information and literature at debriefings, etc.).

3) Is self-sufficient (Travel Card or Credit Card).

4) A Peer of fireline personnel are required to have all required Personal 

Protective Equipment (PPE) to meet with affected personnel on the 

fireline, in spike camps, and other remote locations.

Prior to the arrival of the CIPS Group Leader, a Peer may be called on to 

initiate contact with local managers and staff to explain the peer support 

program, gather information, and coordinate logistics.

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informally with those affected or involved with the critical incident.

g. Use Of Mental Health Professional

Prior to any crisis intervention, the CIPS Group leader and the Mental Health 

Professional (MHP) will meet and agree to the appropriate International 

Critical Incident Stress Foundation (ICISF) intervention techniques, format, 

and the roles each will perform during the process.

The role of CIPS Group MHP is to provide affected individuals any 

information the clinician feels appropriate during and after the Peer 

Supporter’s presentations:

1) Addresses any issues which are outside of the Peer Supporter training and

established boundary of competence.

2) Are free to apply their expertise, as they deem necessary.

3) When there is a need for the MHP role to expand (defusings/debriefings), 

the Peer Supporter role will change to one of support as the MHP directs 

the intervention toward the information they feel is essential. The BLM 

requires an MHP during defusings/debriefings.

4) Due to the ad hoc nature and vast, rural areas protected by public land 

management agencies, the MHP should factor in the limited availability of 

any follow-up care (EAP) that might be offered.
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CHAPTER IX. WORKFORCE CONSIDERATIONS

A death in the workplace can feel a lot like a death in the family to employees. It is critical the 

organization communicates quickly, consistently, and with compassion to employees. More than 

ever, employees will rely on leadership’s support in providing a path forward. The following 

summarizes several programs available to support and assist grieving employees through this 

difficult time.

A. Sick Leave/Annual/Administrative Leave

Agency Administrators will coordinate with the State Director to grant members of a 

deceased employee’s “Core Group” administrative leave to deal with the emotions and 

effects of the loss of a colleague.

A unit may ask for outside staff resources to temporarily fill the work roles of affected 

employees. It is important for District Managers and Supervisors to be sensitive and 

understand that association with the scene of an employee death soon after the tragedy can 

adversely affect employees. Providing relief will allow them more time to cope with the 

personal and professional loss and related issues associated with a co-worker’s death.

Prior to authorizing leave, Agency Administrators need to consider any potential conflicts 

with the timing of the leave request and any incoming Review/Investigation Teams, CISM, 

etc. Coordination is required between the SAI Team Lead, Liaison, and Delegating Official 

for the SAIT. While doing everything possible to take care of the effected employees is of 

primary concern, this must be done without neglecting the critical coordination 

responsibility.

Managers are authorized to approve sick leave or annual leave for those bereaved 

employees experiencing difficulty in returning to regular duties.

B. Post-Traumatic Stress Disorder

Those BLM employees associated with the death of an agency employee may experience 

Post-Traumatic Stress Disorder (PTSD). Diagnosis can occur months later. Therefore, it is 

strongly recommended that employees and supervisors file the necessary paperwork 

immediately, as precautionary action, for potentially affected employees (see Notice of 

Occupational Disease and Claim for Compensation Form).

C. Employee Assistance Program (EAP)

The Employee Assistance Program (EAP) offers professional confidential counseling and 

consultation services to agency employees and their families who may need longer term 

care. The EAP provider offers assessment, short- term counseling, and referral services.
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CHAPTER X. BUSINESS PRACTICES

The organizational business practices, as presented below, are intended as a helpful tool in 

supporting the Agency Administrator when allocating agency funding for expenses associated 

with the death of an employee.

PLEASE NOTE: This guide acknowledges that circumstances may, on occasion, call for 

modification. In such cases, the State Director of the state of the incident, in cooperation with 

Deputy Director of Operations, shall determine BLM’s support, funding expenditures, and 

involvement.

A. Transport of Deceased Body

1. Employee Line Of Duty

The body of an employee whose home is in the United States, may be embalmed and 

transported in a hermetically sealed casket to his home or last place of residence at the 

expense of the Employees’ Compensation Fund if—

a. The employee dies from—

1) The injury while away from his home or official station or outside the 

United States; or

2) From other causes while away from his home or official station for the 

purpose of receiving medical or other services, appliances, supplies, or 

examination under this subchapter; and

b. The relatives of the employee request the return of his body.

Under 41 CFR Part 303-70, the preparation and transportation of employee remains for 

those hired under a BLM Hiring Authority (i.e., temporary, permanent full time, career 

seasonals) are allowed when in travel status.

Expenditures shall be charged to the program in which the individual was working at the 

time of the incident. For wildland fire, charge to the specific incident funding code.

For Federal cooperators, state cooperators, and contractors, refer to their employing 

agency.

2. Employee On Duty And Off Duty Death

The agency does not pay for the transport of remains except in situations where the 

employee is in travel status.

B. Escort of Remains

1. Employee Line of Duty

Under 41 CFR Part 303-70.200, the agency can authorize up to two personnel to escort 

the remains of BLM employees and Federal cooperators. State cooperators and 

contractors may be escorted by personnel if authorized by the BLM Deputy Director of 

Operations.
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2. Employee On Duty And Off Duty Death

The agency does not provide escort of remains except in situations where the employee is 

in travel status.

C. Agency Memorial Ceremonies

PLEASE NOTE: This section will address the appropriate use of Federal funds for 

Memorial Ceremonies. Since funeral or memorial services are NOT appropriate use of 

government funds, monetary support of these services is not approved; however, employees 

may help coordinate the BLM involvement if requested by the family.

1. Employee Line of Duty

The agency may expend funds, within reason and with a high level of prudence, at the 

discretion of the State Director, Fire and Aviation (FA) Director, and/or the Deputy 

Director of Operations to hold a memorial ceremony for employees to honor the 

deceased.

Memorial ceremonies may be a part of the funeral/memorial service, such as the indoors 

solemn entry of mourners or the outdoors procession of vehicles. Additionally, memorial 

ceremonies may be an independent or completely different event directed by the BLM 

from the formal funeral/memorial services.

Ceremonies to honor the contributions of deceased employee (whether or not a 

funeral/memorial service) is an important aspect of BLM culture. Such ceremonies are a 

tribute to the families of the deceased and further serve the interest of the BLM. 

Activities to honor the deceased are conducted in a manner that displays an appropriate 

level of respect. Agency Administrators are expected to be fully aware of and approve the 

appropriate amount of Federal resources devoted to the ceremony. The allocation shows 

proper respect for the deceased while reflecting wise and efficient use of government 

funds, property, and employees’ official time.

The cost of the memorial ceremonies, including the planning and execution, should be 

charged to the fund and program where the employee was working when the incident 

occurred. For those incidents where there are interagency implications or uncertainties 

regarding which organization(s) and fund(s) should be charged, the State or National 

office (fire specific) will establish the appropriate charge codes(s).

Authorized expenses for good and services in connection with a memorial ceremony are 

guided by appropriation law. A complete list of allowable or prohibited item when 

planning for these events would be extensive.

Examples of some common requests that are not allowable uses of appropriated funds are 

food, beverages, music (whether live or recorded), floral arrangements, and plants. These 

types of services and supplies are often furnished through private donations

During the ceremony (whether or not a funeral/memorial service), the BLM may present 

to the families of the deceased a posthumous non-monetary award to honor the fallen 

employee. The Government Employees Incentive Awards Act (5USC 4503) is the 
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statutory authority for the award. Limitation on non-monetary awards must be used as 

guidance on what is appropriate for family gifting.

2. Employee On Duty And Off Duty Death

This guide acknowledges that circumstances may, on occasion, call for modification. In 

such cases, the State Director of the state of the incident, in cooperation with Deputy 

Director of Operations, shall determine BLM’s support and involvement.

If appropriate, activities to honor the deceased are conducted in a manner that displays an 

appropriate level of respect. All proposed activities associated with on duty and off duty agency 

support of a memorial ceremony need to be approved in advance by the Deputy Chief of 

Operation.

D. Funeral and Memorial Attendance

1. Employee Line Of Duty, On Duty Death, And Off Duty Death

The appropriate BLM State Director shall provide direction on employee attendance for 

memorial services and funerals of BLM employees authorized to attend in official 

capacity. For those not authorized to attend memorial services and funerals in official 

capacity, managers may allow for liberal leave. Per the Comptroller General, agencies 

have discretion to use appropriated funds for the official travel of an agency 

representative to an employee funeral when it has been determined by a senior official 

that such representation would serve the governmental purpose of sustaining employee 

morale and reinforcing the significance of the deceased to the agency. The Comptroller 

General has not provided guidance on when greater agency representation may be an

appropriate use of agency funds. When circumstances suggest that a greater degree of 

official agency representation may be appropriate, the State Director of the state of the 

incident, in cooperation with Deputy Director of Operations, may determine an 

appropriate level of BLM representation, which serves agency needs, including 

sustaining employee morale, while maintaining the governmental obligation to conserve 

appropriated funds.

Employees attending the funeral or memorial service or ceremony as an official duty 

shall charge their salary and travel to their respective work-related fund and program.

2. Death Of Other Personnel

The appropriate BLM State Director or Deputy Director of Operations will provide 

direction on employee attendance for memorial services and funerals for former or retired 

agency employees. This guide acknowledges that circumstances may, on occasion, 

require the need for further guidance.

In situations involving the death of other agency personnel, e.g., Forest Service, National 

Park Service, etc., the State Director will determine who will represent the BLM at those 

services. An exception is Fire and Law Enforcement. Under 5 U.S.C 6328, a Federal Law 

Enforcement Officer or Federal Firefighter may be excused with supervisor approval 

from duty to attend services and be considered on official duty to attend the services of 

another Federal Fire Fighter or Law Enforcement Officer.

E. Honor Watch
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Honor Watch is an established tradition that ensures the deceased is never left alone from 

the time of death until the interment or at which time the family wishes for it to conclude. 

Honor Watch is an honor that may be carried out by BLM employees. It is not exclusive 

to the Honor Guard and is often recommended to be provided as part of the healing 

process. Honor Watch entails being present at the location of the remains, i.e., scene of 

death, medical examiner’s office, funeral home, or while in transport.

1. Employee Line Of Duty And On Duty Death

Employees who wish to participate in Honor Watch may do so on a volunteer basis or 

official capacity. It is the responsibility of the home unit or the unit to which employee is 

assigned to provide guidance on whether employees can participate in an official 

capacity. In addition, the home unit or unit to which the employee is assigned will 

provide a funding code to charge to. In situations where the funding code is different 

from the home unit and location where incident occurred, the home unit will provide the 

approval and local funding code for employees who choose to participate in Honor 

Watch.

F. Travel of Family Members

1. Employee Line Of Duty Death

Families of deceased employees may not travel at the Federal Government’s expense to 

attend private award ceremonies, memorial services, or other functions not federally 

sponsored (Comp. Gen.B-258216 July 27, 1995).

The BLM may, however, use invitational travel orders to pay the travel costs of a family 

member to attend an agency award ceremony recognizing the deceased employee with a 

posthumous non-monetary award, in accordance with the Government Employees 

Incentives Award Act (5 U.S.C 4503). Invitational travel is limited under federal 

appropriations law to individuals who will be providing a direct service to the agency. 

For this reason, providing invitational travel orders for the deceased employee’s 

immediate family to accept the posthumous award in the employee’s name is an 

allowable exercise of discretion under appropriations law.

2. Employee On Duty And Off Duty Death

The BLM has no authority to expend funds for the travel of family members when an 

employee death did not occur as a direct and proximate result of personal injury sustained 

in the performance of official duties or while in travel status.

G. Additional Support

Up to two BLM employees may be authorized to escort the remains of the deceased 

employee. Refer to Federal Travel Regulations §303-70.600 through §303-70.602.
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H. BLM Funding Matrix – Serious Illness or Injury/Death

NOTE: Funding is subject to change and verification. Casual hires are covered by the 

Federal Employees Compensation Act (FECA) for work related injuries and illnesses, 

including death.

Employee Transportation of 

Deceased

Escort of 

Remains

Memorial 

Ceremony7F

8

Memorial/Funeral 

Attendance

FA & OLES

Memorial/Funeral 

Attendance

Honor 

Watch

EMPLOYEE LINE-OF-DUTY DEATH

BLM

Permanent 

Full Time

Yes 5 U.S.C 8134

41 CFR 303-70.101

Yes, up to 2 

personnel 41 

CFR 303-

70.201

Yes, State 

Director

TBD by State or 

BLM Deputy 

Director of 

Operations

Yes 5 U.S.C.

Section 6328

TBD by 

Home 

Unit

Career 

Seasonal

Yes 5 U.S.C 8134

41 CFR 303-70.101

Yes, up to 2 

personnel 41 

CFR 303-

70.201

Yes, State 

Director

TBD by State or 

BLM Deputy 

Director of 

Operations

Yes 5 U.S.C.

Section 6328

TBD by 

Home 

Unit

Temporary 

Seasonal

Yes 5 U.S.C 8134

41 CFR 303-70.101

Yes, up to 2 

personnel 41 

CFR 303-

70.201

Yes, State 

Director

TBD by State or 

BLM Deputy 

Director of 

Operations

Yes 5 U.S.C.

Section 6328

TBD by 

Home 

Unit

Casual Hire Yes 5 U.S.C 8134

41 CFR 303-70.101

Yes, up to 2 

personnel 41 

CFR 303-

70.201

Yes, State 

Director

TBD by State or 

BLM Deputy 

Director of 

Operations

Yes 5 U.S.C.

Section 6328

TBD by 

Home 

Unit

Federal 

Cooperators

Refer to employing 

agency

Yes, up to 2 

personnel 41 

CFR 303-

70.201

Yes, State 

Director

TBD by State or 

BLM Deputy 

Director of 

Operations

Yes 5 U.S.C.

Section 6328

TBD by 

Home 

Unit

State 

Cooperators

Refer to employing 

agency

Yes, up to 2 

personnel TBD 

by BLM 

Deputy 

Director of 

Operations

Yes, State 

Director

TBD by State or 

BLM Deputy 

Director of 

Operations

Yes 5 U.S.C.

Section 6328

TBD by 

Home 

Unit

Contactors Refer to employing 

agency

Yes, up to 2 

personnel TBD 

by BLM 

Deputy 

 

Yes, State 

Director

TBD by State or 

BLM Deputy 

Director of 

Operations

Yes 5 U.S.C.

Section 6328

TBD by 

Local Unit

 8 Refer to Agency Memorial Ceremonies for additional information
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Employee Transportation of 

Deceased

Escort of 

Remains

Memorial 

Ceremony8

Memorial/Funeral 

Attendance

FA & OLES

Memorial/Funeral 

Attendance

Honor 

Watch

EMPLOYEE OFF-DUTY DEATH & EMPLOYEE ON-DUTY DEATH

BLM

Permanent 

Full Time

No, unless in Travel

Status/Official Duty 

5 U.S.C 8134

41 CFR 303-70.101

No, unless In 

Travel Status 

41 CFR 303-

70.201

TBD by 

State 

Director

TBD by State or 

BLM Deputy 

Director of 

Operations

No, unless in 

travel status 5 

U.S.C.

Section 6328

Not 

Applicable

Career 

Seasonal

No, unless in Travel

Status/Official Duty 

5 U.S.C 8134

41 CFR 303-70.101

No, unless

In Travel Status 

41 CFR 303-

70.201

TBD by 

State 

Director

TBD by State or 

BLM Deputy 

Director of 

Operations

No, unless in 

travel status 5 

U.S.C.

Section 6328

Not 

Applicable

Temporary 

Seasonal

No, unless in Travel

Status/Official Duty

5 U.S.C 8134

41 CFR 303-70.101

No, unless

In Travel Status 

41 CFR 303-

70.201

TBD by 

State 

Director

TBD by State or 

BLM Deputy 

Director of 

Operations

No, unless in 

travel status 5 

U.S.C.

Section 6328

Not 

Applicable

Casual Hire No, unless in Travel

Status/Official Duty 

5 U.S.C 8134

41 CFR 303-70.101

No, unless

In Travel Status 

41 CFR 303-

70.201

TBD by 

State 

Director

TBD by State or 

BLM Deputy 

Director of 

Operations

No, unless in 

travel status 5 

U.S.C.

Section 6328

Not 

Applicable

Federal 

Cooperators

No No No TBD by State or 

BLM Deputy 

Director of 

Operations

TBD by State or 

BLM Deputy 

Director of 

Operations

Not 

Applicable

State 

Cooperators

No No No TBD by State or 

BLM Deputy 

Director of 

Operations

TBD by State or 

BLM Deputy 

Director of 

Operations

Not

Applicable

Contractors No No No TBD by State or 

BLM Deputy 

Director of 

Operations

TBD by State or 

BLM Deputy 

Director of 

Operations

Not 

Applicable

DEATH OF OTHER PERSONNEL

Former or 

Retired 

Employee

Not Applicable Not Applicable No TBD by Deputy 

Director

TBD by State or 

BLM Deputy 

Director of 

Operations

Not 

Applicable
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CHAPTER XI. SERVICES, MEMORIALS, AND CEREMONIES

Services, memorials, and ceremonies give meaning and hope to survivors left behind. They pay 

tribute to those who should be honored for their sacrifice, which may or may not include worship 

or a religious ceremony.

• Funeral Service: An organized event to honor and memorialize a fallen employee, which 

may or may not include a religious service. A funeral is generally organized by the family 

and usually private and less formal. It is not appropriate to use government funds to 

monetarily support these services; however, employees may help coordinate BLM 

involvement if requested by the family.

• Memorial Ceremony: Public recognition of a fallen employee or gathering to honor the 

deceased. These public recognitions may be organized by the BLM or others. The agency 

may expend funds, within reason, at the discretion of the State Director, Fire and 

Aviation (FA) Director, and/or the Deputy Director of Operations to hold a memorial 

ceremony for employees to honor the deceased.

• A Memorial Ceremony may be a part of the funeral/memorial service, such as the indoors 

solemn entry of mourners or the outdoors procession of vehicles. Additionally, memorial 

ceremonies may be an independent or completely different event directed by the BLM 

from the formal funeral/memorial services.

• Memorial Service: An organized event to honor and memorialize a fallen employee, 

which may or may not require a worship or religious ceremony. It is not appropriate to 

use government funds to monetarily support these services; however, employees may 

help coordinate BLM involvement if requested by the family.

A. Respecting The Surviving Family’s Wishes

The wishes of the family(ies) are a priority consideration, including whether or not they 

desire agency involvement in private memorials or funeral services. However, prior to any 

planning or agency involvement, the Family Liaison must obtain concurrence and approval 

from the State Director, the Assistant Director Fire and Aviation or other high-level 

leadership, particularly when appropriated funds will expended.

In any loss of human life, preparation for the Funeral/memorial service or memorial 

ceremony should rely strongly on the family’s wishes. It is not the purpose of this guide to 

suggest mandatory practices when planning for the service or funeral. For instance, if 

protocol suggests sending the full BLM Honor Guard for an employee killed in the line of 

duty, and the family does not want this honor, it will not be used.

B. Agency Administrator’s Responsibility

In the case of a loss of human life incident that requires an SIOF Response Team, the 

memorial service or funeral planning will be managed by the Team, specifically the Event 

Planner, with input from the local unit and the family. This responsibility shifts to the local 

manager when a Team is not involved in the incident.

In situations where the family is holding a funeral or memorial service the agency may only 
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provide BLM employees in the capacity of attendance and planning and may NOT spend 

agency funds for goods or services.

1. Cultural Values

The cultural values of employees and their families must be respected and considered 

during memorial/funeral planning.

2. Attendance Protocols For Line-Of-Duty Death, Employee On-Duty Death, And 

Employee Off–Duty Death

Employee attendance at the funeral or memorial service or ceremony of a co-worker is 

considered appropriate for the purpose of sustaining employee morale, maintaining 

employee productivity, and reinforcing to the BLM and others the significance of the 

deceased to the BLM. Employees attending the funeral or memorial service or ceremony 

as an official duty shall charge their salary and travel to their respective work-related 

fund and program.

The appropriate BLM State Director shall provide direction on employee attendance for 

memorial services and funerals of BLM employees authorized to attend in official 

capacity. For employees who are not authorized to attend memorial services and funerals 

in official capacity, managers may allow for liberal leave. This guide acknowledges that 

circumstances may, on occasion, call for modification. In such cases the State Director of 

the state of the incident, in cooperation with Deputy Director of Operations, shall 

determine BLM representation at the memorial service or funeral.

Employees attending a memorial service or funeral are authorized to wear the BLM 

uniform with concurrence of the family. The Family Liaison will work in consultation 

with the family to determine their wishes and then communicate that to BLM employees.

Under 5 U.S.C 6328, a Federal Law Enforcement Officer or Federal Firefighter may be 

excused with supervisor approval from duty to attend services and be considered on 

official duty.

3. Employee Attendance Attire

All BLM employees should honor the deceased and family by dressing as professionally 

as possible. Business attire or official uniform is recommended.

a. Full Service Uniform: Employees should wear their official uniform:

1) Fire and Aviation: Full service uniform includes official BLM uniform or 

crew shirt and attire.

2) Office of Law Enforcement and Security: BLM Rangers will wear dress 

Law Enforcement uniform of the day as directed by the LEO in charge. 

Special agents will wear suits.

b. Badges: Employees should follow the procedures regarding mourning bands 

on badges:

c. Fire and Aviation: A black elastic banding tape 3/4” wide placed horizontally 

across the middle of the badge will be used. Employees not issued badges may 

wear a 3/8” purple satin ribbon, folded in 1” loop pinned above the nametag.
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d. Hat Protocol: Employees should follow the procedures when wearing their 

hats:

1) When entering the building for a funeral or memorial service, employees 

remove their hats, place them under the left arm with the brim forward, 

and go directly to the area reserved for them. When seated, employees 

place their hats upright in their laps.

2) At the end of the service, employees rise in unison and place their hats 

under the left arm in preparation for filing past the casket or exiting the 

building. They hold their hats in this position until they have passed the 

casket and arrived outside. Once outside, they put on their hats again.

4. Honor Guard Services

Deployment of the Honor Guard may be requested in all line of duty deaths. Initial 

approval to deploy the Honor Guard rests with the BLM Fire & Aviation Honor Guard 

Liaison, in accordance with current honor guard policy, and will be funded by the 

affected BLM unit. The family will be offered a selection of honors they wish to have 

provided with the assistance and guidance of the BLM Honor Guard Liaison, or designee

and the BLM Family Liaison. These may include:

a. Door guards.

b. Casket guards.

c. Color guard.

d. Pallbearers.

e. Flag folding and presentation.

f. Firing party.

g. Bugler/bagpiper.

h. Funeral processions.

C. Flag Lowering Protocols

1. National Lowering: The U.S. flag may be lowered nationally to honor the line of duty 

death of any employee. Authority for national lowering resides with the Deputy 

Director.

2. State Lowering: The U.S. flag may be lowered regionally to honor the line of duty 

death of any employee who was killed accidentally or for an employee missing and 

presumed dead. Authority for regional lowering resides with the affected State 

Director. State Directors from other states where a deceased employee worked 

previously may also approve flag lowering statewide.

3. Email Notification: Upon approval of flag lowering, the Washington Office or 

affected state will use email notification to issue direction.

See Flag Lowering Fillable Templates in Appendix 19.

4. Duration: Half-staffing of the flag begins upon approval by the proper authority and 

concludes after 48 hours. Outside of the authorized lowering of 48 hours, short 
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duration half-staffing is allowed at the specific state or office of the employee on the 

day of interment.
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CHAPTER XII.BENEFITS

When an employee of the BLM dies, numerous programs and benefits for his or her survivors 

will come into play. The application and processing of the many kinds of financial 

compensation, support, and assistance can be complex, even daunting. The following 

summarizes survivor benefits and includes appendix links for more detailed information and 

forms.

A. Unpaid Compensation and Final Time Sheets

Unpaid Compensation consists of the employee’s last paycheck and any remaining available 

annual leave and/or compensatory time off. The Unpaid Compensation (i.e., unused sick 

leave incorporated into an annuity) will not be paid out until the benefits package is 

completed and forwarded from the NOC Operations Benefits Branch.

The BLM National Operations Center (NOC) Benefits Human Resources (HR) Specialist 

will forward the SF- 1153 and SF-1152 to Denver Payroll once it has received the forms 

and a copy of the death certificate. The servicing HR office should work with Denver 

Payroll to make sure that all amendments regarding the employee’s time sheets and any 

requests for converting compensatory time to overtime have been processed before the 

NOC Benefits HR Specialist releases the death in service SF-50 personnel action. Denver 

Payroll will process the employee’s last pay check and distribute this money and any lumpsum annual leave payable into the bank accountant on record.

If a surviving spouse asks the final employment paycheck not to be held for inclusion in the 

Unpaid Compensation payment, request Denver Payroll to process it as normal. As a 

courtesy, inform the surviving spouse of the possibility that a payroll payment sent directly 

to a bank account with only the deceased employee’s name on it, if that is the case, could 

potentially take longer to access than the Denver Payroll’s Unpaid Compensation payment.

For more information, see Appendix 5.

B. Compensation for Missing Employees

An employee determined as missing status as defined in 5 U.S.C. Section 5561 is entitled to 

receive or have credited to the employee’s account, for the period the employee is in that

status, the same pay and allowances to which the employee was entitled at the beginning of 

that period or may become entitled thereafter to include:

1. Basic pay.

2. Special pay.

3. Incentive pay.

4. Basic allowance for housing.

5. Basic allowance for subsistence.

6. Station per diem allowances for not more than 90 days.

7. Annual leave accruals to include that forfeited under Use or Lose (5 U.S.C. Section 

5562).
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8. Within-grade increases.

9. Promotions.

10. Annual pay adjustment.

For more information, see Appendix 6 Missing Employee Benefits.

C. Survivor Benefits

There are numerous benefits available to family and dependents of Federal employees. 

These benefits vary based on each employee’s unique situation.

1. Death Gratuity (Servicing Human Resource Office)

Authority for full administration of the death gratuity is delegated to the level of State 

Director or Center Director. The State Director or Center Director may approve the death 

gratuity payment when presented with clear and convincing evidence that an employee 

sustained an injury in the line of duty that resulted in the employee’s death. If the State 

Director or Center Director does not believe the evidence clearly and convincingly 

establishes entitlement to a death gratuity payment, the State Director or Center Director 

may await a Department of Labor’s Office of Workers’ Compensation (OWCP) 

determination.

Public Law 104-208 Section 651, effective September 30, 1996, gave department and 

agency heads the authority to pay up to $10,000 as a death gratuity to the personal 

representative of a Federal employee who dies from an injury sustained in the line of duty 

on or after August 2, 1990. This includes a department or agency employee who dies 

after separation from service, if the death is the result of any injury sustained in the line 

of duty. It does not include employees whose death is determined to have resulted from 

willful misconduct.

Before the amount of the gratuity can be determined, the following payments must be 

taken into account:

a. $200 payable under 5 U.S.C. Section 8133(f) for reimbursement of the costs of 

termination of the decedent’s status as an employee of the United States (payment 

made through OWCP);

b. Up to $800 payable under 5 U.S.C. Section 8134(a) for funeral and burial 

expenses in cases of employees who died as a result of an injury sustained in the 

performance of duty (payment made through OWCP); and

c. Any amount paid (i.e., $9,000) under Public Law 103-332 Section 312 for the 

Department of the Interior and Related Agencies Appropriations Act, 1995. This 

authority provides for payment of up to a total of

d. $10,000 in reimbursement for burial costs and related out-of-of pocket expenses 

for employees killed in the line of duty in agencies that receive appropriations 

under a Department of the Interior and Related Agencies Appropriations Act for 

fiscal year 1995 and thereafter.

The amount paid under these three authorities, plus the gratuity paid under the new 
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authority, may not total more than $10,000. The gratuity is NOT reduced by any other 

amounts, including other benefits payable under the Federal Employees’ Compensation 

Act.

For more information, see Appendix 7 LODD Death Gratuity Payment

2. Office Of Workers Compensation (OWCP)

The Federal Employees’ Compensation Act (FECA) (5 U.S.C. Section 8101), which is 

administered by the Office of Workers’ Compensation Programs of the U.S. Department of 

Labor, provides compensation benefits to civilian employees of the United States for 

disability due to personal injury or disease sustained while in the performance of duty, as 

well as for payment of benefits to dependents if a work-related injury or disease causes an 

employee’s death.

When an employee dies because of an injury incurred in the performance of duty, the 

supervisor should immediately notify the District Office, and coordinate with the local HR 

OWCP Compensation Coordinator to report to OWCP and obtain a claim number.

PLEASE NOTE: Eligible beneficiaries must elect between survivor’s (OPM FERS 

retirement) benefits and OWCP. It can take OPM months to process a retirement claim.

For more information, see Appendix 8.

3. Employee Retirement Systems Death Benefits

A family member (survivor annuitant) of a deceased Federal employee or annuitant is 

entitled to an annuity under a retirement system established for employees. The widow or 

widower, former spouse (if any), and child(ren) may qualify for a survivor annuity if the 

death occurs while employed and the deceased was subject to the Civil Service 

Retirement System (CSRS) and completed at least 18 months of creditable civilian 

service, or was subject to the Federal Employees Retirement System (FERS) and 

completed at least 10 years of creditable service (see 5 CFR 831 Subpart F; 838, 842, and 

843). If there are no eligible survivor annuitants, there may be a lump sum benefit 

payable.

For more information, see Appendix 9 Employee Retirement Systems Death Benefits

4. Federal Employee Health Benefits

Eligible family (survivors) may continue enrollment in the FEHB program if the decedent 

was enrolled for Self and Family at the time of death and at least one family member is 

entitled to an annuity as a survivor of the deceased employee. Not all survivors who are 

covered under an employee’s FEHB program qualify to continue the FEHB enrollment if 

the employee dies. If the enrollment continues, eligible survivors are entitled to the same 

benefits and government contribution as active and retired employees enrolled in the 

same plan. The survivor annuitant's share of the premiums is normally deducted from 

his/her annuity payments.

For the surviving family members to continue health benefits enrollment, the following 

requirements must be met:
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a. The deceased must have been enrolled for Self and Family at the time of 

death; and

b. At least one family member must be entitled to a survivor annuity.

All survivors who meet the definition of "family member" can continue their health 

benefits coverage under the deceased’s enrollment as long as any one of them is entitled 

to a survivor annuity.

For more information, see Appendix 10.

5. Federal Employee Dental & Vision Program (FEDVIP)

FEDVIP is a Federal dental and vision insurance program that certain survivors may be 

eligible for. It is separate from the FEHB program. For more information, see Appendix 10.

6. Thrift Savings Plan (TSP)

TSP is a retirement savings and investment plan for Federal employees. Any money the 

decedent contributed to the TSP cannot remain in the decedent’s TSP account and will 

need to be distributed to the beneficiary(ies), either through direct payment or, if there is 

an eligible surviving spouse, into a TSP account in the spouse’s name.

There are two ways in which a deceased employee’s TSP contributions could be 

distributed: 1) either through a Designation of Beneficiary, which must be on file (e.g. 

TSP-3 Form) with TSP prior to the employee’s death, or according to the Statutory Order 

of Precedence.

For more information, see Appendix 11 Thrift Savings Plan (TSP).

7. Federal Employee Group Life Insurance Program (FEGLI)

Beneficiaries of employees covered under the Federal Employees’ Group Life Insurance 

(FEGLI) program may be entitled to insurance death benefits. The following are the 

benefits that might be payable to beneficiaries upon the death of an employee:

a. Basic Insurance: Is an amount equal to an employee’s annual salary, rounded 

up to the next thousand- dollar amount, plus $2,000. (A higher amount is 

payable if an employee was under age 45 at the time of death.)

b. Option A: If elected (standard optional insurance), coverage is $10,000.

c. Option B: If elected (additional optional insurance), comes in 1-5 multiples of 

an employee’s salary.

Life insurance benefits are paid in addition to any workers’ compensation, Social 

Security, or Federal retirement pension benefits.

For more information, see Appendix 12 Federal Employees Group Life Insurance 

Program (FEGLI).

D. Specialized Benefits

This section provides an overview of specialized benefits administered by other agencies. 

This overview is not inclusive of all benefits. Benefit eligibility may be dependent on 

military time, firefighter or Law Enforcement status, and various other factors.
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1. Public Safety Officers’ Benefit (PSOB)

The Public Safety Officers’ Benefits Act of 1976, as amended, authorizes the Department 

of Justice, Bureau of Justice Assistance, Office of Justice Programs, to pay a benefit to: 

1) specified survivors of public safety officers found to have died as the direct and 

proximate result of a personal, traumatic injury involving external force sustained in the 

line of duty, and 2) claimant public safety officers found to have been permanently and 

totally disabled as the direct result of a catastrophic injury sustained in the line of duty.

This program provides death and education benefits to survivors of fallen Law 

Enforcement Officers, Firefighters, and other first responders, as well as disability 

benefits to officers catastrophically injured in the line of duty.

The amount of the PSOB benefit for eligible deaths fluctuates with every fiscal year and 

can be determined at the following link, https://psob.bja.ojp.gov/knowledgebase/benefits-by-year/.

It is Federally tax free, but you must check with your state to see if any state taxes may 

apply. This benefit does not affect the eligibility for any other death benefits received:

a. Death Benefit: One-time benefit to eligible survivors whose deaths were the 

direct and proximate result on an injury sustained in the line of duty.

b. Disability: One-time benefit to eligible public safety officers who were 

permanently and totally disabled as a result of a catastrophic injury sustained 

in the line of duty.

c. Education: Support provided for higher education to eligible spouses and 

children of public safety officers who died in the line of duty or were 

catastrophically disabled in the line of duty.

For more information, see Appendix 13 Fire and Law Enforcement Benefits.

2. Veteran Affairs Benefits

There are many different benefits that certain survivors and dependents might be eligible 

for through the Department of Veteran Affairs (VA), such as burial expenses; headstones 

or markers; burial flags; plot internment allowance and in some cases death gratuities; 

educational assistance; life insurance; and many others. Many states also offer benefits to 

eligible survivors and dependents of veterans that are independent of Federal benefits and 

vary by state. If the deceased employee was a Veteran, make sure to refer the survivors to 

the following Veterans Affairs website “I am a Dependent or Survivor” for all benefits 

that they might be entitled to.

For more information, see Appendix 14 Veteran’s Administration (VA) Benefits.

3. Social Security Administration

The BLM as an agency does not administer Social Security Administration (SSA) 

program. The survivor must contact SSA direct.
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Social Security is not just for retirement. There are other benefits available to surviving 

spouses; divorced spouses; school-aged and disabled children; as well as dependent 

parents. Anyone who has worked and paid Social Security taxes has earned benefits for 

his or her family. The amount of work (quarters) needed to make survivors eligible 

depends upon the worker's age at death. For more additional information,

For more information, see Appendix 15, visit the Social Security Administration website, 

or refer to the regional SSA office.

4. Federal Long Term Care Insurance Program (FLTCIP)

Federal Long Term Care is personal care and other related services provided on an 

extended basis to people who need help with specific everyday activities or who need 

supervision due to a severe cognitive impairment. The surviving spouse may be eligible 

to apply for this insurance benefit or may need to contact the carrier to cancel the 

decedent’s policy. There is no time limit for applying for this insurance; however, 

premiums are based on age and will therefore go up with each year.

For more information, see Appendix 16 Federal Long Term Care Insurance Program 

(FLTCIP).
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Benefit 

Program

Administering 

Agency

Permanent Full 

Time Employee

Career Seasonal 

Employee

Temporary 

Seasonal 

Employee

Casual 

Hires

EMPLOYEE LINE-OF-DUTY DEATH

Employee 

Retirement 

System Death 

Benefits (FERS 

or CERS)

Office of 

Personnel 

Management 

(OPM) - Dept. Of 

Interior

X X N/A N/A

Office of 

Workers’ 

Compensation 

(OWCP)

Office of 

Personnel 

Management 

(OPM) - Dept. Of 

X X X X

Office of 

Workers’ 

Compensation 

(OWCP) Burial 

Expense

Depart. Of Labor X X X X

Death Gratuity Dept. Of Interior 

& Dept. Of Labor

X X X X

Federal 

Employee Life 

Insurance 

(FEGLI)

Dept of Interior & 

Dept. Of Labor

Dependent on 

Employee 

Enrollment

Dependent on 

Employee 

Enrollment

N/A N/A

Public Safety Dept. Of Justice 

(DOJ)

Dependent on Dependent on Dependent on Dependent
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Benefit Program Administering 

Agency

Permanent 

Full Time 

Employee

Career 

Seasonal 

Employee

Temporary 

Seasonal 

Employee

Casual Hires

Officers Benefit 

Program (PSOB)

Department of 

Justice (DOJ)

Employee 

Profession & 

Circumstance 

of Death

Employee 

Profession & 

Circumstance 

of Death

Employee 

Profession & 

Circumstance 

of Death

On Employee 

Profession & 

Circumstance e 

of Death

Federal 

Employee 

Health Benefits 

(Health 

Insurance & 

Dental)

Office of 

Personnel 

Management 

(OPM) - Dept. 

Of Interior

Dependent on 

Employee 

Enrollment

Dependent on 

Employee 

Enrollment

Dependent on 

Employee 

Enrollment

N/A

Thrift Savings 

Plan (TSP)

Office of 

Personnel 

Management 

(OPM) - Dept. 

Of Interior

X X N/A N/A

Unpaid Leave Office of 

Personnel 

Management 

(OPM) - Dept. 

Of Interior

X X X N/A

Social Security 

Administration

Dept. Of Labor X X X X

Veterans 

Administration

Veterans 

Administration

Dependent on 

Military 

Service Time

Dependent on 

Military 

Service Time

Dependent on 

Military 

Service Time

Dependent on 

Military 

Service Time
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EMPLOYEE ON-DUTY DEATH & EMPLOYEE OFF-DUTY DEATH

Federal Employee 

Retirement System 

(FERS or CERS)

Office of Personnel 

Management 

(OPM) - Dept. Of 

Interior

X X N/A N/A

Office of Workers’ 

Compensation 

(OWCP)

Office of Personnel 

Management 

(OPM) - Dept. Of 

Interior

X X X X

Federal Employee 

Life Insurance 

(FEGLI)

Dept. Of Interior 

and Dept. Of Labor

Dependent 

on Employee 

Enrollment

Dependent 

on Employee 

Enrollment

N/A N/A

Federal Employee 

Health Benefits 

(Health Insurance 

& Dental)

Office of Personnel 

Management 

(OPM) - Dept. Of 

Interior

Dependent 

on Employee 

Enrollment

Dependent 

on Employee 

Enrollment

Dependent 

on Employee 

Enrollment

N/A

Thrift Savings Plan 

(TSP)

Office of Personnel 

Management 

(OPM) - Dept. Of 

Interior

X X N/A N/A

Unpaid Leave Office of Personnel 

Management 

(OPM) - Dept. Of 

Interior

X X X N/A

Social Security 

Administration

Dept. Of Labor X X X X

Veterans 

Administration

Veterans 

Administration

Dependent 

on Military 

Service Time

Dependent 

on Military 

Service Time

Dependent 

on Military 

Service Time

Dependent 

on Military 

Service Time
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CHAPTER XIII. REMEMBERING AND HONORING

It is important for family, friends, and co-workers that an employee and his or her contributions 

to the agency will not be forgotten. Special considerations should be given to the family on the 

one-year anniversary for remembrance.

A. Temporary Commemoration

Several avenues and methods for remembering and honoring employees can be used 

without the restrictions of permanent memorialization. For example, some State and District 

Offices have established walls or areas where memorial plaques, pictures, and 

commemorative statements are displayed. Some BLM units hold “anniversary” events to 

honor those who died in the line of duty. These events and memorial places allow 

employees to remember their BLM comrades and carry forward the excellence of a program 

or project in their honor. An invitation may be extended to surviving family members to 

attend such events; however, Federal funds may not be used for travel.

B. Permanent Commemoration

A permanent commemoration, such as a monument or interpretive site, is at the discretion 

of the local District Management, who is responsible for ensuring conformity with local 

land use plans and National Environmental Policy Act (NEPA) requirements.

Appropriate funds may be used to build an interpretive site, such as a kiosk, to provide 

information to the public about fire prevention or other guidelines for visitor safety and 

resource protection on BLM-managed land. The names of employees killed in the line of 

duty may be included with appropriate respect and dignity in the display. Follow existing 

guidelines for planning, approving, and funding the construction and maintenance of the 

interpretive site.

C. Retirement of Law Enforcement Shields

Requests must be made in writing to the Director, Office of Law Enforcement and Security 

(OLES), including the name of the employee, badge number, and the requested disposition 

of the shield (burial and/or presentation).

D. State and National Memorials

Consider State and National memorials with various jurisdictions where appropriate.
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APPENDIX 1- DEFINITIONS

Agency Administrator: The BLM manager who has direct line authority over employee activity 

when and where a serious accident occurs.

Beneficiary: A person or persons designated by the employee as recipients of specific death 

benefits.

Benefits: Financial payments made to the named survivor(s).

Critical Incident Peer Support (CIPS): A group of individuals consisting of fire, aviation, and 

possibly other related Peers that includes a licensed Mental Health Professional (MHP) trained in 

crisis intervention that specializes in trauma and is familiar with the wildland fire community. 

The CIPS Group will have a CIPS Group Leader, an MHP, and usually three or four Peer Group 

members. The actual size of the Group depends on the incident, numbers of individuals affected, 

geographic area distances between affected Groups, and the impacts to the event on the local (or 

other) organizations.

Critical Incident Stress Management (CISM): A wide range of various activities, including crisis 

intervention and follow-up, to mitigate the impact of an event and accelerate the recovery 

process.

Designated Agency Safety and Health Official (DASHO): A BLM leader with sufficient 

authority and responsibility to represent effectively the interest and support of the BLM Director 

in the management and administration of the agency occupational safety and health program.

Funeral: An organized event to honor and memorialize a fallen employee, which may or may not 

include a religious service. A funeral is generally organized by the family and usually private and 

less formal. It is not appropriate to use government funds to monetarily support these services; 

however, employees may help coordinate BLM involvement if requested by the family.

Memorial Ceremony: Public recognition of a fallen employee or gathering to honor the deceased. 

These public recognitions may be organized by the BLM or others.

Memorial Service: An organized event to honor and memorialize a fallen employee, which may 

or may not require a worship or religious ceremony. A memorial service also may be an 

organized gathering of employees independent of a private family service or other funeral 

service.

Office of Law Enforcement and Security (OLES): The BLM OLES serves as the focal point to 

provide program guidance and oversight of the Bureau’s law enforcement, security, intelligence, 

counterintelligence/insider threat, and information sharing programs.

Personal Representative: The formally designated executor or administrator of the employee's 

estate under State law. The department or agency head determines who the personal 

representative is for each case.
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Serious Accident Investigation (SAI) Team: A Team assigned to investigate a serious accident 

and to report the accident facts and corresponding conclusions and recommendations.

Serious Incident or Fatality (SIOF) Response Plan: A Plan that supports the activities of the 

Agency Administrator, support services staff, and other involved personnel during a serious 

incident or fatality.

Serious Incident or Fatality (SIOF) Team: A designated Team of individuals tasked with 

managing a SIOF. Depending on the scope of the incident, the SIOF Team can be scaled and 

positions combined to meet needs of the response.

Servicing Human Resources Office or Servicing Personnel Office (SHRO or SPO): The Office 

responsible for personnel actions of the deceased’s unit. The two terms are used interchangeably 

throughout the document.

Survivors: Immediate family members, including spouse; all children, including stepchildren and 

legally- adopted children; parents; siblings; and significant others, as recognized by State law.
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APPENDIX 2 – LAW ENFORCEMENT LODD PROTOCOL

The term "Line-of-Duty Death" (LODD) shall mean the death of a Bureau of Land Management 

(BLM) Law Enforcement Officer (LEO) arising out of and in the performance of that person’s 

assigned duties, including all normal and special assignments as ordered by his or her superiors 

or assignments undertaken while acting as a BLM LEO under laws, rules, directions or 

regulations promulgated by the appropriate employing authority, within or outside of normal 

duty hours.

A. Law Enforcement Incident Notification

1. Notification requirements for incidents involving Law Enforcement personnel 

will be followed. As soon as an LODD is verified, notifications will be made to 

the following:

a. Special Agent-in-Charge (SAC).

b. Office of Law Enforcement and Security (OLES) Duty Officer.

c. State Director.

d. Federal Bureau of Investigation.

e. Appropriate U.S. Attorney’s Office.

f. BLM Public Affairs.

g. Director, OLES.

h. Deputy Director, OLES.

i. Chief of the Office of Professional Responsibility (OPR), OLES

j. Interior Operations Centers (IOC).

k. District/Field Manager.

l. Public Affairs.

m. Other sacs.

2. Other contacts may include:

a. Professional organizations.

b. Concerns of Police Survivors, Inc.

c. Chaplain/Clergy.

B. Roles and Responsibilities

To facilitate consistent and coordinated management of critical incidents, five primary roles 

have been established to perform essential functions during a critical incident response. 

These roles are designated the: 1) Involved LEO, 2) Senior On-Scene LEO, 3) Support 

LEO, 4) Special Agent-in-Charge (SAC), and 5) OLES Duty Officer. Each of these roles 

has a corresponding set of prescribed responsibilities. Because a variety of factors (e.g., 

multi- agency operations, jurisdictional concerns) can influence how a critical incident is 
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managed, the prescribed roles and responsibilities may require adjustment on a case-by-case 

basis. (Refer to General Order 13 Critical Incidents for complete details.)

1. Involved Law Enforcement Officer

An Involved Law Enforcement Officer (LEO) is a BLM officer who has been directly 

involved in a critical incident. Involved leos, unless incapacitated, will:

a. Ensure that the scene is safe.

1) Secure all suspect weapons.

2) Secure all suspects.

b. Render first aid and/or request medical assistance as appropriate.

c. Control the scene.

1) Secure the scene and preserve all evidence (e.g., weapons, vehicles) until 

the arrival of the lead investigating unit.

2) Identify and detain potential witnesses.

d. Notify dispatch.

1) Provide responding Law Enforcement personnel with any information 

necessary to apprehend fleeing suspects and/or to ensure the safety of the 

public.

e. Notify the Special Agent-in-Charge (SAC) or OLES Duty Officer.

f. When it is safe to do so, weapon(s) used by the Involved LEO(s) during the incident 

must be turned over to the BLM’s Senior On-Scene LEO or to other Law 

Enforcement agency personnel designated by the SAC or OLES Duty Officer.

1) Weapons used in the incident must be treated as evidence. To the extent 

possible, maintain all firearms, magazines, and ammunition in exactly the 

same condition they were in immediately after being discharged.

2. Senior On-Scene Law Enforcement Officer

The Senior On-Scene LEO is the highest graded or longest tenured BLM LEO at or 

specifically dispatched to the scene. The Senior On-Scene LEO cannot have been directly 

involved in the critical incident.

The Senior On-Scene LEO will:

a. Ensure that the responsibilities of the Involved LEO(s) have been carried out.

b. Ensure that the essential responsibilities of the Support LEO are carried out until 

such time as the Support LEO arrives on-scene.

c. Assume custody of any weapon(s) used by the Involved LEO(s) during the incident.

d. Firearms and ammunition magazines should be maintained in exactly the same 

condition they were in immediately after being discharged.

e. Assume custody of or safeguard all evidence until the arrival of the lead 

investigating unit.
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f. Ensure government property and the personal belongings of the Involved LEO(s) are 

safeguarded.

g. Remove the Involved LEO(s) from the immediate scene of the incident as quickly as 

possible.

h. Establish Liaison with other involved agencies and serve as the On-Scene BLM 

Representative.

i. Serve as the primary On-Scene Point-of-Contact for the SAC and the BLM Office of 

Professional Responsibility (OPR) Investigator.

3. Support Law Enforcement Officer

The Support Law Enforcement Officer (LEO) is a BLM LEO (or an officer of an allied 

Law Enforcement agency) responsible for providing for the welfare of the involved 

LEO(s). The Support LEO cannot have been directly involved in the critical incident.

The Support LEO will:

a. Ensure that the Involved LEO(s) is not isolated or left alone for any extended period 

of time.

b. Provide for the essential needs of the Involved LEO(s) such as food, water, and 

shelter.

c. Provide for the safekeeping of any personal effects (e.g., badge, credentials, 

uniform, duty belt, wallet) separated from the Involved LEO(s) as a result of medical 

treatment, emergency transport, etc.

d. Transport the Involved LEO(s) to the office or other locations as necessary and 

ultimately home.

e. Serve as the primary point-of-contact for the Involved LEO(s).

1) This will remain in effect through the duration of the Administrative 

Leave period or until relieved of this responsibility by the Involved LEO(s).

f. Ensure that any statements required of the Involved LEO(s) are only given after the 

Involved LEO(s) has been afforded reasonable time to regain composure and is 

capable of understanding his or her rights.

1) The Involved LEO(s) should be advised to consider retaining an attorney 

prior to making any statements to best safeguard his/her personal interests.

2) Provide for the essential needs of the Involved LEO(s) such as food, 

water, and shelter.

4. Special Agent-In-Charge

The Special Agent-in-Charge (SAC) of the state in which the critical incident occurred is 

responsible for overall management of the incident.

The SAC will:

a. Ensure that a BLM Senior LEO, not directly involved in the incident, is immediately 

dispatched to the incident to fulfill the role and responsibilities of the Senior On-
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Scene LEO.

b. Ensure that a Support LEO(s) is immediately dispatched to the incident.

1) If possible, seek the input of the Involved LEO(s) in selecting the Support 

LEO. Ensure that responding LEOs are made aware of all other responding 

LEOs and their assignments.

2) Immediately notify the OLES Duty Officer and the State Director 

regardless of the time of day. Ensure the family of the Involved LEO(s) is 

notified of the incident/status of the Involved LEO.

3) If the Involved LEO is injured, ensure that BLM representative(s) provide 

any necessary assistance to the family (e.g., transportation to the hospital, 

arranging for clergy, etc.).

c. Ensure security is provided for the family if needed or requested.

d. Ensure that the appropriate District/Field Manager are notified.

e. Notify the Federal Bureau of Investigation (FBI) and the appropriate U.S. Attorney’s 

Office.

f. Notify the BLM Public Affairs and establish a media point-of-contact.

g. Coordinate to ensure that only appropriate information is released to the media.

h. Make arrangements for the immediate replacement of weapons surrendered by the 

Involved LEO unless the Involved LEO is exhibiting aberrant behavior or there is 

probable cause to believe the Involved LEO has committed a crime.

i. Identify all BLM support personnel (dispatchers, etc.) Involved in the incident to 

facilitate CIMS response.

j. Ensure that other affected employees (e.g., Field or State Office staff) are kept 

apprised of pertinent details concerning the incident.

5. Office Of Law Enforcement And Security Duty Officer

The Office of Law Enforcement and Security (OLES) Duty Officer is responsible for 

serving as the primary critical incident point-of-contact outside the state in which the 

incident occurred. All incident-related communication outside the state in which the 

incident occurred should be handled by the OLES Duty Officer. The OLES Duty Officer 

is also responsible for providing the SAC with any advice and assistance necessary.

The OLES Duty Officer will:

a. Maintain an incident log of phone conversations, actions taken or requested, 

notifications, etc.

b. Obtain the following information:

1) Description of incident.

2) Date, time, and place of the incident.

3) Name(s), condition, and location of all Involved LEO(s).
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4) Injuries caused and/or received and to whom.

5) Description of any weapon(s) involved, including any used by the suspect(s).

6) Description of any property damage.

7) Description of the Involved LEO(s) activity prior to the incident (e.g., patrol, 

investigation, search, arrest).

8) Name of any person(s) arrested and current custodian(s) of arrestee(s), and list 

of possible offenses to be charged.

9) Identification of other persons witnessing and/or involved in the incident.

10) Involvement of other agencies either in the incident itself or the investigation 

of the incident.

11) Special or extenuating circumstances.

12) Anything else that may be necessary to answer the initial questions regarding 

who, what, when, and where.

c. Notify the OLES Director, OLES Deputy Director, and the Chief, Office of 

Professional Responsibility (OPR).

d. Notify the Department of the Interior Operations Center (IOC).

e. Ensure the following notifications have been completed:

13) State Director.

14) District/Field Manager.

15) Public Affairs.

16) Federal Bureau of Investigation (FBI).

17) U.S. Attorney’s Office.

18) Additional notifications as required (e.g., family, clergy, state/local agencies).

19) Arrangements for CISM services.

f. Telephonically notify the other sacs about the incident.

g. Complete the OLES Serious Incident Report for distribution to the Director, the 

IOC, affected State Director, and all BLM leos.

C. Law Enforcement Serious Incident Review Team

The death or serious injury of a BLM LEO while in the performance of or on account of 

official duties is considered a Category 1 – Serious Incident and requires investigation.

1. Chief, Office Of Professional Responsibility

Upon notification of the occurrence of any such incident, the Chief, Office of 

Professional Responsibility (OPR) will immediately assign an officer to conduct an 

investigation of the incident or to liaise with the lead investigative agency. The 

investigating officer will operate under the direction of the Chief, OPR.
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2. Board Of Review

Line-of-Duty Deaths require examination by a Board of Review (Board). The purpose of 

a Board is to provide a thorough, objective, and timely analysis of an incident to 

determine if the BLM LEOS and officials involved acted in accordance with agency 

policy and procedure; and to assess the adequacy of agency policy, procedure, standards, 

and training as they relate to the incident. The purpose of a board is not disciplinary in 

nature. A Board will not make recommendations for administrative or corrective actions 

that are specific to the employee involved.

3. Membership

The OLES Director has overall responsibility for appointing Board members and 

designating a chairperson to administer Board functions. A Board will have a minimum 

of three members. The composition of a Board will vary according to the nature of the 

serious incident under review and may include representatives from the categories listed 

below or any subject matter experts deemed relevant to the review:

a. LEO assigned to the OLES National Office.

b. SAC or State Chief Ranger from outside the state in which the incident occurred.

c. LEO from another Federal land management agency.

d. BLM manager who has supervised LEOS, attended the Law Enforcement for 

Managers course, and is assigned to a management unit outside the state in which 

the incident occurred.

A Board will always include a BLM Peer LEO selected by the LEO(s) involved in the 

incident under review. If the LEO(s) declines to select a Peer LEO, the OLES Director 

will appoint one with similar duties and grade. A board will not include any individual 

involved in the incident, their supervisors, or witnesses to the incident.

4. Review Procedures

A Board will be convened, in person and/or telephonically, within 30 days of completing 

the investigation of a serious incident. Using all available information, a Board will at a 

minimum: 1) review the facts of the incident; identify applicable requirements of law, 

policy, and procedure; 3) assess overall compliance with those requirements by all 

individuals involved in the incident; 4) assess the adequacy of existing policy, procedure, 

standards, and training as they relate to the incident; and 5) formulate non-disciplinary 

recommendations as necessary.

5. Documentation

A report documenting the review will be completed within 60 days of the conclusion of 

the Board. The report is subject to the review and approval of the OLES Director and will 

address each of the following topical areas separately:

a. Identification of Board members.

b. Brief summary of the serious incident.

c. Scope of employment.

d. Authority and jurisdiction.
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e. Incident analysis, i.e., a presentation of facts.

f. Conclusions, e.g., observations regarding policy, procedure, standards, training as 

they relate to the incident, etc.

g. Recommendations and corrective actions, e.g., prescriptive actions to prevent the 

recurrence of similar incidents, improvement of the handling of future incidents, 

modification of existing policy, procedure, training practices, etc.

1) As necessary, the OLES Director, in consultation with the BLM Director 

and the appropriate State Director and SAC, will ensure target completion 

dates and responsible parties are established for each action being taken in 

response to the recommendations of the Board.

h. Attachments, e.g., copies of relevant investigative reports, witness statements, 

training records, etc.

D. Departmental Serious Incident Review Group

In accordance with DOI policy, all Board reports will be forwarded to the DOI OLES for 

possible review by a Serious Incident Review Group (SIRG). The SIRG process is 

designed to utilize the collective expertise of all the DOI Law Enforcement programs to 

identify and address policy, procedure, or training issues that may have Departmental 

implications. The purpose of a SIRG is not disciplinary in action. A SIRG will not make 

recommendations for administrative or corrective actions that are specific to the BLM 

employees involved.

E. OLES Honor Guard Standard Operating Procedures

Please refer to General Order 44.
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F. OLES Serious Incident Report
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APPENDIX 3 – PROCEDURES FOR DEATH NOTIFICATION

A. Introduction

The purpose of this appendix8F

9 is to help those who must notify survivors of the death of a 

family member due to homicide, an automobile crash, a heart attack, drowning, or other 

sudden and unexpected events. We believe this is the first manual of its type in the nation, 

and my office is proud to cooperate in its preparation and distribution.

1. Death notification is acknowledged to be one of the most difficult tasks faced by Law 

Enforcement Officers and other professionals, because learning of the death of a 

loved one often is the most traumatic event in a person’s life.

2. The moment of notification is one that most people remember very vividly for the rest 

of their life – sometimes with pain and anger.

3. Some survivors hear the news first through the media or a reporter calling, and then 

have flashbacks to that moment for years. Others tell how they were stunned to hear 

the person who was killed referred to as "the body" only minutes after the death.

4. We suggest ways to notify survivors effectively and sensitively, including tips on 

what not to do or say.

5. Notification is an exceedingly important duty. Besides being sensitive, notifiers must 

be prepared in case a survivor goes into shock and requires emergency medical 

treatment.

6. Notifiers also can provide very important information to survivors, including details 

about how death occurred. They can volunteer to notify others and provide other 

invaluable support.

7. The principles described here are simple: Notification should be done in person, in 

time, in pairs whenever possible, in plain language, and with compassion.

The recommended procedures were developed by people with much experience in death 

notification, and with help from survivors who have been through it. As one of the survivors 

put it, “Please remember you are assisting innocent victims of circumstance.”

An adaptation from Tom Miller, Attorney General of Iowa.

B. Basic Death Notification Procedures

These are some of the cardinal principles of death notification. Some of the points overlap 

and all will be refined by the notifier’s experience and judgment.

1. “In person, In time” recommended procedures for death notification

a. Notifications of death should be delivered:

1) In Person.

 9 This appendix was prepared in cooperation with Dr. Thomas L. Bennett, State Medical Examiner, Iowa 

Organization for Victim Assistance (IOVA), MADD/Polk County Chapter and Polk County Victim Services and 

Crime Victim Assistance Division Iowa Department of Justice, Thomas J. Miller Attorney General of Iowa.
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2) In Time.

3) In Pairs.

4) In Plain Language.

5) With Compassion.

2. “In Person”

a. Notifiers should:

1) Always make death notification in person, not by telephone.

2) Provide the survivor with a human presence or “presence of compassion” 

during an extremely stressful time. Notifiers should also help if the 

survivor has a dangerous shock reaction (which is not at all uncommon), 

including helping the survivor move through this most difficult moment.

3) Arrange notification in person even if the survivor lives far away.

4) Contact a Medical Examiner or Law Enforcement department in the 

survivor’s home area to deliver the notification in person.

5) Never take death information over the police radio.

6) Get the information over the telephone, to avoid unintended information 

sharing through the media or private parties. If radio dispatchers start to 

give information over the radio, notifiers should immediately request a 

phone call to relay information.

3. “In Time” – And With Certainty

a. Notifers should:

1) Provide notification as soon as possible, but be absolutely sure that there is 

positive identification of the victim. Notifiers should also alert next of kin 

and others who live in the same household, including roommates and 

unmarried partners.

2) Too many survivors are devastated by learning of the death of a loved one 

from the media. Mistaken death notifications also have caused enormous 

trauma.

3) Quickly gather accurate information pertinent to the notification and be 

sure of the victim’s identity. The notifier should obtain as much detail as 

possible about the circumstances of the death, about health considerations 

concerning the survivors to be notified, and whether other people are 

likely to be present at the notification.

4. “In Pairs”

a. Notifiers should:

1) Always attempt to have two people present to make the notification.

2) Ideally, the notifiers would be a law enforcement officer, in uniform, and 

the medical examiner or other civilian such as a chaplain, victim service 
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counselor, family doctor, clergy person, or close friend. A female/male 

Team often is advantageous.

3) Be prepared for survivor/s to experience severe emotional or physical 

reactions including medical or violent reactions. Notifiers can also support 

one another before and after the notification.

4) Take separate vehicles if possible to allow for emergencies.

5) Plan the notification procedure.

6) Before they arrive, notifiers should decide who will speak, what will be 

said, and how much can be said.

5. “In Plain Language”

a. Notifiers should:

1) Clearly identify themselves, present their credentials, and ask to come in.

2) Ask to move inside and get the survivor seated in the privacy of the home. 

Notifiers should be sure they are speaking to the correct individual and 

offer to tell children separately if that is desired by adult survivors.

3) Relate the message directly and in plain language. Survivors are usually 

served best when they are told what happened with clear text. The 

presence of the notifiers has likely alerted them of a problem.

4) Inform the survivor of the death, speaking calmly and carefully giving any 

details that are available.

5) Begin by saying, “I have some very bad news to tell you,” or a similar 

statement. This gives the survivor an important moment to prepare for the 

shock. Then, avoid vague expressions such as “Sally was lost” or “passed 

away.” Examples of plain language include: “Your daughter was in a car 

crash and she was killed.” “Your husband was shot today, and he died.” 

“Your father had a heart attack at his work place, and he died.”

6) Call the victim by name, rather than “the body”.

7) Patiently answer any questions about the cause of death, the location of 

the deceased’s body, how the deceased’s body will be released and 

transported to a funeral home, and whether an autopsy will be performed. 

If you don’t know the answer to a question, don’t be afraid to say so. Offer 

to get back to the survivor when more information is available, and be sure 

to follow through.

8) Understand that there are few consoling words that survivors find helpful, 

but it is always appropriate to say, “I am sorry this happened.”

6. “With Compassion”

a. Notifiers should:

1) Remember that their presence and compassion are the most important 

resources that they bring to the death notification. Survivors bear the 
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burden of inevitable responsibilities. Notifiers can help them begin to 

move through the mourning and grieving process by providing immediate 

direction in dealing with the death.

2) Accept the survivor’s emotions and their own. It is better to let a tear fall 

than to appear cold and unfeeling. Notifiers should never try to “talk 

survivors out of their grief” or offer false hope and should be careful not to 

impose their own religious beliefs upon the survivors.

3) Not use phrases such as: “It was God’s will,” “She led a full life,” and “I 

understand what you are going through” (unless the notifier indeed had a 

similar experience)

4) Plan to take time to provide information, support, and direction. Notifiers 

should never simply notify and leave.

5) Not take a victim’s personal items with them at the time of notification. 

Survivors often need time, even days, before accepting the victim’s 

belongings. Eventually, survivors will want all items, however. (A 

victim’s belongings should never be delivered in a trash bag.) Notifiers 

should tell survivors how to recover items if they are in the custody of law 

enforcement officials.

6) Give survivors helpful guidance and direction.

7) Offer to help contact others who must be notified and offer to call a friend 

or family member who will come to support the survivor. The notifiers 

should stay until that individual arrives.

8) Transcribe important details as survivors may have a hard time 

remembering what is done and said. For example, notifiers can note the 

names of all family who are contacted.

9) Inform the survivor of any chance to view the deceased’s body.

10) Be available to transport the survivor or representative for identification of 

the victim, if necessary. Explain the condition of the deceased’s body and 

any restrictions on contact that may apply if there are forensic concerns. If 

appropriate, explain that an autopsy will be done.

11) Offer the surviving loved one the choice to view the deceased employee. 

The notifier should provide accurate information in advance to help a 

survivor make that decision. Some survivors will choose to see the body 

immediately, and this should be allowed if possible. (Denying access to 

see the body is not an act of kindness.)

12) Provide other specific information.

13) Fill out and keep the “Survivor Intake Form” located in this document. 

This form records basic information about survivors and their wishes. The 

notifier should complete the form, sign it, and keep it with the report or

investigation file.

C. Follow-Up
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a. Notifiers should:

1. Always leave a name and phone number with survivors. Most survivors are 

confused, and some might feel abandoned after the initial notification. They may 

need clarification or additional direction on arrangements that are necessary.

2. Plan to make a follow-up contact with the survivor the next day. Following up can 

be the last step in completing a “person-centered” and sensitive death notification 

that is truly helpful to survivors. The notifiers should be sure they are clear on any 

follow-up assignments they need to carry out.

3. If the death occurred in another county or state, the notifier should leave the name 

and phone number of a contact person at that location.

D. Death Notification in The Work Place

1. Survivors may be notified at their work place. Here are several tips to help apply 

the basic principles described above to a work place notification:

2. Ask to speak to the manager or supervisor, and ask if the person to be notified is 

available. It is not necessary to divulge any details regarding the purpose of your 

visit.

3. Ask the manager or supervisor to arrange for a private room in which to make the 

notification.

4. Follow the basic notification procedures described above, e.g., in person, in time, 

in pairs, in plain language, with compassion.

5. Allow the survivor time to react and offer your support.

6. Transport the survivor to his or her home, or if necessary to identify the body.

7. Let the survivor determine what he or she wishes to tell the manager or supervisor 

regarding the death. Offer to notify the supervisor, if that is what the survivor 

prefers.

E. Death Notification in A Hospital Setting

1. Law Enforcement Officers and Medical Examiners may be called on to do death 

notification at a hospital after an accident or a shooting, for example:

a. It is a very good idea for hospitals and other officials to determine general 

procedures and protocols in advance, so all parties are familiar with their 

duties and roles.

2. The principles of death notification described above all apply in the hospital 

setting. Here are a few points to be sure to remember:

a. Find a quiet room for the notification and be sure survivors are seated. (Do not 

notify in a crowded hall or waiting room.)

b. Arrange for a doctor to be present or available shortly to answer medical 

questions. Doctors should be in clean uniform.

c. Inform simply and directly. Provide assistance and guidance:
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1) Ask if survivors wish to spend time with the body of the deceased.

2) Explain the procedure, if identification of the deceased is necessary. 

Explain about autopsy or organ donation, if appropriate.

3) Volunteer to help notify others. Make a list of any calls made.

4) If there are media calls, refer them to the investigating officer or, if 

available, a victim service advocate.

5) Do not leave survivors alone. Be sure someone is there to accompany 

them.

6) Fill out the Survivor Intake Form below for your records. Be sure the 

survivor has your name and number.

7) Contact the survivor the next day.

F. General Information on How Survivors Respond To Death Notification

1. Physical Shock

Persons learning of the death of a loved one may experience symptoms of shock such as 

tremors and a sudden decrease in blood pressure.

Shock is a medical emergency; help should be summoned. Some of the factors that affect 

stress reactions are:

a. The intensity of the event, e.g., violent death vs. Heart attack

b. The survivor’s ability to understand what’s happening.

c. The survivor’s equilibrium.

d. Whenever possible, notifiers should be aware of any available background 

information about the survivors, including medical or emotional history.

2. Other General Reactions To Death Notification

Even if there is no physical shock response, death notification must be considered a crisis 

for the survivors. They will have a need to express feelings for calm and reassuring 

authority, for help in determining what happens next, and to begin restoring control by 

making some choices, e.g., naming a support person to call or selecting a funeral home.

These needs can be met through the humane, patient, and non-judgmental approach of 

notifiers. 

Allow survivors to express their grief freely. Take the time to give them adequate 

information about the death and about official procedures subsequent to the death.

Many survivors, regardless of background, find themselves numb and unable to take the 

next step. This is where the support person helps the most. Survivors need support 

persons to help them through the initial crisis. Before you leave a survivor, make sure 

such ongoing support is available.

The Survivor Intake Form below has suggestion that will help with this process.
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G. “Debriefing” For Death Notification Volunteers and Professionals

Members of a Notification Team should meet as soon as possible to debrief the situation:

• Double-check who is responsible for any follow-up tasks to help ease the pain and 

suffering of survivors.

• Review the notification: what went wrong, what went right, how it could be done 

better in the future.

• Share personal feelings and emotions of the Notification Team.

• Death notifications are, without a doubt, stressful and difficult and sometimes very 

depressing.

• Be frank and honest. Share your concerns with one another. Discuss any feelings 

Team Members have about the death and notification. For example, the notification 

experience may have triggered emotions and stress related to a notifier’s own loss of 

a loved one.

• Support one another.

H. Survivor Intake Form (Fillable Form)

See Survivor Intake Form (Appendix 19)
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APPENDIX 4 – LOCAL UNIT INITIAL ACTIONS AND PREPARING FOR 

SERIOUS ACCIDENT INVESTIGATIONS

The Agency Administrator is responsible to immediately initiate actions which provide effective, 

efficient, and timely leadership in critical incidents within their jurisdiction. The Agency 

Administrator should determine the scope of the accident, the jurisdictions involved, and other 

affected agencies. The Agency Administrator should also implement the unit’s Emergency 

Response Plan.

A. Initial Actions

Implement Local Emergency Response Plan and Initiate the Following Actions:

☐ Provide for and emphasize the treatment and care of survivors, coworkers, and their families.

☐ Ensure that any rescue/response is activated and can be conducted safely and do not further 

endanger emergency responders.

☐ Account for all injured or missing personnel and/or damaged equipment.

Determine scope of the incident, identify the involved jurisdiction, and implement initial actions.

☐ Secure and document the accident site to preserve the evidence and protect personal and 

government property ☐ Gather and verify initial information (see next section below for additional details).

☐ For agency employees from your unit:

Obtain victims personal emergency notification information and make notification to next of 

kin. For off-unit or other agency employees:

C i t ith ff it i ti ’ h d t t ti

☐ In case of serious injury or death to a Native American, immediately contact the home Tribal 

Leadership for Cultural considerations.

☐ Implement reporting/notification procedures.

☐ Ensure that communications are controlled to guarantee privacy of names until the next of kin 

are notified

☐ The Agency Administrator should inquire from the witnesses if any photographs were taken of 

the accident event. If the witnesses have photos/videos, they should be encouraged to share 

those with the SAI Team. (To maintain the integrity of the investigation and to protect the 

id tit f l i l d i th id t it h ld b i f d t f i f 

☐ When off-unit employees are involved, the Agency Administrator should personally contact the 

Agency Administrator for the victim’s home duty station with as much information as possible, 

including names and telephone numbers of contacts Gather, Verify, and Record Initial Accident Information:

Who Full name of victims, including 

nickname.

When Approximate time and date of 

Where Location of accident (closest 

town, jurisdiction, notification 

protocols other geographic 

What Damage, Injuries, Fatalities.
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B. Notifications

As soon as serious accident is verified and after the initial response, notification of the 

incident should proceed to the groups and individuals listed immediately below. Local Units 

should follow established notification processes within their State, and States should follow 

notification established by the National Office.

1. Agency Specific:

a. Local Unit to State Office (based on State-determined notification process).

b. State Office to National Office.

2. County Sheriff or local Law Enforcement as appropriate to jurisdiction.

3. Agency Law Enforcement.

4. Responsible Safety Manager.

5. Servicing Personnel Office.

6. Public Affairs.

7. OSHA Notification 

Follow agency protocols for OSHA notification within 8 hours of the accident and

provide them with the following information:

a. Name of Local Unit.

b. Location and Zip Code of Incident.

c. Time of Incident.

d. Numbers of Fatalities and/or Hospitalized Employees.

e. Your Contact Person and Contact Information.

f. A Brief Description of Incident.

g. Inform them that an Agency SAI Team is Enroute.

C. Preparing For the SAI Team

1. Scene Protection

Upon completion of rescue and medical assistance of any survivors, the scene must be 

secured. This may be done by Law Enforcement; however, it may be done by any 

responsible person under the direction of the Agency Administrator. The scene must 

remain secure until released by the Accident Investigation Team. Methods to secure the 

site:

a. Ropes.

b. Barrier Tape.

c. Cones.

d. Signs.

e. Flashing Lights.

f. Posted guards.
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g. Flagging.

h. Do not move equipment, shelters, or any other items at the scene. Do not walk 

around the scene unless it is necessary for rescue and medical assistance. Do not 

collect evidence at the scene unless it is in danger of disappearing. Try to contact the 

Team Leader or Chief Investigator if you think it is necessary to remove evidence 

from the scene. Photograph the scene (video or stills) if evidence could be lost 

before the Accident Investigation Team arrives.

2. Documentation

The Following are types of documents that should be collected in preparation for the 

arrival of the SAI Team:

a. Radio Logs (written and recorded).

b. Dispatch Logs.

c. Occupant Emergency Plans.

d. Maps.

e. Risk Assessments.

f. Safety Briefings.

g. Employee Training Records.

h. Medical Examination Records.

i. Qualifications/Certificates.

j. Timesheets for at least Two Pay Periods (current and before the accident).

k. Equipment Maintenance Records.

l. Equipment Performance Tests.

m. Inspection Documents.

n. Remote Automated Weather System (RAWS) Information.

o. Weather (forecast/conditions).

p. Delegation of Authority.

q. MOU/Agreements.

r. Specifications/Drawings.

s. Press Releases.

t. 911 Dispatch Log.

u. Witness Statements.

v. Photos, Videos, Recordings.

w. Internal Policies/Guidelines.

x. Unit Safety Plan.

3. Fire Specific
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The following is a list of specific fire-related documents that should be collected:

a. Fire Behavior/Weather Observations.

b. Incident Complexity Analysis.

c. Documented Risk Management Process.

d. Recent Fire Assignments.

e. Fire Management Plan.

f. Incident Organizer.

g. Incident Action Plans/Personnel Lists.

h. Fire Qualifications (consult with appropriate IQCS managers regarding Incident 

Qualifications Cards).

i. Team Briefings.

j. Work Capacity Test Results.

k. Prescribed Fire Documents.

4. Witness Statements

Identify witnesses for the Serious Accident Investigation Team. Have the witness(s) write 

a statement in their own words, including:

a. Name, Work Address, and Phone Number.

b. Time and Location of Events.

c. Description of the Sequence of Events Leading Up to Accident.

d. Environment (weather, lighting, temperature, noise).

e. Positions of People, Equipment, Material, as well as Witness(s).

f. What has been Moved, Repositioned, Turned Off or on, or Removed from Scene.

g. What Actions Witness(s) Took at Accident Site.

h. Other Witnesses or Involved People.

5. SAI Team Administrative Support

The Serious Accident Investigation (SAI) Team will need the following:

a. A person to serve as a Local Unit Liaison, including phone numbers and fax 

numbers. (The Liaison should not be directly or indirectly involved in the accident.) 

This person is identified in the Local Unit SIOF Plan.

b. Lodging/meeting place to include private interview rooms and work space.

c. Office supplies (including flip charts, markers):

1) Documentation Supplies.

2) Shredder (or access to).

3) Fax.
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4) Computers with Internet Availability.

5) Printers (or access to).

6) Speaker Phone.

7) Copier.
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APPENDIX 5 – UNPAID COMPENSATION, TIMESHEETS, AND QUICKTIME

A. Overview

Denver Payroll will process the employee’s last pay check and distribute this money and 

any lump-sum annual leave payable. The) NOC BEBS will forward the SF-1153 and SF1152 to Denver Payroll once they have received the forms and a copy of the death 

certificate. You will need to work with Denver Payroll to make sure that all amendments 

regarding the employee’s timesheets and any requests for converting compensatory time to 

overtime have been processed before NOC BEBS releases the death action.

B. Unpaid Compensation

Unpaid Compensation usually consists of the employee’s last paycheck and any remaining 

available annual leave and/or compensatory time off. Form SF-1153 needs to be completed 

and forwarded to the Denver Payroll Office along with a copy of the death certificate. The 

Unpaid Compensation will not be paid out until the benefits package is completed and 

forwarded from NOC BEBS. If a surviving spouse is in need of the final paycheck, request 

that Denver Payroll not hold the final paycheck, but allow it to process as normal. Be 

advised that a payment that is sent to a bank account that only has the deceased employee’s 

name on it might take longer to access than if Denver Payroll was to hold it until it could be 

paid out with the Unpaid Compensation payment.

C. Annual Leave Lump-Sum Payment

An employee will receive a lump-sum payment for any unused annual leave when he or she 

separates from Federal service or enters on active duty in the U.S. Armed Forces and elects 

to receive a lump-sum payment. Generally, a lump-sum payment will equal the pay the 

employee would have received had he or she remained employed until expiration of the 

period covered by the annual leave.

OPM Lump-Sum Payments for Annual Leave; 5 U.S.C. Section 5551 and 6306; and 5 CFR 

part 550, subpart L

D. Compensatory Time

Compensatory time is time off earned in lieu of overtime pay. A deceased employee may 

have unused compensatory time off available.

A non-exempt, deceased employee automatically pays out at the overtime rate.

An exempt, deceased employee may be paid out at the discretion of the head of the agency 

(recommend approval to pay out all unused compensatory time for exempt employees at the 

time of death.)

Complete the Client Interface Manual Appendix Form A-02. Authorization for expired 

compensatory time is to be paid as overtime for the exempt employee.

5 USC 5543, and 5342(2) and 5 CFR 550.114 and 551.531.

E. Travel Comp Time

Travel compensatory time may not be paid out at an employee’s death. 5 CFR 550.1408

states, “As provided by 5 U.S.C. Section 5550b(b), an individual may not receive payment 

under any circumstances for any unused compensatory time off he or she earned under this 

subpart. This prohibition against payment applies to surviving beneficiaries in the event of 

the individual’s death.” Because travel compensatory time cannot be paid out, there is no 

difference between FLSA exempt and non-exempt employees.
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F. Time-Off Awards

5 CFR 451.104(f) “A time-off award granted under this subpart shall not be converted to a 

cash payment under any circumstances.”

G. Cash, Honorary and/or Informal Recognition Awards

5 CFR 451.104(e) “An award may be granted to a separated employee or the legal heir(s) or 

estate of a deceased employee.”

H. How to Record Date of Death on Timesheet

If the employee died on a regularly scheduled work day, code 010 regular hours worked for 

all hours regularly scheduled to work on that day, as long as the employee was in a pay 

status at the close of business on the last day of the preceding administratively established 

workweek. Code DE on last timesheet in QuickTime.

B-52981, October 31, 1945, 25 Comp. GEN. 366

I. Missing In Service

An employee who is determined to be in a missing status as defined in 5 U.S.C. Section 

5561 is entitled to receive or have credited to his account, for the period he is in that status, 

the same pay and allowances (as defined in 5

Section 5561) to which he was entitled at the beginning of that period or may become 

entitled thereafter to include:

1. Basic pay.

2. Special pay.

3. Incentive pay.

4. Basic allowance for housing,

5. Basic allowance for subsistence

6. Station Per Diem allowances for not more than 90 days.

7. Annual Leave accruals to include that forfeited under Use or Lose (5 U.S.C. Section 

5562).

8. Within-Grade increases.

9. Promotions.

10. Annual pay adjustments expiration of benefits payable to a missing employee (5 

U.S.C. Section 5562).

These entitlements end on the date of:

1. Receipt by the head of the agency concerned with evidence that employee is dead, or

2. Death prescribed or determined under 5 U.S.C. Section 5565.

The entitlements do not end on:

1. The Expiration of the Term of Service or Employment of an employee while he/she 

is in a missing status, or

2. Earlier than the dates prescribed in the above.
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Therefore, while an employee is in a missing status, they will continue to get paid while in that 

status.

No career seasonal (furlough) employee shall be placed into a non-pay status during the period 

of missing status but will continue to be coded as 010 regular hours worked.

If an employee in a missing status is still in that status at the end of his/her appointment limit 

date, the appointment shall be extended to a period of 12 months from the date of the missing 

status, and the missing employee will continue to be coded as 010 regular hours worked until 

either requirement for the expiration of benefits as described above is met.

J. References and Links

1. 5 CFR Chapter 1, Section 178.204

2. Client Interface Manual

3. 5 U.S.C. Sections 5561-5569

K. Forms

1. SF-1152, Designation of Beneficiary – Unpaid Compensation of Deceased Civilian 

Employee.

2. SF-1153, Claim for Unpaid Compensation of Deceased Civilian Employee.

3. Authorization for Expired Compensatory Time to be paid As Overtime for the 

Exempt Employee.

4. Deceased Payment Packet Checklist.
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APPENDIX 6 – MISSING EMPLOYEE BENEFITS

A. Designation of Authority

Under this BLM policy, the State Director is appointed the designee authorized to 

administer, in full, 5 U.S.C. Subchapter VII, Payments to Missing Employees

B. Authority

1. Section 5566 (A) (1-5) Agency Determinations

The State Director is delegated the authority to make any determination necessary to 

administer 5 Subchapter VII Payments to Missing Employees, and when so made it is 

conclusive as to:

a. Death or finding of death.

b. The fact of dependency under this subchapter.

c. Any other status covered by this subchapter.

d. An essential date, including one on which evidence or information is received by 

the head of the agency concerned.

e. Whether information received concerning an employee is to be construed and 

acted on as an official report of death.

2. Section 5566 (B-D)

When the State Director receives information that he/she considers to conclusively 

establish the death of an employee, he/she shall take action thereon as an official report 

of death, notwithstanding an earlier action relating to death or other status of the 

employee.

“Conclusively Established” includes the following:

a. Death Certificate, or

b. Body of the deceased.

After the end of 12 months in missing status prescribed by section 5565 of this title, the 

Agency Administrator shall make a finding of death when he/she considers that the 

information received or a lapse of time without information establishes a reasonable 

presumption that an employee in a missing status is dead.

The Agency Administrator may determine the entitlement of an employee to pay and 

allowances under this subchapter (including credits and charges in his/her account) and 

that determination is conclusive.

When circumstances warrant the reconsideration of a determination made under this 

subchapter, the Agency Administrator may change or modify it.

C. Agency Review – Establishing Date of Death

1. Section 5565 (A-C). Agency Review
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When an employee has been in a missing status almost 12 months and no official report 

of his/her death has been received, the State Director shall have the case fully reviewed. 

After that review and the end of 12 months in a missing status, or after any later review 

which shall be made when warranted by information received or other circumstances, 

the State Director may:

a. Direct the continuance of his/her missing status, if there is a reasonable 

presumption that the employee is alive, or

b. Make a finding of death.

When a finding of death is made, it shall include the date death is presumed to have 

occurred for the purpose of the ending of crediting pay and allowances and settlement of 

accounts. That date is:

a. The day after the day on which the 12 months in a missing status ends, or

b. A day determined by the head of the agency concerned or his designee when the 

missing status has been continued under subsection (a) of this section a

determination under this section made by the State Director is conclusive on all 

other agencies of the United States.

D. Entitlements

1. SEC. 5562 Pay And Allowances

An employee who is determined to be in a missing status as defined in 5 U.S.C. Section 

5561 is entitled to receive or have credited to his account (for the period he is in that 

status) the same pay and allowances (as defined in 5 Section 5561) to which he/she was 

entitled at the beginning of that period or may become entitled thereafter to include:

a. Basic pay.

b. Special pay.

c. Incentive pay.

d. Basic allowance for housing.

e. Basic allowance for subsistence.

f. Station per diem allowances for not more than 90 days.

g. Annual leave accruals to include that forfeited under Use or Lose (5 U.S.C. 

Section 5562).

h. With-in-grade increases.

i. Promotions – evaluated on a case-by-case basis to determine completion of 

specialized experience requirements.

j. Annual pay adjustments.

2. Duration Of Entitlements

a. Expiration of Benefits Payable to a Missing Employee (5 U.S.C. Section 5562)

1) These entitlements end on the date of:
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i. Receipt by the head of the agency concerned of evidence that the 

employee is dead (conclusively established), or

2) Death prescribed or determined under 5 U.S.C. Section 5565.

3) The entitlements do not end on:

i. The expiration of the term of service or employment of an employee 

while he is in a missing status, or

ii. Earlier than the dates prescribed in the above.

iii. If a death certificate is not issued or a body is not recovered, the 

employee will remain in a missing status for 12 months from the date 

in which he/she went missing. All pay and allowances will continue 

during that 12-month period.

3. Settlement Of Accounts

5 U.S.C Sec. 5567 gives the head of the agency concerned or his designee the authority 

to settle the accounts of a missing employee for whose account payment has been made 

under 5 U.S.C. Sections 5562, 5563, and 5565. This policy delegates this authority to 

the Authorized Officer.

Any payments or settlements of an account made pursuant to a report, determination, or 

finding of death may not be recovered or reopened because of a later report or 

determination which fixes a date of death. However, an account shall be reopened and 

settled on the basis of a date of death so fixed which is later than that used as a basis for 

earlier settlement.

4. Administrative Procedure

Therefore, while an employee is in a missing status, they will continue to get paid while 

in that status.

No subject to non-pay employee shall be placed into a non-pay status during the period 

of missing status but will continue to be coded as 010 regular hours worked.

If an employee in a missing status is still in that status at the end of his/her appointment 

limit date, the appointment shall be extended to a period of 12 months from the date of 

the missing status, and the missing employee will continue to be coded as 010 regular 

hours worked until either requirement for the expiration of benefits as described above 

is met.

5. Other Entitlements Available

The State Director has the authority to administer all additional entitlements related to 

missing employees under Title 5 U.S.C. Subchapter VII.
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APPENDIX 7 – LODD DEATH GRATUITY PAYMENT

A. Overview

Public Law 104-208 Section 651, effective September 30, 1996, gave department and 

agency the authority to pay up to $10,000 as a death gratuity to the personal representative 

of a Federal employee who dies from an injury sustained in the line of duty on or after 

August 2, 1990. This includes a department or agency employee who dies after separation 

from service, if the death is the result of any injury sustained in the line of duty. It does not 

include employees whose death is determined to have resulted from willful misconduct.

The payment of the death gratuity, as provided in statute, will be made from appropriated 

funds.

Before the amount of the gratuity can be determined, the following payments must be taken 

into account:

1. $200 payable under 5 U.S.C. Section 8133(f), for reimbursement of the costs of 

termination of the decedent’s status as an employee of the United States (payment is 

made through OWCP).

2. Up to $800 payable under 5 U.S.C. Section 8134(a), for funeral and burial expenses 

in cases of employees who died as a result of an injury sustained in the performance 

of duty (payment is made through OWCP).

Any amount paid under Public Law 103-332 Section 312, the Department of the 

Interior and Related Agencies Appropriations Act, 1995. This authority provides for 

payment of up to $10,000 in reimbursement for burial costs and related out-of-of 

pocket expenses for employees killed in the line of duty in agencies that receive 

appropriations under a Department of the Interior and Related Agencies 

Appropriations Act for fiscal year 1995 and thereafter.

The amount paid under these three authorities, plus the gratuity paid under the new 

authority, may not total more than $10,000. The gratuity is NOT reduced by any other 

amounts, including other benefits payable under the Federal Employees’ Compensation 

Act.

For the purpose of full administration of this death gratuity, authority is delegated to the 

level of the State Director or Center Director. The State Director or Center Director may 

approve the death gratuity payment when presented with clear and convincing evidence 

that an employee sustained an injury in the line of duty, which resulted in the employee’s 

death. If the State Director or Center Director not believe the evidence clearly and 

convincingly establishes entitlement to a death gratuity payment, the State Director or 

Center Director may await a Department of Labor’s Office of Worker’s Compensation 

(OWCP) determination.

B. Eligibility

The death gratuity will be paid to the personal representative of any Federal employee who 

dies from an injury that was sustained on or after August 2, 1990, in the line of duty. This 

includes a department or agency employee who dies after separation from service, if the 
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death is the result of any injury sustained in the line of duty.

A personal representative is defined as the formally designated executor or administrator of 

the employee's estate under State law. The department or agency head determines who the 

personal representative is in any particular case.

C. Process

In order to help the personal representative with the cost of burial and/or other expenses 

incurred from the employee’s death, the death gratuity should be processed as soon as 

possible9F

10. The following guidance provides the steps for, and authority to, process the 

death gratuity payment for the personal representative.

1. Authority is delegated to the Agency Administrator to determine if the death was in 

the line of duty. The Agency Administrator may use the guidelines below as 

examples of what is considered “in the line of duty” but is not restricted to those 

examples.

2. Authority is delegated to the Agency Administrator to determine who the personal 

representative is. The Agency Administrator may use the guidelines below as 

examples of who is considered the “personal representative” but is not restricted to 

those examples.

3. If the Agency Administrator declares the death to be in the line of duty, the Agency 

Administrator will authorize the Human Resource Office (HRO) to initiate a $9,000 

death gratuity payment to the personal representative as designated by the 

Authorized Officer.

4. Once authorization is received, the HRO will contact the Personal Representative to 

obtain their Social Security Number (as needed to process the death gratuity 

payment and report to the IRS) and prepare a memorandum advising the Chief 

Financial Officer to request a check from Accounting Operations Center (AOC) (see 

Sample Memorandum to Chief Financial Officer below).

5. The HRO will ask the CFO to submit the check request to AOC for payment using 

the attached Obligation Transmittal Sheet.

6. The HRO will issue a letter to the personal representative, concurrent with the 

payment request, stating that the check will be sent directly to them. The letter 

should explain how the amount was determined and that if OWCP does not pay the 

$200 payable under 5 U.S.C. Section 8133(f) and the full $800 payable under 5 

U.S.C. Section 8134(a) the remaining amount, up to the $10,000 total allowable, can 

be paid out to the personal representative. The letter will also explain the tax 

implications (see Sample Letter to Personal Representative below).

7. If the total additional death gratuity payments from OWCP, as stated above, do not 

total $1000, the remainder will be paid to the representative once the Application for 

Consideration for Additional Death Gratuity Payment form is received. Follow steps 

 10 At present, the death gratuity is paid from the BLM’s account. Any budget adjustment requests are to 

be decided between the Agency Administrator and the State Director or Assistant Fire Director for deaths 

of fire personnel.
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4-5 above and issue a final letter to the personal representative explaining that the 

total death gratuity payment of $10,000 has been reached (see Sample Letter to 

Personal Representative Regarding Additional Death Gratuity Payment below.)

Former employees who die as a result of an injury sustained in the line of duty are also 

eligible for the death gratuity. Follow the above guidelines for initiating the death gratuity 

payment and include the following:

1. Request an official statement from the physician of record or medical examiner 

stating that the injury sustained in the line of duty caused the death of the former 

employee.

2. Request documentation from OWCP that the former employee sustained this injury 

in the line of duty. Contact the appropriate Regional OWCP Office for employee 

claim information and Claim Number.

D. Personal Representative

The personal representative is the formally designated executor or administrator of the 

employee's estate under State law. The department or agency head determines who the 

personal representative is in any particular case. The designation of a personal 

representative may be determined as being:

1. A legally appointed executor/executrix of the estate as designated by the decedent or 

by operation of State law; or

2. If there is no legally appointed representative, consideration will be given to the 

order of precedence governing the payment of a Federal employee’s unpaid 

compensation, as set forth in 5 U.S.C. Section 5582(b);

In order to facilitate the settlement of the accounts of deceased employees, money due an 

employee at the time of his death shall be paid to the person or persons surviving at the date of 

death, in the following order of precedence, and the payment bars recovery by another person of 

amounts so paid:

1. First, to the beneficiary or beneficiaries designated by the employee in writing 

received in the employing agency before his death;

2. Second, if there is no designated beneficiary, to the widow or widower of the 

employee;

3. Third, if none of the above, to the child or children of the employee and descendants 

of deceased children by representation;

4. Fourth, if none of the above, to the parents of the employee or the survivor of them;

5. Fifth, if none of the above, to the duly appointed legal representative of the estate of 

the employee;

6. Sixth, if none of the above, to the person or persons entitled under the laws of the 

domicile of the employee at the time of his death; or

7. If other complex issues exist regarding the determination, the issue may be referred 

to OPM Associate General Counsel (Compensation) for opinion.
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How to determine if the death is a “line-of-duty” death:

1. The Agency Administrator is delegated the authority to make a determination of 

“Line-of-Duty” death. A determination made by the Department of Labor’s Office of 

Workers’ Compensation Program (OWCP) may be used to establish whether an 

employee sustained an injury or illness while in the line of duty.

2. Request documentation from OWCP that the former employee sustained this injury in 

the line of duty. Contact the appropriate Regional OWCP Office for employee claim 

information and Claim Number. However, it is left up to the discretion of the Agency 

Administrator. In the LODD of fire employees, the Fire Director make this 

determination and authorization.

E. Tax Implications

The IRS has now issued a ruling that a death gratuity payment, while not subject to Federal 

income tax withholding, is fully subject to Federal income tax if the death occurred on or 

after August 20, 1996 (see BAL 97- 104, IRS Form 1099-R, and IRS Instructions for 

1099-R):

1. BAL 97-104 – Tax Status of New Death Gratuity Payment Authority

2. IRS Form 1099-R

3. IRS Instructions for Form 1099- R

F. Links for More Information

1. PL 104-208 Section 651

2. BAL 96-109 – New Death Gratuity Payment Authority

3. CSRS and FERS Handbook – Chapter 70, Section 70C2.1-1 – Death Gratuity 

Authorized by Public Law 104-108

G. Memorandum to Chief Financial Officer (Fillable Template)

See Fillable Template in Appendix19

H. Sample Letter to Personal Representative (Fillable Template)

See Fillable Template in Appendix 19

I. Application for Additional Death Gratuity Payment (Fillable Template)

See Fillable Template in Appendix 19

J. Letter to Personal Representative Regarding Additional Death Gratuity Payment (Fillable 

Template)

See Fillable Template in Appendix 19
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APPENDIX 8 – OFFICE OF WORKERS’ COMPENSATION LODD BENEFITS

A. Overview

The Federal Employees’ Compensation Act (FECA) (5 U.S.C. Section 8101), which is 

administered by the Office of Workers’ Compensation Programs of the U.S. Department of 

Labor, provides compensation benefits to civilian employees of the United States for 

disability due to personal injury or disease sustained while in the performance of duty, as 

well as for payment of benefits to dependents if a work- related injury or disease causes an 

employee’s death.

When an employee dies because of an injury incurred in the performance of duty, the 

supervisor should immediately notify the OWCP Federal Employees Compensation (FEC) 

District Office.

B. Claims for Death Benefits – Forms To Complete

The survivors or supervisor of a deceased employee should use forms CA-5 Claim for 

Compensation by Widow, Widower, and/or Children and CA-5b Claim for Compensation

by Parents, Brothers, Sisters, Grandparents to submit claims for death benefits. Forward to 

OWCP with a copy of the death certificate, marriage certificate, divorce or annulment 

decree, and/or birth certificates, whichever apply.

The supervisor completes Form CA-6 Official Supervisors Report of Employee Death to 

report the work- related death and sends to OWCP no more than 10 working days after 

notification of the death.

1. Division of Federal Employees' Compensation (DFEC)

The Federal Employees' Compensation Act (FECA) (5 U.S.C. 8101 et seq.) Is 

administered by the Office of Workers' Compensation Programs (OWCP) of the 

U.S. Department of Labor. It provides compensation benefits to civilian employees 

of the United States for disability due to personal injury sustained while in the 

performance of duty or to employment-related disease. The FECA also provides for 

the payment of benefits to dependents if the injury or disease causes the employee's 

death.

DCA CA-11, When Injured at Work DFEC Information Guide for Federal 

Employees

2. Compensation for Death

If no child is eligible for benefits, the widow’s or widower's compensation is 50 

percent of the employee's pay at the time of death if death was due to the 

employment-related injury or disease. If a child or children are eligible for benefits, 

the widow or widower is entitled to 45 percent of the pay and each child is entitled 

to 15 percent. If children are the sole survivors, 40 percent is paid for the first child 

and 15 percent for each additional child, to be shared equally. Other persons such as 

dependent parents, brothers, sisters, grandparents, and grandchildren may also be

entitled to benefits. The total compensation may not exceed 75 percent of the 

employee's pay or the pay of the highest step for GS- 15 of the General Schedule, 

except when such excess is created by authorized cost-of-living increases.
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Compensation to an employee's surviving spouse terminates upon his or her death or 

remarriage. However, a widow or widower's benefits continue if the remarriage 

takes place after the age of 55.

Awards to children, brothers, sisters, and grandchildren terminate at the age of 18, 

unless the dependent is incapable of self-support or continues to be a full-time 

student at an accredited institution until he or she reaches the age of 23 or has 

completed four years of education beyond the high school level.

Eligible beneficiaries must elect between survivor’s (retirement) benefits and OWCP but 

can change election later.

Burial expenses up to $800 are payable. If the Department of Veterans Affairs (VA) also 

pays a burial allowance, that allowance must be deducted. If the employee dies away from 

home, the cost of transporting the body to the place of burial will be paid in full. In addition, 

a $200 allowance will be paid for terminating the deceased's status as a Federal Employee.

In addition to any burial expenses or transportation costs, a $200 allowance is paid for the 

administrative costs of terminating an employee's status with the Federal Government.

C. CA-810, Injury Compensation for Federal Employees Publication

This publication was prepared by the Office of Workers’ Compensation Programs (OWCP), 

U.S. Department of Labor. It serves as a handbook for Federal agencies in providing basic 

information about the administration of the Federal Employees’ Compensation Act (FECA), 

which provides compensation benefits to civilian employees of the United States for 

disability due to personal injury or disease sustained while in the performance of duty.

CA-810, Injury Compensation for Federal Employees Publication:

1. See Chapter 2-5 for information on forms.

2. See Chapter 3-1A-D for Provisions of the Law.

3. Generally speaking, for injuries and deaths on or after September 7, 1974, the law 

provides that a claim for compensation must be filed within three years of the injury or 

death (5 U.S.C. Section 8122). See these references for details and exceptions.

4. See Chapter 7-2 on Death Benefits for:

a. Entitlement

b. Compensation Payments

c. Funeral and Burial Expenses

d. Employing Agency Death Gratuity

e. FECA Death Gratuity

5. See Chapter 7-3 for what constitutes Dual Benefits.

6. See Chapter 7-4 for Computing Compensation.
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D. Survivors of “An Employee Who Dies of Injuries Incurred in Connection With the 

Employee’s Service With an Armed Force In a Contingency Operation”

This is a new provision that creates a death gratuity for Federal employees (and employees 

of non-appropriated fund instrumentalities) by authorizing the United States to pay up to 

$100,000 to the survivors of "an employee who dies of injuries incurred in connection with 

the employee's service with an Armed Force in a contingency operation." On January 28, 

2008, the Federal Employees' Compensation Act (FECA) was amended by adding a new 

section 8102a (5).

E. U.S.C. Section 8102a – Death Gratuity

This provision creates a death gratuity for Federal employees (and employees of nonappropriated fund instrumentalities) by authorizing the United States to pay up to $100,000 

to the survivors of “an employee who dies of injuries incurred in connection with the 

employee's service with an Armed Force in a contingency operation.” The $100,000 amount 

must by law be reduced and offset by any other Federally provided death gratuity.
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APPENDIX 9 – EMPLOYEE RETIREMENT SYSTEMS DEATH BENEFITS

A. Overview

A Survivor Annuitant is a family member of a deceased Federal employee or annuitant who 

is entitled to an annuity under a retirement system established for employees. 10F

11The widow 

or widower, former spouse (if any), and child(ren) may qualify for a survivor annuity if the 

death occurs while employed and the deceased was subject to the Civil Service Retirement 

system (CSRS) and completed at least 18 months of creditable civilian service or was 

subject to the Federal Employees Retirement System (FERS) and completed at least 10 

years of creditable service. See 5 CFR 831 Subpart F; 838, 842, and 843. If there are no 

eligible survivor annuitants, there may be a lump sum benefit payable.

B. Benefits Payable

Refer to the CSRS and FERS Handbook for Personnel and Payroll Offices for details on 

following CSRS and FERS benefits payable and other information:

CSRS FERS

Monthly Survivor Annuity

Current 

Spouse 

Child(ren) 

Former Spouse

Basic Employee Death Benefit

Current 

Spouse 

Child(ren) 

Former Spouse

Lump-Sum Credit Monthly Survivor Annuity

Voluntary Contributions Lump-Sum Lump-Sum Credit

Reemployed Annuitants Reemployed Annuitant

C. Other Information

1. Refer to the CSRS and FERS Handbook for Personnel and Payroll Offices:

a. Applying for CSRS and FERS Survivor Annuity Benefits.

b. When Benefits Begin.

c. Contacts for Processing CSRS and FERS Annuity and Lump-Sum Benefits.

d. Additional Information for Processing the CSRS/FERS Annuity/Lump-Sum 

Benefits.

 11 Retirement Systems are processed by the Branch of Employee Benefits Services (BEBS)/Office of 

Personnel Management (OPM).
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D. Civil Service Retirement System (CSRS)

1. Monthly Survivor Annuity – CSRS

a. Eligibility

1) Current Spouse if:

i. The employee who died completed at least 18 months of creditable 

civilian service,

ii. The employee who died was covered by the Civil Service 

Retirement System (CSRS) when he/she died, and

iii. The current spouse was married to the employee for at least nine 

months (if the death was accidental or there was a child born of 

your marriage to the employee, the nine-month requirement does 

not apply).

iv. If a court order awards part of the total survivor annuity to a 

former spouse, the current spouse will receive the remainder. If the 

former spouse loses entitlement because of death or remarriage 

before age 55, the current spouse may begin to receive the full 

annuity.

2) Child(ren) if:

The employee completed at least 18 months of creditable civilian service, and 

the child is an: 

i. Unmarried dependent child under age 18, and/or

ii. Unmarried dependent child from age 18 to age 22, if attending an 

accredited educational institution full- time, and/or

iii. Unmarried, disabled dependent child if the disability occurred 

before age 18.

3) To a Former Spouse if:

i. Specified under a qualifying court order, and

ii. The employee who died completed at least 18 months of creditable 

civilian service,

iii. The former spouse was married to the employee for at least nine 

months, and

iv. The former spouse did not remarry before reaching age 55 (unless 

he/she was married to the deceased for at least 30 years).

b. References and Links

1) CSRS and FERS Handbook for Personnel and Payroll Offices

2) Chapter 70: Spouse Benefits – Death of an Employee

3) Chapter 73: Children(s) Benefits
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4) Chapter 74: Former Spouse Survivor Benefits

i. 5 CFR, Administrative Personnel

• Part 831, Retirement

• Part 841, FERS, General Administration

• Part 843, FERS, Death Benefits and Employee Refunds

ii. 5 US Code, Part III, Subpart G, Chapter 83, Subchapter III

iii. Section 8331, Definitions

iv. 8332, Creditable Service

v. 8341, Survivor Annuities

vi. 8342, Lump-Sum Benefits; Designation of Beneficiary; Order of 

Precedence

c. Forms to Complete

The Benefits Counselor will complete as much information as possible prior 

to sending documents to the family. Once the family has the information, the 

Benefits Counselor will counsel the family on items they will need to 

complete.

1) Current Spouse, Former Spouse and Child(ren):

i. Form SF 2800 and SF 2800A must be completed and sent to the 

Branch of Employee Benefits Services (BEBS).

ii. Include a certified copy of death certificate.

iii. Student(s) and Disabled Child(ren):

iv. OPM will request form RI 25-41 if the child(ren) is listed as a 

student, and/or RI 25-43 if listed as disabled. You can include 

these forms along with the SF-2800 to expedite processing, but do 

not wait to submit the SF-2800 if you do not have these forms.

v. RI 25-41, Initial Certification of Full-Time School Attendance

vi. RI 25-43, Documentation in Support of Claim for CSRS or FERS 

Benefits

2) Military Service:

Military Service may be creditable towards calculating the annuity 

benefit.

If the employee was eligible to but did not pay back his military 

deposit or only paid back a portion of the deposit, the survivor must 

elect to make the deposit in writing by completing:

i. OPM Form 1519, Survivor’s Military Service Election, and

ii. SF 2803, Application to Make Deposit or Redeposit (showing 

military service only).
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iii. Additional information needed is RI 20-97, Estimated Earnings 

During Military Service and the DD Form 214, Discharge Papers 

and Separation Documents. Deposit must be made to the agency 

prior to adjudication of the retirement application and release of 

the IRR from payroll. Also, we are unable to determine cost of buy 

back until earning are received.

iv. See Chapter 23 for additional information on military deposit 

accounts.

v. See Chapter 81 for instructions on how to complete SF 2806, 

Individual Retirement Record. (Payroll completes the Individual 

Retirement Record form.)

2. Lump-Sum Credit – CSRS

If an employee dies and no survivor annuity is payable based on his/her death, the 

retirement contributions remaining to the deceased person’s credit in the Civil 

Service Retirement and Disability Fund, plus applicable interest, are payable.

a. Payees for Lump Sum Benefits – Chapter 75

1) If a lump sum benefit is payable, it is paid to the first person eligible under 

the following order of precedence:

i. To the designated beneficiary.

2) If there is no such beneficiary, to the widow or widower.

i. If none of the above, to the child or children, with the share of any 

deceased child distributed among the descendants of that child.

3) If none of the above, to the parents in equal shares or the entire amount to 

a surviving parent.

4) If none of the above, to the executor or administrator of the estate.

5) If none of the above, to the next of kin as determined under the laws of the 

state where the retiree lived.

Note: If there is no survivor entitlement to a monthly survivor annuity, the total 

lump-sum is payable. If there is a survivor entitled to a monthly survivor annuity, 

then a portion of the lump-sum is payable. Voluntary Contributions are not part of 

the lump-sum credit.

b. Forms to Complete

1) SF-2800, Application for Death Benefits.

2) SF 2800A, Documentation and Election in Support of Application for 

Death Benefits When Deceased Was an Employee at the Time of Death 

(Agency Certification of Death in Service).

3) SF 2806, Individual Retirement Record (completed by payroll).

3. Voluntary Contributions Lump Sum Benefit Payable – CSRS

Chapter 31 Subchapter 31A covers voluntary contributions to the Civil Service 
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Retirement and Disability fund. Employees covered under CSRS and CSRS Offset 

might have elected to participate in voluntary contributions. FERS employees are not 

eligible for voluntary contributions.

If the employee dies while still in Federal service or after separation from service but 

before becoming a retiree and contributed to the voluntary contributions account, the 

voluntary contributions account, including interest, is paid in a lump-sum payment to 

the person or persons who survive the employee and who are entitled under the 

normal order of precedence given in Chapter 34. (Designation of Beneficiary form.)

a. Order of Precedence:

Lump-sum payments upon the death of an employee, former employee, or retiree 

are paid to the person or persons surviving the deceased in accordance with the 

following order of precedence:

1) To the properly designated beneficiary or beneficiaries.

2) If there is no properly designated beneficiary, to the widow or widower.

3) If none of the above, to the child or children, with the share of any 

deceased child distributed among the descendants of that child.

4) If none of the above, to the parents in equal shares or the entire amount to 

the surviving parent.

5) If none of the above, to the executor or administrator of the estate, or to 

any other person who has authority under applicable State law to represent 

the deceased's estate.

6) If none of the above, to the other next of kin who are entitled under the 

laws of the domicile of the deceased at the date of death.

This payment after death also includes money credited as voluntary contributions 

for service performed in excess of that required for the 80-percent maximum 

annuity (see Chapter 50, section 50A3.1-2).

b. References and Links

1) SF-2804A, Information Regarding Voluntary Contributions -- CSRS

2) SF-2804, Application to Make Voluntary Contributions

c. Forms to Complete

1) SF-2800, Application for Death Benefits SF 2800A – Agency Certification 

of Death in Service

2) SF 2806, Individual Retirement Record (to be completed by payroll)

3) SF 2801-1, Certified Summary of Federal Service – CSRS

4. Reemployed Annuitant Death Benefits For CSRS – Chapter 100

a. If the annuity continued through reemployment – Forms SF-2806, Individual 

Retirement Record and SF 2800, Application for Death Benefits.
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b. If the annuity was terminated on or during reemployment – process in the same 

manner as any other death.

E. Federal Employees Retirement System (FERS)

1. Basic Employee Death Benefit (BEDB) – FERS

a. Eligibility

1) Current Spouse if:

i. The employee who died completed at least 18 months of 

creditable civilian service,

ii. The employee who died was covered by the Federal Employees 

Retirement System (FERS) when he/she died, and

iii. The current spouse was married to the employee for at least nine 

months (if the death was accidental or there was a child born of 

your marriage to the employee, the nine-month requirement does 

not apply).

2) Child(ren) if:

i. This benefit is not payable to children.

3) To a Former Spouse if:

i. A qualifying court order is on file at the Office of Personnel 

Management (OPM),

ii. The former spouse was married to the deceased for a total period 

of at least nine months, and

iii. The former spouse did not remarry before reaching age 55 (unless 

he/she was married to the deceased for at least 30 years).

2. Amount of Basic Employee Death Benefit

50% of the employee’s final salary (average salary, if higher), plus

$15,000 increased by Civil Service Retirement System (CSRS) cost-of-living 

adjustments beginning 12/1/87.

3. General Information

a. The surviving spouse or former spouse must elect to receive this benefit in 

either:

1) One payment, or

2) 36 monthly installments.

4. References and Links

Chapter 70, Spouse Benefits – Death of an Employee

5. Forms to Complete

Form SF 3104B Section 2, Documentation and Elections in Support of Application 

for Death Benefits when Deceased was an Employee at the Time of Death (FERS). 

This form must be completed and submitted to BEBS.
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Note: Any surviving spouse or former spouse who appears to be eligible to receive a 

lump sum should be given the IRA Rollover Option Information, including the 

Death Benefit Payment Rollover Election Form (located on SF-3104B section 5) 

since taxable lump sums, if not rolled over, are subject to a mandatory 20 percent 

withholding for Federal income tax.

6. Monthly Survivor Annuity – FERS

a. Eligibility

1) Current Spouse if:

i. The employee who died completed at least 10 years of creditable service 

(18 months of which must be creditable civilian service),

ii. The employee who died was covered by the Federal Employees 

Retirement System (FERS) when he/she died, and

iii. The current spouse was married to the employee for at least nine months 

(if the death was accidental or there was a child born of the marriage to 

the employee, the nine-month requirement does not apply).

iv. If a court order awards part of the total survivor annuity to a former 

spouse, the current spouse will receive the remainder. If the former 

spouse loses entitlement because of death or remarriage before age 55, 

the current spouse may begin to receive the full annuity.

v. Annuity Benefit – In addition to the BEDB, an eligible spouse may 

receive a monthly survivor annuity.

2) Child(ren) if:

i. The employee completed at least 18 months of creditable civilian service, 

and

ii. The child is an

iii. Unmarried dependent child under age 18, and/or

iv. Unmarried dependent child from age 18 to age 22, if attending an 

accredited educational institution full-time, and/or

v. Unmarried, disabled dependent child if the disability (certified as such by 

the Social Security Administration) occurred before age 18.

vi. The combined benefit of all the children is reduced by the total amount of 

the child’s insurance benefits that are payable (or would, upon proper 

application, be payable) under Title II of the Social Security Act for the 

same month to all children of the deceased based on the total earnings of 

the deceased. Any monthly FERS survivor benefit payable to any child is 

reduced (offset) by the total amount of any Social Security survivor 

benefit payable to the child(ren). In most cases, the FERS benefit is 

reduced to $0.

3) To a Former Spouse if:
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i. Specified under a qualifying court order,

ii. The employee who died completed at least 18 months of creditable 

civilian service,

iii. The former spouse was married to the employee for at least nine months, 

and the former spouse did not remarry before reaching age 55 (unless 

he/she was married to the deceased for at least 30 years).

7. References And Links

a. Chapter 70, Spouse Benefits – Death of an Employee

b. Chapter 73, Children(s) Benefits

c. Chapter 74, Former Spouse Benefits

d. SF-3114, Applying for Death Benefits Under FERS

8. Forms To Complete

a. Current Spouse, Former Spouse and Child(ren):

1) SF-3104, Application for Death Benefits

2) SF-3104B Sections 1 and 4, Survivor’s Military Service Election

3) SF-3108, Application to Make Service Credit Payment for Civilian Service

4) SF-3100, Individual Retirement Record (Payroll form)

b. Student(s) and Disabled Child(ren):

OPM will request form RI 25-41 if the child(ren) is listed as a student, and/or 

form RI 25-43 if listed as disabled. You can include these forms along with the 

SF-3104 and SF-3104B to expedite processing, but do not wait to submit the SF3104 and SF-3104B if you do not have these forms.

c. Military Service:

Military Service may be creditable towards calculating the annuity benefit. The 

procedure under CSRS section 70A4.4-1 and 70A5.3-1 are applicable under 

FERS, with the exception of the forms. If the employee was eligible to but did 

not pay back his military deposit or only paid back a portion of the deposit, the 

military earnings RI 20- 97 and DD 214 are required.

1) The survivor must elect to make the deposit in writing. Deposit must 

be made to the agency prior to adjudication of the retirement 

application and release of the IRR from payroll. Also, we are unable 

to determine cost of buy back until earning are received.SF-3104B, 

Sections 1 and 4, Survivor’s Military Service Election

Notes:

• Generally, the CSRS provisions explained in Part 70A6 apply to FERS employees 

except that the compensation benefits are reduced if the employee was covered 

under FERS and their survivors are eligible for Social Security benefits. The 

BEDB is not payable if the OWCP benefits are elected.

• As under CSRS, the survivors must choose between death compensation benefits 
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from OWCP and FERS survivor benefits. If they elect OWCP benefits, they may 

also elect to receive a lump sum of the employee’s retirement contributions plus 

interest, but not survivor annuity or BEDB. However, if the survivor choses a 

lump sum payment of the retirement they will lose future rights.

• In general, a former spouse must follow the same procedures as a current spouse 

when applying for survivor benefits.

9. Lump-Sum Credit Benefit – FERS

If an employee dies and no survivor annuity is payable based on his/her death, the 

retirement contributions remaining to the deceased person’s credit in the Civil 

Service Retirement and Disability Fund, plus applicable interest, are payable.

a. Payees for Lump Sum Benefits

If a lump sum benefit is payable, it is paid to the first person eligible under the 

following order of precedence:

1) To the designated beneficiary,

2) If there is no such beneficiary, to the widow or widower,

3) If none of the above, to the child or children, with the share of any 

deceased child distributed among the descendants of that child,

4) If none of the above, to the parents in equal shares or the entire amount to 

a surviving parent,

5) If none of the above, to the executor or administrator of the estate, or

6) If none of the above, to the next of kin as determined under the laws of the 

state where the retiree lived.

7) Subchapter 75B – SF 3104, Application for Death Benefit 5 U.S.C. 

Section 8424 and 5 CFR 843 Subpart A and B)

8) If there is no survivor who is entitled to monthly survivor annuity, a lumpsum payment may be made. If there is a survivor who is entitled to a 

monthly survivor annuity, they must choose between the annuity and the 

lump-sum payment.

For further information on the lump-sum payment, see Chapters 32, 70, and 72.

10. Reemployed Annuitant Death Benefits For FERS – Chapter 100

a. If the annuity continued through reemployment – complete Forms SF-3100, 

Individual Retirement Record and SF-3104, Application for Death Benefits.

b. If the annuity was terminated on or during reemployment – process in the same 

manner as any other death.

F. Applying For CSRS or FERS Survivor Annuity Benefits

A retiree’s survivor should work with the Office of Personnel Management (OPM); 

however, the Benefits Counselor will assist with the forms that need to be completed.
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Contact the personnel office of the Federal agency where the employee worked. You should 

complete the Application for Death Benefits, SF 2800 (CSRS) or SF 3104 (FERS) and 

attach any other forms and/or evidence as the application or circumstances require. Attach a 

certified copy of the employee’s death certificate and a copy of the certificate of the 

marriage to the widow or widower. Send the application to BEBS

If you are the surviving spouse or former spouse of a deceased FERS employee, you will 

work with BEBS to also complete SF 3104B, Standard Documentation and Elections in 

Support of Application for Death Benefits, when deceased was an employee at the time of 

death.

A widow or widower who is claiming benefits for himself/herself and on behalf of children 

should file one application.

If the employee’s death was job-related, workers’ compensation benefits may be payable.

1. When Benefits Begin

a. Widow or Widower

Your survivor annuity begins on the day after the employee’s or retiree’s death. 

If you are eligible for benefits and we are unable to pay you because a former 

spouse is entitled, your annuity would begin the day after the former spouse 

loses entitlement to benefits.

b. Former Spouse

If you are a former spouse who was awarded a survivor annuity based on a court 

order, your survivor annuity begins to accrue on whichever day is later:

1) The day after the employee’s or retiree’s death, or

2) The first day of the second month after we receive a certified copy of the 

court order along with any additional necessary supporting documentation.

3) If you are eligible for benefits and we are unable to pay you because 

another former spouse is entitled, your annuity would begin the day after the 

former spouse loses entitlement to benefits.

c. Child

Your survivor annuity begins to accrue on the day after the employee’s or 

retiree’s death.

2. Worker’s Compensation Verses Survivor Annuity

The FECA prohibits payment of compensation and survivor annuity at the same 

time. This prohibition does not, however, prevent an individual from filing for both 

benefits. If both benefits are approved, the rules prohibiting dual benefits apply. If 

the surviving spouse and/or children of an individual who died as a result of a jobrelated disease or injury are eligible for both death compensation benefits from 

OWCP and CSRS or FERS survivor benefits (see Section 70B6 for differences in 

application of FERS benefits), the survivor must elect which of the two benefits he 

or she wishes to receive.
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Most survivors will choose compensation benefits instead of a survivor annuity 

because compensation normally pays a higher amount. If the survivor elects 

compensation benefits, he or she may also elect to receive a lump sum payment of 

the employee's contributions to the retirement fund. (It would be beneficial to have a 

future retirement annuity if the survivor remarries.) The lump sum is paid under a 

statutory order of precedence:

a. First, to the designated beneficiary,

b. If none designated, to the surviving spouse,

c. If none, to the child or children and descendants of deceased children, by 

representation,

d. If none, to any surviving parents,

e. If none, to the duly appointed executor or administrator of the estate, or

f. If none, to the next of kin.

g. If the employee was single and had no dependent children, there would be no

survivor annuity benefit or lump sum payable under OWCP unless there are 

dependent parents, grandparents, brothers, sisters, and grandchildren. FECA 

specifies the percentage of salary used to determine each benefit according to 

the degree of dependence. If there was no former spouse eligible for CSRS 

benefits, a lump sum of the employee's retirement contributions would be paid 

to his or her survivors under the order of precedence.

See Chapter 70 Section 70A6.1-1 Benefits Payable

3. References And Links

a. Chapter 102 and Chapter 70

b. 5 U.S.C. Sections 8116, 8332, 8337, 8344, 8411, 8464a, and 8468

c. 5 CFR Parts 831 and 842

G. Contacts For Processing CSRS And FERS Annuity And Lump-Sum Benefits

1. Bureau of Land Management

Bureau of Land Management NOC

Benefits and Retirement OC-240

Denver Federal Center Building 50

Denver, CO 80225-0047

Benefits Fax: 303-236-6685

Benefits email: blm_oc_ben_and_ret@blm.gov FEDHR Navigator

2. Office of Personnel Management (OPM)

Once the survivor annuity package is received, the agency and/or survivor may 

contact OPM.
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Office of Personnel Management

Box 45 Boyers, PA 16017

OPM for Retirement/Annuity Questions 1-888-767-6738

H. Additional Information For Processing The CSRS/FERS Annuity/Lump-Sum 

Benefits

1. BEBS will complete the Electronic Quick Pay Report for Surviving Spouses to 

submit to OPM

2. If divorced after 1985, you will need to include a copy of dissolution of marriage.

3. Each child (over 22) must complete the 2800 or 3104 to receive any retirement 

benefit.

4. Make sure to include all names used on the forms as OPMs documents for 

retirement benefits are filed by name not Social Security Number.
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APPENDIX 10 – FEDERAL EMPLOYEES HEALTH BENEFITS (FEHB)

A. Overview

Eligible survivors may continue enrollment in the FEHB program if: 1) the decedent was 

enrolled for Self and Family at the time of death, and 2) at least one family member is 

entitled to an annuity as a survivor of the deceased employee. Not all survivors who are 

covered under an employee’s FEHB qualify to continue the FEHB enrollment if the 

employee dies. The above two criteria must first be met. If the enrollment continues, 

eligible survivors are entitled to the same benefits and Government contribution as active 

and retired employees enrolled in the same plan. The survivor annuitant's share of the 

premiums is normally deducted from his/her annuity payments.

B. Eligibility

The Branch of Employee Benefits Services (BEBS) will tentatively determine the survivors' 

eligibility for continued health benefits enrollment. OPM will make the final determination 

of their eligibility after it reviews all of the retirement and health benefits records.

C. Requirements For Continuing Enrollment

For the surviving family members to continue health benefits enrollment, all the following 

requirements must be met:

1. The deceased must have been enrolled for Self and Family at the time of death, and

2. At least one family member must be entitled to a survivor annuity.

All survivors who meet the definition of “family member” can continue their health 

benefits coverage under the deceased’s enrollment as long as any one of them is entitled 

to a survivor annuity.

Under FERS, the surviving spouse who is entitled to a basic employee death benefit or 

whose benefits are offset by Social Security may continue health benefits enrollment by 

paying premiums directly to OPM.

If the survivor annuity is not large enough to cover the enrollee share of the premiums, 

the survivors may either change to a lower-cost plan or option or choose to pay the 

premiums directly to OPM.

D. Process

1. Eligible Survivor Action

No action to be taken to continue enrollment, as is, if all the eligibility 

requirements are met.

2. Cancelling Enrollment

If the survivors do not want to continue enrollment, they must send a letter 

to OPM or a Health Benefits Election form (SF 2809) canceling the 

enrollment. The survivors must take this action; the Branch of Employee 

Benefits Services (BEBS) will not terminate enrollment when the employee 

dies unless it appears that no survivors are eligible.
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3. When a Survivor is Eligible Both as an Employee and a Survivor Annuitant

If a Survivor, whose spouse dies, is an employee eligible for health benefits who is 

covered as a family member under their spouse's Self and Family enrollment and 

they are eligible to continue the enrollment as a survivor annuitant, they may:

a. Cancel their enrollment as an annuitant and enroll as an employee because they 

had a change in family status (death of spouse), or

b. They may continue the enrollment as a survivor annuitant.

c. However, if they want to participate in premium conversion, they must be 

enrolled as an employee.

4. BEBS Procedures

Visit the OPM Healthcare webpage for these and other topics pertaining to 

Annuitants and Compensationers:

a. Qualifying Retirement Systems (CSRS and FERS).

b. Procedures for Retiring Employees.

c. If You Want to Continue Your Health Benefits Coverage.

d. If You Want to Cancel or Change Your Health Benefits Coverage.

e. Opportunities for Survivor Annuitants to Change Enrollment.

f. If the Deceased Was Not Enrolled.

E. Extension of FEHB Coverage

1. Overview

Eligible family members’ coverage continues at no cost for 31 days after enrollment 

terminates for any reason except when voluntarily cancelled or the plan is 

discontinued. If an eligible family member is an inpatient in a hospital on the 31st 

day of extension of coverage, FEHB benefits for the hospitalized person will 

continue for the length of the hospitalization, up to a maximum of 60 more days, 

unless the coverage is converted to an individual contract.

If no survivors are eligible to continue the enrollment, BEBS will terminate 

enrollment on the Notice of Change in Health Benefits Enrollment (SF 2810), note 

in the Remarks section: "Enrollee died (date)," and send the enrollee copy of the SF 

2810 to the nearest living relative or to the representative of the estate. However, if it 

appears that a survivor who has been covered as a family member may be eligible 

for conversion, BEBS will send the SF 2810 to him/her.

For additional information on eligibility for extension of coverage, see the FEHB 

Handbook.

2. Process

The 31-day extension is automatic unless the coverage was voluntarily cancelled or 

the plan is discontinued. There are no forms to complete for the 31-day extension of 

coverage. Before the 31-day extension terminates, the survivors should look into 

their eligibility to convert to their own FEHB plan (see FEHB Conversion Rights

below to file for Temporary Continuation of Coverage (TCC).
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F. FEHB Conversion Rights

1. Overview

a. Conversion Rights

When your enrollment terminates, you are entitled to convert to an individual 

policy offered by the carrier of your plan. You are not required to provide 

evidence of insurability.

Exception: You are not entitled to convert to an individual policy if you 

voluntarily canceled your enrollment or your plan was discontinued.

b. Benefits under a Conversion Contract

Many conversion contracts provide fewer benefits at a higher cost than what 

is offered under the FEHB Program. Also, there is no Government 

contribution to the cost of the individual conversion contract. If you 

anticipate that a family member will lose coverage in the near future, the 

benefits and cost of a plan's conversion contract may be an important 

consideration in your choice of a health plan. If you or a family member is 

considering converting to an individual policy, you should contact the carrier 

of your plan for information about the benefits and cost of its conversion 

contract.

c. Effective Date of Conversion Contract

Your or your family member's conversion contract becomes effective at the 

end of the 31-day extension of coverage, even when you or your family 

member is an inpatient in a hospital on the 31st day of extended coverage.

2. Eligibility

All eligible family members who were covered under the decedent’s FEHB plan and 

are no longer eligible to continue FEHB coverage either through being a current 

federal employee or being a survivor who is receiving a survivor annuity, may 

convert their coverage to an individual policy.

3. Process

To apply for conversion, you or your family member must make a written request to 

the carrier of your plan. The plan will promptly send you an application form and 

details concerning benefits and rates of the nongroup contract to which you may 

convert. You or your family member must apply for conversion within 31 days after 

his/her coverage as a family member terminated.

4. BEBS Procedures

When your enrollment terminates, BEBS must give you a notice of your right to 

convert to an individual policy on the Notice of Change in Health Benefits 

Enrollment form (SF 2810). BEBS should provide you with this notice immediately 

upon your enrollment termination, but no later than 60 days from the termination 

date.

G. Forms

1. Form for Current Federal employees who wish to change enrollment due to 

Qualifying Life Event:
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a.SF-2809 Health Benefits Election Form

BEBS will process the SF-2810 to terminate FEHB if there are no eligible survivors, 

or to change from Self and Family plan to Self Only:

b.SF-2810 Notice of Change in Health Benefits Enrollment 

2. Forms for Survivor’s receiving a survivor annuity:

a.OPM-2809 Health Benefits Registration Form

b.RI 79-9 Health Benefits Cancellation/Suspension Confirmation

H. Links for More Information

1. OPM Website for FEHB

2. OPM Website for FEHB Handbook – Survivor Annuitants

3. 2RI-70-1 2015 Guide to Federal Benefits for Federal Civilian Employees – Overview 

of benefits for current employees

4. 2RI-70-9 2015 Guide to Federal Benefits for Federal Retirees and Their Survivors –

Overview of benefits for survivor annuitants

5. RI-79-2 Information for Retirees and Survivor Annuitants - FEHB

6. FEHB Handbook – 31-Day Extension of Coverage and Conversion Rights

7. SF-2810 Notice of Change in Health Benefits Enrollment

I. Contacts

Questions regarding FEHB termination or to obtain a copy of the SF 2810:

Bureau of Land Management NOC

Benefits and Retirement OC-240

Denver Federal Center Building 50

Denver, CO 80225-0047

Benefits Fax: 303-236-6685

Benefits email: blm_oc_ben_and_ret@blm.gov FEDHR Navigator

1. OPM Office of Retirement Programs

OPM – Office of Retirement Programs PO Box 45

Boyers, PA 16017

Email: retire@opm.gov Fax: 1-724-794-6633

OPM for Survivor Annuitants 1-888-767-6738 7:30-5:30pm (Eastern Time) TTY 1-

800-878-5707

2. BEBS

The Branch of Employee Benefits Services (BEBS) will process SF-2810 and SF2809 if there is a current Federal employee who needs to change their FEHB plan.

OPM will process OPM-2809 and RI 79-9 for survivor annuitants who need to 

change or cancel their plan.
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J. Regulations And Authorities

1. CFR Part 890 – Federal Employees Health Benefits Program

2. Affordable Care Act (Public Law 111-148) – Extended coverage to children up to 

their 26th birthday, removed requirement for children to be unmarried, for 

stepchildren to live with the enrollee, and for children (except foster children) to be 

dependent on the enrollee.

3. CFR Subpart D – Temporary Extension of Coverage and Conversion 890.401(a) – (c)

4. CFR Subpart D – Temporary Extension of Coverage and Conversion 890.401 (a) –

(c)

K. FEHB Temporary Continuation Of Coverage (TCC)

1. Overview

a. What is temporary continuation of coverage (TCC)?

TCC is a feature of the Federal Employees Health Benefits (FEHB) Program 

that allows certain people to temporarily continue their FEHB coverage after 

regular coverage ends.

There may be eligible dependent children who were on the decedent’s Self and 

Family FEHB plan who might soon be turning 26 and therefore no longer 

eligible to remain enrolled in FEHB. Let the survivors know that TCC might 

be an option for a child dependent once they reach the age of 26. Also, if a 

child is receiving a survivor annuity and that annuity stops, they may be 

eligible for TCC (see “Eligibility” below).

Children who lose coverage because they are no longer dependent may carry 

the enrollment for 36 months from the time they cease being an eligible family 

member for FEHB purposes.

A TCC enrollee may cancel the enrollment at any time. However, once the 

cancellation takes effect, the enrollee cannot reenroll, and the cancellation is 

final.

b. How much does TCC cost?

TCC enrollees must pay the full premium for the plan they select (that is, both 

the employee and Government shares of the premium) plus a 2 percent 

administrative charge.

2. Eligibility

a. For children, the qualifying events that might make them eligible for TCC are:

1) Reaching age 26,

2) Loss of status as stepchild, foster child, or recognized natural child,

3) In the case of children whose coverage has continued beyond age 26 

because of their inability to support themselves due to a disability 

occurring before they reached age 26, recovering from the disability 
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or becoming self-supporting,

4) Death of the employee or annuitant if the child does not qualify for a 

survivor annuity, and

5) Survivor annuity stops for any reason, including because he or she is 

no longer a full-time student.

b. A spouse who loses coverage because of the death of an employee or 

annuitant is not eligible for TCC. (Most surviving spouses can continue 

regular coverage as survivor annuitants, and so don't need TCC.)

When your child's TCC enrollment terminates, he/she may be entitled to convert 

to an individual policy.

3. Process

a. BEBS will process all TCC claims for children who are dependents of active 

federal employees.

b. OPM will process all TCC claims for children who are dependents of survivor 

annuitants or were receiving a survivor annuity themselves.

c. Visit the OPM Temporary Continuation of Coverage website for additional 

information, including:

1) How to obtain TCC for children who lose FEHB coverage.

2) Who is covered in a TCC family enrollment. Premium payments.

3) Opportunities to change enrollment.

4) Termination of enrollment or coverage.

5) Thirty-one-day temporary extension of coverage and conversion to an 

individual contract

4. Forms

a. SF-2809 – Health Benefits Election for children who lose their FEHB 

coverage as a child of a current employee. CSRS and FERS children of 

survivor annuitants use OPM-2809.

b. OPM-2809 – Health Benefits Registration Form for children who lose their 

FEHB coverage as a child of a survivor annuitant or if they were receiving a 

survivor annuity themselves.

5. Contacts

U.S. Office of Personnel Management Retirement Operations Center

P.O. Box 45

Boyers, PA 16017-0045

Email: retire@opm.gov Phone: 1-888-767-6738

TTY line: 1-800-878-5707

7:30 a.m. To 7:45 p.m. (Eastern)

Benefits Fax: 303-236-6685
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Benefits email: blm_oc_ben_and_ret@blm.gov fedhr Navigator

6. BEBS

If the child is covered under a current Federal employee’s FEHB plan, BEBS will 

process the form. If the child is covered under a survivor annuitant’s FEHB plan, 

OPM will process.

7. Regulations And Authorities

Title II of Public Law 100-654, effective January 1, 1990, established the temporary 

continuation of coverage provision for the FEHB Program.

CFR Subpart K – Temporary Continuation of Coverage 890.1101-1113

L. Federal Flexible Spending Account Program (FSAFEDS)

1. Overview

FSAFEDS offers pre-tax savings on common, out-of-pocket expenses. A decedent 

may have a Federal Flexible Spending Account (FSA) that they have been paying 

into that a surviving spouse/dependent(s) and/or estate may need to think about.

2. Eligibility

Only active employees of the Executive Branch or another agency that participates 

in FSAFEDS who are eligible to enroll in Federal Employees Health Benefits 

(FEHB) Program are eligible to enroll in FSAFEDS (see faqs for Eligibility and 

Enrollment).

a. Process

Reimbursements for expenses can be paid out up until the date of death; all 

monies remaining in the account after that point will be forfeited.

What happens to eligible expenses if the FSA account holder dies?

If the FSAFEDS enrollee dies before the end of the Benefit Period, the 

account holder’s surviving spouse/dependent(s) and/or estate may submit 

claims or receive payment for eligible expenses incurred through the account 

holder’s date of death. Expenses incurred after the date of death are not 

eligible for reimbursement. In addition to submitting the claim form and 

supporting documentation (e.g., receipts, LMN, etc.), provide the name and 

address of the executor/executrix of the FSAFEDS enrollee’s estate.

b. Contacts

FSAFEDS Program – Claims

Box 14127

Lexington, KY 40512-4127

Customer Service Toll-Free: 1-877-372-3337 

TTY Line: 1-866-353-8058

International: 1-650-577-5294

Claims Processing Toll-Free FAX: 1-866-643-2245

c. BEBS

BEBS does not process FSAFEDS. The survivor will need to contact 
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FSAFEDS directly.

d. Regulations And Authorities

The Federal FSA Program is a tax-savings plan governed by the rules of 

Section 125 of the Internal Revenue Code.

M. Deductible Health Plans (HDHP) High

1. Overview

a. What is a High Deductible Health Plan?

A High Deductible Health Plan (HDHP) is a health plan product. When 

combined with a Health Savings Account (HSA) or a Health Reimbursement 

Arrangement (HRA), it provides insurance coverage and a tax-advantaged 

way to help save for future medical expenses.

b. Health Saving Account (HSA): An HSA is a tax-sheltered trust account 

owned for the purpose of paying qualified medical expenses when enrolled in 

an HDHP.

What happens when employee dies? The HSA would pass to the surviving 

spouse or named beneficiary tax free, and the account can continue to be used 

as before. If the deceased is unmarried and does not have a named beneficiary, 

the money is disbursed to the estate and is subject to any applicable taxes. 

(See HDHP with HSA FAQS for more information.)

c. Health Reimbursement Arrangement (HRA): An HRA is an employer-funded 

tax-sheltered account to reimburse allowable medical expenses. HDHP 

members who did not qualify for an HSA will be provided an HRA.

What happens when employee dies? If the surviving spouse does not enroll 

in an HDHP, the funds will be forfeited.

N. Federal Employees Dental and Vision Program (FEDVIP)

1. Overview

FEDVIP is a Federal dental and vision insurance program that certain survivors may 

be eligible for. It is separate from the Federal Employees Health Benefits program.

2. Eligibility

a.Who is eligible to enroll in FEDVIP?

Federal employees eligible for FEHB coverage (whether or not enrolled) and 

annuitants/survivor annuitants (regardless of FEHB eligibility) are eligible to 

enroll.

b.Who is considered an eligible family member?

Family member eligibility under FEDVIP is NOT the same as for FEHB. Eligible 

family members under FEDVIP are your:

1) Spouse,

2) Unmarried dependent child(ren) under age 22 (including an adopted child, 

stepchild, foster child, and recognized natural child), and

3) Child age 22 or over who is incapable of self-support because of a mental 

or physical disability that existed before the child reached age 22.
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4) Changes in dependent eligibility under healthcare reform (Affordable Care 

Act) do not affect eligibility for children under FEDVIP.

c.Who is not eligible to enroll in FEDVIP?

The following people are not eligible to enroll in FEDVIP, regardless of FEHB 

eligibility or receipt of an annuity or portion of an annuity:

1) Deferred annuitants,

2) Former spouses of employees or annuitants,

3) FEHB temporary continuation of coverage (TCC) enrollees,

4) Temporary employees who are:

i. Serving under an appointment limited to one year or less and have not 

completed at least one year of current continuous employment, 

excluding any break in service of 5 days or less; or

ii. Expected to work less than 6 months in each year.

5) Intermittent employees (who do not have a prearranged regular tour of 

duty),

6) Seasonal or occasional employment for one calendar year that amounted 

to less than 6 months of work does not meet the one year of current 

continuous employment requirement, and

7) Anyone receiving an insurable interest who is not an eligible family 

member.

3. Process

The eligible survivor must use BENEFEDS to enroll or change enrollment in a 

FEDVIP plan. BENEFEDS is a secure enrollment website (www.BENEFEDS.com) 

sponsored by OPM. If they do not have access to a computer, they call 1-877-888-

FEDS (1-877-888-3337), TTY number 1-877-889-5680 to enroll or change their 

enrollment.

a.Contacts

Phone: 1-877-888-FEDS (1-877-888-3337)

TTY number 1-877-889-5680

Website: https://www.benefeds.com/

b.BEBS

BEBS does not process FEDVIP programs; survivors will need to contact 

FEDVIP themselves.

c.Regulations And Authorities

5 CFR 894 – Federal Employees Dental and Vision Insurance Program
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APPENDIX 11 – THRIFT SAVINGS PLAN (TSP)

A. Overview

TSP is a retirement savings and investment plan for Federal employees. Any money the 

decedent contributed to the TSP cannot remain in the decedent’s TSP account and will 

need to be distributed to the beneficiary(ies), either through direct payment or if there is 

an eligible surviving spouse into a TSP account in the spouse’s name.

There are tax implications related to distribution of a deceased employee’s contributions 

to the TSP account. It is important for beneficiaries to be aware of these implications. For 

detailed information about the rules associated with death benefit payments, read the TSP 

tax notice “Important Information About Thrift Savings Plan Death Benefit Payments.” 

Also, consult a tax advisor.

B. Eligibility

There are two ways in which a deceased employee’s TSP contributions could be distributed: 

1) either through a Designation of Beneficiary, which must be on file with TSP prior to the 

employee’s death, or 2) according to the Statutory Order of Precedence.

1. Distribution According To The Tsp Designation Of Beneficiary

TSP will not honor a will, prenuptial agreement, separation agreement, property 

settlement, court order, or a trust document when distributing an account.

The only document the TSP will use to distribute death benefits is Form TSP-3, Designation 

of Beneficiary, formerly TSP-U-3 for uniformed services members. By law, the TSP must 

pay the properly designated beneficiary, or beneficiaries, under all circumstances.

or –

2. Distribution According To The Statutory Order Of Precedence

If no Designation of Beneficiary form is on file with the TSP, the decedent’s money will be 

distributed according to the following order of precedence required by law:

a. To the spouse:

b. If none, to the child or children equally, and to the descendants of deceased children,

c. If none, to the parents equally or a surviving parent,

d. If none, to the appointed executor or administrator of the estate, or

e. If none, to the next of kin who is entitled to the estate under the laws of the state in 

which the decedent resided at the time of death.

C. Process

1. The beneficiary(ies) must complete the TSP-17 and submit it, along with a copy of the 

death certificate, to TSP.

2. Once the TSP processes this information and determines the beneficiaries for the account, 

they will contact the beneficiaries with additional information and instructions.

3. If the spouse beneficiary’s share of a deceased civilian TSP participant’s account is $200 

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they will receive a “welcome letter” providing information about how the account is 

initially invested and what they can expect from the TSP.

4. If the spouse beneficiary’s share of the balance is less than $200, it will be paid directly 

to the spouse and they will not be able to remain in the TSP.

D. Forms

1. TSP-17, Thrift Savings Plan Information Relating to Deceased Participants.

2. TSP-3, Designation of Beneficiary. (Must be on file with TSP prior to the employee’s 

death.)

E. Contacts

1. Thrift Savings Plan

Thrift Savings Plan

Box 385021 Birmingham, AL 35238

TSP death benefits phone: 1-800-371-2365 FAX 1-866-817-5023

Thriftline Phone: 1-TSP-YOU-FRST (1-877-968-3778)

Monday – Friday, 7 a.m. To 9 p.m. (Eastern)

Automated Response System available 24 hours a day, 7 days a week Thrift Savings Plan 

Homepage

F. BEBS

BEBS will send the beneficiary a copy of the TSP-17 to complete. The beneficiary 

should send the completed back to BEBS

G. Regulations and Authorities

3. 5 CFR Parts 1600-1690 Thrift Savings Plan
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APPENDIX 12 – FEDERAL EMPLOYEES GROUP LIFE INSURANCE PROGRAM 

(FEGLI)

A. Overview

Claims for benefits are adjudicated and paid by the Office of Federal Employees' Group 

Life Insurance (OFEGLI). Beneficiaries of employees covered under the Federal 

Employees’ Group Life Insurance (FEGLI) program may be entitled to insurance death 

benefits. The following are the benefits that might be payable to beneficiaries upon the 

death of an employee:

1. Basic Insurance – Is an amount equal to an employee’s annual salary, rounded up to the 

next thousand- dollar amount, plus $2,000. (A higher amount is payable if an employee 

was under age 45 at the time of death.)

2. Option A – If elected (standard optional insurance) coverage is $10,000.

3. Option B – If elected (additional optional insurance) comes in 1-5 multiples of an 

employee’s salary.

In addition, Basic insurance and Option A have accidental death and dismemberment 

(AD&D) benefits. However, there is no AD&D coverage with Option B. Accidental death 

benefits for Basic insurance benefits are equal to the Basic insurance amount; accidental 

death benefits for Option A are $10,000. These benefits may be payable in addition to 

regular death benefits.

Currently, life insurance benefits are not considered taxable income to recipients for income 

tax purposes. (Refer to the FEGLI website and consult a tax advisor for final determination 

on tax obligations.)

Life insurance benefits are paid in addition to any workers’ compensation, Social Security, 

or Federal retirement pension benefits.

B. Eligibility

FEGLI insurance benefits are payable depending on many factors. (For a detailed 

explanation on who may receive these benefits, see FEGLI Program Booklet for 

Federal/Postal Employees: Who Gets the Money After I Die?)

C. Process

OFEGLI can only pay death benefits after it has received:

1. Claim for Death Benefits (Form FE-6),

2. Certified copy of the death certificate or other satisfactory proof of death, and

3. Certification by the employing office (NOC BEBS), Agency Certification of Insurance 

Status (SF 2821). The certification must include all supporting documentation, as 

described below:

a. All designations of beneficiary (if any), all FEGLI election forms, any 

assignments, and any court order(s) on file that direct payment of FEGLI 

benefits.
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D. Forms

Forms to complete, if applicable:

1. BAL # 09-102 Attachment 3 – Preliminary Information to OFEGLI (BEBS will 

complete)

2. Claim for Death Benefits (FE-6)

3. Statement of Claim, Option C – Family Life Insurance (FE-6DEP)

4. Notice of Conversion Privilege (SF 2819)

5. Agency Certification of Insurance Status (SF 2821) (BEBS will process and submit)

Forms on file that will need to be referenced:

1. Designation of Beneficiary (SF 2823)

2. Life Insurance Election (SF 2817)

3. Agency Certification of Status of Reemployed Annuitants (OPM 1482) 

Forms should be returned to BEBS. BEBS will forward to OFEGLI.

NOTICE: The address given on these forms for submission of the completed form is no longer 

correct. The form should be sent to:

OFEGLI

Box 8149

Long Island City, NY 11101-8149

E. Links For More Information

1. FEGLI Calculators

2. FEGLI Handbook Chapter on "Claims"

3. FEGLI FAQS – Claim for FEGLI Benefits

a. FEGLI Booklet for Federal Employees (FE 76-21)

b. FEGLI Program Booklet for Federal/Postal Employees: Who Gets the Money After 

I Die?

c. FEGLI Program Booklet for Federal/Postal Employees: How Should Someone File 

a Claim?

d. FEGLI Program Booklet for Federal/Postal Employees: How Are Benefits Paid?

e. Life Insurance Payment Fact Sheet

4. Assignment of Life Insurance (RI 76-10)

F. Contacts

Any questions about the status of a claim must be directed to the OFEGLI office at:

OFEGLI

Box 6512

Utica, NY 13504-6512
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Phone: 800-633-4542

8:30 AM to 4:00 PM EST

Phone for overseas beneficiaries: 212-578-2975

G. BEBS

BEBS will send the applicable forms to the survivors and request that the forms are 

returned to BEBS. BEBS will then forward the forms to OFEGLI.

H. Regulations And Authorities

1. 5 CFR Part 870 – Federal Employees Group Life Insurance Program
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APPENDIX 13 – FIRE AND LAW ENFORCEMENT BENEFITS

A. Law Enforcement Officers, Firefighters and First Responders

1. Public Safety Officers’ Benefits Program (PSOB)

The Public Safety Officers’ Benefits Act of 1976, as amended, authorizes the 

Department of Justice, Bureau of Justice Assistance, Office of Justice Programs, to 

pay a benefit to specified survivors of public safety officers found to have died as 

the direct and proximate result of a personal, traumatic injury involving external 

force sustained in the line of duty, and to claimant public safety officers found to 

have been permanently and totally disabled as the direct result of a catastrophic 

injury sustained in the line of duty.

This program provides death and education benefits to survivors of fallen Law 

Enforcement Officers, Firefighters, and other first responders, as well as disability 

benefits to officers catastrophically injured in the line of duty.

The amount of the PSOB current (fiscal year 2018) death benefit is $350,079. This 

amount fluctuates with every fiscal year. It is Federally tax free, but you must check 

with your state to see if any State taxes may apply. This benefit does not affect the 

eligibility for any other death benefits received.

a. Death Benefit: One-time benefit to eligible survivors whose deaths were the 

direct and proximate result on an injury sustained in the line of duty.

b. Disability Benefit: One-time benefit to eligible public safety officers who 

were permanently and totally disabled as a result of a catastrophic injury 

sustained in the line of duty.

c. Education Benefit: Provides support for higher education to eligible spouses 

and children of public safety officers who died in the line of duty or were 

catastrophically disabled in the line of duty.

Heart Attacks and Strokes: On December 15, 2003, President Bush signed the 

Hometown Heroes Survivors Benefits Act that expanded the circumstances under 

which public safety officer deaths resulting from heart attacks and strokes may be 

covered by the program.

If an autopsy or toxicology report was processed, it must be provided; otherwise, a 

letter on letterhead from head of the agency or medical examiner stating that no 

autopsy or toxicology analysis was performed will suffice.

Original birth certificates or death certificates do not need to be submitted for 

processing a PSOB claim; copies are acceptable:

Public Safety Officers’ Benefits Office Bureau of Justice Assistance

Office of Justice Programs 810 Seventh Street NW Fourth Floor Washington, DC 

20531

Phone: 202-307-0635
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Toll-free: 1-888-744-6513

E-mail: askpsob@usdoj.gov 

Website: https://psob.bja.ojp.gov/

For important guidance, see the PSOB Checklist.

You can apply online at the BJA Public Safety Officers’ Benefits Program website or by 

completing the Report of Public Safety Officer’s Death form.

B. Line-of-Duty Death Law Enforcement (Only)

1. Public Safety Officers’ Educational Assistance (PSOEA) program

Formerly “Federal Law Enforcement Dependents Assistance of 1996 Act (Public 

Law 104-238 and [42 USC 3796]). PSOEA's sole purpose is intended to defer 

educational expenses through an established monthly allowance. Those who are 

eligible are spouses and children of public safety officers who have been killed or 

permanently disabled in the line of duty. (Public safety officers include Law 

Enforcement Officers, Firefighters, and members of rescue squads and ambulance 

crews.)

For the most current information, see the BJA Public Safety Officers’ Benefits 

Program website. View the PSOEA payment amounts for full-time students.

To provide key information regarding filing a PSOB Education Claim, call the 

PSOB Call Center toll-free at 1- 888-744-6513, Monday through Friday from 7:00 

a.m. To 5:00 p.m. Eastern time.

2. Concerns of Police Survivors, Inc. (COPS)

Organized in 1984, COPS is a national organization to: 1) support Law Enforcement 

survivors emotionally, financially, and legally, 2) assist Law Enforcement agencies 

to prepare for issues associated with the sudden loss of a Law Enforcement Officer 

in the line of duty, 3) act as a public relations organization. The organization is 

comprised of spouse’s parents, children, siblings, significant others, and co-workers 

effected by Line-of-Duty Deaths.

Concerns of Police Survivors, Inc.

P.O. Box 3199 846 Old South 5

Camdenton, MO 65020

Email: cops@nationalcops.org Phone: 573-346-4911

Fax: 573-346-1414

3. Robert D. May Scholarship Fund

A scholarship of up to $10,000 is available to qualified dependents of Federal Law 

Enforcement Officers killed or permanently disabled in the line of duty. The 

scholarship may be used to pursue any academic higher education (as defined by the 

Department of Labor). The program is administered by the FBI, with specific 

qualification and application requirements.

Federal Bureau of Investigation Employee Benefits Unit PA 570

1001 Pennsylvania Ave NW Washington, DC 20535-0001

Phone: (202) 220-9027
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C. Firefighters (Only)

1. National Fallen Firefighters Foundation

The United States Congress created the National Fallen Firefighters Foundation to 

lead a nationwide effort to remember America’s fallen firefighters.

National Fallen Firefighters Foundation

Drawer 498 Emmitsburg, MD 21727

Phone: 301-447-1365

Fax: 301-447-1645

Www.firehero.org

2. Resources For Newly Bereaved Families Of Fallen Firefighters

Resources for Newly Bereaved Families of Fallen Firefighters

3. Educational Assistance: Sarbanes Scholarship Program

In 1992, the U. S. Congress created the National Fallen Firefighters Foundation. Our 

mission is to honor all fallen firefighters and to assist their survivors in rebuilding 

their lives. One way we do this is by offering spouses and children the opportunity 

to pursue their personal, educational, and career goals through the Foundation's 

scholarship programs.

4. International Association Of Firefighters (IAFF)

The IAFF, through the W.H. “Howie” McClennan Scholarship, makes annual 

scholarship awards available to children of firefighters who died in the line of duty. 

The applicant’s parent must have been a member in good standing of the IAFF at the 

time of death. Call 202-737-8484 for more information.

W. H. "Howie" McClennan Scholarship

5. Association Of Aerial Firefighters/Associated Airtanker Pilots (AAP)

To aid families of fallen aerial firefighters, including fixed and rotary wing aircraft 

that: a) drop fire retardant, foam, or water; b) fly in a lead plane or tactical aircontrol capacity; and/or c) provide logistics support or personnel deployment 

missions at fire incidents. AAF has established a memorial fund where proceeds are 

presented directly to the families.

AAP

2406 West White Chapel Avenue

Porterville, CA 93257 

www.airtanker.org

6. Wildland Firefighter Foundation

The Wildland Firefighter Foundation is Federal, State, and local firefighters; private 

sector firefighters; interface firefighters; and volunteers. The Wildland Firefighter 

Foundation honors and recognizes wildland firefighters and strives to take care of 

fallen and injured.

Wildland Firefighter Foundation 2049 Airport Way

Boise, ID 83705
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Phone: 208-336-2996

Fax: 208-336-2995

Www.wffoundation.org
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APPENDIX 14 – VETERAN’S ADMINISTRATION (VA) BENEFITS

A. Overview

There are many different benefits that certain survivors and dependents might be eligible for 

through the Veteran’s Administration (VA), such as burial expenses, headstones or markers, 

burial flags, plot internment allowance, and in some cases death gratuities, educational 

assistance, life insurance, and many others. Many states also offer benefits to eligible 

survivors and dependents of veterans that are independent of Federal benefits and vary by 

state. If the deceased employee was a Veteran, make sure to refer the survivors to the VA 

website for all of the benefits that they might be entitled to.

1. Dependent or Survivor Benefits

B. Burial in A National Cemetery

Burial at no charge may be authorized in any national cemetery and a headstone or marker 

with appropriate inscription may be provided by the government. If the deceased is a 

military veteran, contact the Department of Veterans Affairs (VA) for burial assistance. 

When the burial is in a national, state, or post cemetery, a burial flag will be provided. 

When burial is in a private cemetery, obtain burial flags from VA regional offices, national 

cemetery, or U.S. Post Office by completing VA Form 21-2008 (Application for United 

States Flag for Burial Services), and submit it with a copy of the veteran’s discharge papers 

at any of these locations. Contact the local or regional VA office for specific burial 

assistance information.

1. VA Burial Benefits

2. Persons Eligible for Burial in a National Cemetery

C. Burial Flags

VA Burial Flags

1. Why Does VA Provide A Burial Flag?

A United States flag is provided, at no cost, to drape the casket or accompany the 

urn of a deceased Veteran who served honorably in the U. S. Armed Forces. It is 

furnished to honor the memory of a Veteran’s military service to his or her country. 

VA will furnish a burial flag for memorialization for each, other than dishonorable 

discharged:

a. Veteran who served during wartime.

b. Veteran who died on active duty after May 27, 1941.

c. Veteran who served after January 31, 1955.

d. Peacetime Veteran who was discharged or released before June 27, 1950.

e. Certain persons who served in the organized military forces of the 

Commonwealth of the Philippines while in service of the U.S. Armed Forces 

and who died on or after April 25, 1951.

f. Certain former members of the Selected Reserves.

2. Who Is Eligible To Receive The Burial Flag?
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Generally, the flag is given to the next-of-kin, as a keepsake, after its use during the 

funeral service. When there is no next-of-kin, VA will furnish the flag to a friend 

making request for it. For those VA national cemeteries with an Avenue of Flags, 

families of Veterans buried in these national cemeteries may donate the burial flags 

of their loved ones to be flown on patriotic holidays.

3. How Can You Apply?

You may apply for the flag by completing VA Form 27-2008, Application for 

United States Flag for Burial Purposes. You may get a flag at any VA regional 

office or U.S. Post Office. Generally, the funeral director will help you obtain the 

flag.

4. Can A Burial Flag Be Replaced?

The law allows us to issue one flag for a Veteran's funeral. We cannot replace it if it 

is lost, destroyed, or stolen. However, some Veterans' organizations or other 

community groups may be able to help you get another flag.

5. How Should The Burial Flag Be Displayed?

The proper way to display the flag depends upon whether the casket is open or 

closed. VA Form 27- 2008 provides the correct method for displaying and folding 

the flag. The burial flag is not suitable for outside display because of its size and 

fabric. It is made of cotton and can easily be damaged by weather.

D. Presidential Memorial Certificates

A Presidential Memorial Certificate (PMC) is an engraved paper certificate, signed by the 

current President, to honor the memory of honorably discharged deceased Veterans.

1. Eligibility

Eligible recipients include the next of kin and loved ones of honorably discharged 

deceased Veterans. More than one certificate may be provided.

2. Application

Eligible recipients, or someone acting on their behalf, may apply for a PMC in 

person at any VA regional office or by U.S. mail or toll-free fax. Requests cannot be 

sent via email. Please be sure to enclose a copy of the Veteran's discharge and death 

certificate to verify eligibility, as we cannot process any request without proof of 

honorable military service. Please submit copies only, as we will not return original 

documents.

If you would like to apply for a Presidential Memorial Certificate, please call 1-202-

565-4964 or toll free at 1- 800-827-1000.

VA Form 40-0247 Application for Presidential Memorial Certificate Instructions for 

Ordering a PMC Using Our Toll Free Fax Line

a.Presidential Memorial Certificates General Information

b.VA Form 40-0247 – Application for Presidential Memorial Certificate

E. Headstones and Markers

Headstones and Markers General Information

1. Eligibility For A Headstone Or Marker

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the applicant, a Government headstone or marker for the unmarked grave of any 

deceased eligible veteran in any cemetery around the world, regardless of their date 

of death. The VA may also furnish a headstone or marker for graves that are marked 

with a private headstone or marker for veterans that died on or after November 1, 

1990. Public Law 110-157 also gives VA authority to "furnish, upon request, a 

medallion or other device of a design determined by the Secretary to signify the 

deceased's status as a veteran, to be attached to a headstone or marker furnished at 

private expense." This benefit is available in lieu of a Government furnished 

headstone or marker for veterans in privately marked graves who died on or after 

November 1, 1990.

To order a medallion, claimants should use the form VA 40-1330M, Claim for 

Government Medallion for Placement in a Private Cemetery.

1. Most Recent Legislative Changes Concerning Eligibility For Headstones, 

Markers And Medallions

Headstones, Markers and Medallions Eligibility Legislation

Important: Eligible veterans are entitled to either a Government-furnished headstone 

or marker or the new medallion, but not both.

F. Burial and Plot Interment Allowance

Burial and Plot Interment Allowance Factsheet

1. What Are VA Burial Allowances?

VA burial allowances are partial reimbursements of an eligible Veteran's burial and 

funeral costs. When the cause of death is not service related, the reimbursements are 

generally described as two payments:

a. A burial and funeral expense allowance, and

b. A plot or interment allowance.

2. Who Is Eligible?

a. You may be eligible for a VA burial allowance if:

1) You paid for a Veteran's burial or funeral, and

2) You have not been reimbursed by another government agency or some 

other source, such as the deceased veteran's employer, and

3) The Veteran was discharged under conditions other than dishonorable. 

b. In addition, at least one of the following conditions must be met:

1) The Veteran died because of a service-related disability, or

2) The Veteran was receiving VA pension or compensation at the time of 

death, or

3) The Veteran was entitled to receive VA pension or compensation but 

decided not to reduce his/her military retirement or disability pay, or

4) The Veteran died while hospitalized by VA or while receiving care 

under VA contract at a non-VA facility, or
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5) The Veteran died while traveling under proper authorization and at VA 

expense to or from a specified place for the purpose of examination, 

treatment, or care, or

6) The Veteran had an original or reopened claim pending at the time of 

death and has been found entitled to compensation or pension from a 

date prior to the date or death, or

7) The veteran died on or after October 9, 1996, while a patient at a VAapproved state nursing home.

3. How Much Does VA Pay?

a. Service-Related Death

VA will pay up to $2,000 toward burial expenses for deaths on or after 

September 11, 2001. If the Veteran is buried in a VA national cemetery, 

some or all of the cost of transporting the deceased may be reimbursed.

b. On-Service-Related Death

For deaths on or after October 1, 2011, VA will pay up to $700 toward burial 

and funeral expenses (if hospitalized by VA at time of death), or $300 

toward burial and funeral expenses (if not hospitalized by VA at time of 

death), and a $700.00 plot-interment allowance (if not buried in a national 

cemetery). If the death happened while the Veteran was in a VA hospital or 

under VA contracted nursing home care, some or all of the costs for 

transporting the Veteran’s remains may be reimbursed. An annual increase in 

burial and plot allowances for deaths occurring after October 1, 2011, begins 

in fiscal year 2013 based on the Consumer Price Index for the preceding 12-

month period.

c. Burial Expenses

Any VA burial expenses paid must be subtracted from any allowable OWCP 

bureau payments:

1. Burial expenses up to $800 are payable.

2. If the Department of Veterans Affairs (VA) also pays a burial 

allowance, that allowance must be deducted.

3. If the employee dies away from home, the cost of transporting the 

body to the place of burial will be paid in full.

4. In addition, a $200 allowance will be paid for terminating the 

deceased's status as a Federal employee.

4. How Can You Apply?

You can apply by filling out VA Form 21-530, Application for Burial Benefits. You 

should attach a copy of the veteran’s military discharge document (DD 214 or 

equivalent), death certificate, funeral, and burial bills. They should show that you 

have paid them in full. You may download the form at www.va.gov/vaforms/.

a. Documents Needed

1. The veteran's discharge certificate or DD 214,
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2. The veteran's VA Claim Number or Social Security Number,

3. The veteran's death certificate,

4. Government life insurance policy,

5. A copy of all marriage certificates and divorce decrees (if any),

6. A copy of each child's birth certificate (or adoption order), and

7. Veteran's birth certificate to determine parents' benefits.
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APPENDIX 15– SOCIAL SECURITY ADMINISTRATION (SSA)

A. Overview

BEBS does not administer this program; the survivor must contact them direct.

Social Security is not just for retirement. There are other benefits available to surviving 

spouses; divorced spouses; school-aged and disabled children; and dependent parents.

Anyone who has worked and paid Social Security taxes has earned benefits for his or her 

family. The amount of work (quarters) needed to make survivors eligible depends upon the 

worker's age at death.

Below you will find a summary of Social Security benefits. For more detailed information, 

visit the Social Security Administration website.

B. Eligibility

1. Who May Be Eligible For Survivor Benefits?

a. A surviving widow or widower may be able to receive full benefits at full 

retirement age. The full retirement age for survivors is age 66 for people 

born in 1945-1956 and will gradually increase to age 67 for people born in 

1962 or later. Reduced widow or widower benefits can be received as early 

as age 60. If your surviving spouse is disabled, benefits can begin as early as 

age 50. For more information on widows, widowers, and other survivors, 

visit the Social Security Survivor Benefits Planner webpage. The widow or 

widower can receive benefits at any age if they take care of the deceased’s 

child who is receiving Social Security benefits and younger than age 16 or 

disabled.

b. Unmarried children who are younger than age 18 (or up to age 19 if they are 

attending elementary or secondary school full time) also can receive benefits. 

This also applies to children at any age if they were disabled before age 22 

and remain disabled. Under certain circumstances, benefits also can be paid 

to stepchildren, grandchildren, step grandchildren, or adopted children. 

Generally, Social Security pays more benefits to children than any other 

Federal program.

c. Dependent parents can receive benefits if they are age 62 or older. (For 

parents to qualify as dependents, the decedent would have had to provide at 

least one-half of their support.)

d. Surviving divorced spouse who are age 60 or older (50-59 if disabled) can 

get benefits if your marriage lasted at least 10 years. However, he or she does 

not have to meet the age or length-of-marriage rule if caring for the 

decedent’s child who is younger than age 16 or who is disabled and also 

entitled based on the decedent’s work. The child must be the former spouse’s 

natural or legally adopted child. Benefits paid under the age or disability 

requirement won’t affect the benefit rates for other survivors; however, 

benefits paid for a child under age 16 or disabled in the divorced spouse’s 

care will affect the amount of the benefits of others on the worker’s record.
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2. Benefits Available

a. What does Social Security offer eligible survivors?

The lump-sum death benefit of $255 is payable upon the death of a person 

who has worked long enough to be insured under Social Security.

The one-time lump-sum death payment of $255 is payable to:

1) A surviving spouse if he or she was living with the deceased or, if living 

apart, was receiving certain Social Security benefits on the deceased 

person's record, or

2) If there is no surviving spouse, a child who is eligible for benefits on the 

deceased person's record in the month of death.

If no spouse or child meeting requirements exists, the lump-sum death payment will not be paid. 

The lump-sum death payment cannot be paid to funeral homes or estates for funeral expenses.

To file for the benefit, call 1-800-772-1213 (TTY-1800-325-0778) and request an appointment at 

your local office. You must file the application for the lump-sum death payment within the twoyear period ending with the second anniversary of the insured person's death.

b. Monthly survivor's benefits.

Eligible survivors receive a percentage of the basic Social Security benefit 

that is payable – usually in a range from 75 to 100 percent each. However, 

there is a limit to the amount of money that can be paid each month to a 

family. The limit varies but is generally equal to about 150 to 180 percent of 

the benefit rate.

3. How Much Are Benefits?

How much your family can get from Social Security depends on the decedent’s average 

lifetime earnings. That means the more the decedent earned, the more the benefits will be.

C. Process

1. You Will Need The Following Documents (Either Original Or Copies Certified By 

The Agency That Issued Them) To Apply:

a. Proof of death – either from a funeral home or death certificate,

b. Your Social Security Number, as well as the deceased worker’s,

c. Your birth certificate,

d. Your marriage certificate, if you are a widow or widower,

e. Your divorce papers, if you are applying as a divorced widow or widower,

f. Dependent children’s Social Security Numbers, if available, and birth 

certificates,

g. Deceased worker’s W-2 forms or Federal self-employment tax return for the 

most recent year, and

h. The name of your bank and your account number so your benefits can be 
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deposited directly into your account, and

i. If the deceased worker served in the military, then include the military 

discharge (DD-214).

2. What If The Decedent Was Already Receiving Social Security Benefits?

a. Contact Social Security immediately to report the death.

b. If benefits are being paid through direct deposit, notify the financial 

institution.

c. If benefits are paid by check, do not cash the check and return any checks 

received after the death to Social Security.

3. How Much Will I Receive?

The benefit amount is based on the earnings of the person who died. The more the 

worker paid into Social Security, the greater the benefits will be. Social Security 

uses the deceased worker’s basic benefit amount and calculates what percentage 

survivors are entitled to. The percentage depends on the survivors’ ages and 

relationship to the worker. If the person who died was receiving reduced benefits, 

your survivor’s benefit is based on that amount. Here are the most typical situations:

a. A widow or widower, at full retirement age or older, generally receives 100 

percent of the worker’s basic benefit amount,

b. A widow or widower, age 60 or older, but under full retirement age, receives 

about 71- 99 percent of the worker’s basic benefit amount, or

c. A widow or widower, any age, with a child younger than age 16, receives 75 

percent of the worker’s benefit amount.

d. Children receive 75 percent of the worker’s benefit amount.

D. Things That Can Affect The Amount Of Social Security Benefit Payable

1. Pensions From Work Not Covered By Social Security

If you get a pension from work where you paid Social Security taxes, that pension 

will not affect your Social Security benefits. However, if you get a pension from 

work that was not covered by Social Security (for example, the Federal civil service, 

some State or local government employment, or work in a foreign country), your 

Social Security benefit may be reduced.

For more information, ask for Government Pension Offset (Publication No. 05-

10007), for government workers who may be eligible for Social Security benefits on 

the earnings record of a spouse; and Windfall Elimination Provision (Publication 

No. 05-10045), for people who worked in another country or government workers 

who also are eligible for their own Social Security benefits.

2. What If I Work?

If you work while getting Social Security survivors benefits and are younger than 

full retirement age, your benefits may be reduced if your earnings exceed certain 

limits. (The full retirement age was 65 for people born before 1938 but will 

gradually increase to 67 for people born in 1960 or later.) To find out what the 
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earnings limits are this year and how earnings above those limits reduce your Social 

Security benefits, ask for How Work Affects Your Benefits (Publication No. 05-

10069).

3. Effect Of Entitlement To Social Security Benefits On FERS Child Survivor Annuity 

Benefit

Receipt of Social Security benefits affects a child's entitlement to a FERS survivor 

benefit. The total FERS benefits payable to all children are reduced by the total 

Social Security benefits payable to all children. The remaining amount is divided by 

the total number of children payable under FERS. Each eligible child receives this 

amount. If the Social Security benefits equal or exceed the FERS benefits, no FERS 

benefits are paid. In many cases, the payments from Social Security will eliminate 

the FERS benefit altogether.

E. Supplemental Security Income

The spouse of a deceased employee who is blind, disabled, or age 65 or older, and/or their 

dependent child if blind or disabled could benefit from the Supplemental Security Income 

(SSI). The Social Security Administration (SSA) administers this program, which pays 

monthly benefits to people with limited income and resources who are disabled, blind, or 

age 65 or older. This benefit is not dependent on survivor eligibility (prior work or a family 

member's prior work) for Social Security benefits, but on limited income and resources. 

Someone eligible for SSI may also get medical assistance (Medicaid) to pay for hospital 

stays, doctor bills, prescription drugs, and other health costs. Most states also provide a 

supplemental payment to certain SSI beneficiaries and food assistance.

For more information, visit the Social Security Administration’s (SSA) Understanding 

Supplemental Security Income webpage. Check with SSA for available benefits.

F. OWCP Benefits And SSA Benefits

1. May FECA Benefits Be Paid For The Same Periods Of Time As Benefits Paid By 

The Social Security Administration (SSA)?

An employee may receive OWCP benefits and SSA benefits based on private 

employment for the same periods of time, but SSA may reduce its payments. The 

employee should contact SSA to find out whether this will occur in his or her case.

The Social Security Amendments of 1983 provide full SSA benefits rather than 

CSRS benefits to Federal employees hired on and after January 1, 1984 (i.e., to 

those covered under FERS).

Therefore, employees who are covered by FERS would be required to elect between 

FECA benefits and that portion of their SSA benefits attributable to their Federal 

service.

Apply for benefits as soon as possible because, in some cases, the SS benefits will 

be paid from the time you apply and not the date of death.

G. Links For More Information

Publication 05-10007 Government Pension Offset Publication.

Publication 05-10008 How Social Security Can Help You When a Family Member Dies.
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Publication 05-10024 Understanding the Benefits.

Publication 05-10029 Disability Benefits.

Publication 05-10035 Retirement Benefits.

Publication 05-10045 Windfall Elimination Provision.

Publication 05-10069 How Work Affects Your Benefits.

Publication 05-10077 What You Need to Know When You Get Retirement or Survivors 

Benefits.

Publication 05-10084 Survivors Benefits.

Publication 05-10085 Benefits for Children.

Publication 05-11000 Supplemental Security Income (SSI).

Publication 05-11011 What You Need to Know When You Get Supplemental Security 

Income (SSI).

Apply for Survivor Benefits.

Supplemental Security Income (SSI).

Calculator for Benefit Estimate Based on Your Actual SS Earnings Record.

Click for more Detailed Benefits Calculations.

Fallen Firefighter Benefits – Federal Benefits – Social Security.

Social Security Administration (SSA).

Apply for SSI, Survivors, or Family Benefits.

Publication 554, Tax Guide for Seniors this form is updated every tax year and can be found 

at IRS.gov.

Publication 915, Social Security and Equivalent Railroad Retirement Benefits. This form is 

updated every tax year and can be found on the IRS website.

H. Forms

IRS Form W-4V to request that Federal Taxes be withheld from your SS Benefits contact 

IRS at 1-800-829-3676.

I. Contacts

Social Security

Toll-Free, 1-800-772-1213

TYY 1-800-325-0778

7 a.m. To 7 p.m. M-F

Automated phone service 24 hours a day Social Security Office Locator
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APPENDIX 16 – FEDERAL LONG TERM CARE INSURANCE PROGRAM 

(FLTCIP)

A. Overview

Federal Long Term Care is personal care and other related services provided on an extended 

basis to people who need help with specific everyday activities or who need supervision due 

to a severe cognitive impairment. The surviving spouse may be eligible to apply for this 

insurance benefit or may need to contact the carrier to cancel the decedent’s policy. There is 

no time limit for applying for this insurance; however, premiums are based on age and will 

therefore go up with each year.

B. Eligibility

1. Can My Family Continue My Coverage If I Die?

No. Federal Long Term Care Insurance Program coverage is specific to the enrolled 

individual. If an enrollee dies, no one can continue that enrollee's coverage. 

However, any enrolled relatives of a deceased enrollee can continue their coverage 

as long as they continue to pay premiums. Most Federal survivor annuitants are 

eligible to apply for coverage.

C. Process

If their premiums were paid through payroll/annuity deduction of the deceased, they will 

need to contact Long Term Care Partners, LLC to make other arrangements for premium 

payment.

D. Forms

1. FLTCIP Forms

E. Links For More Information

1. OPM Website on LTCIP

2. FLTCIP Eligibility

3. FLTCIP Information

F. Contacts

Long Term Care Partners, LLC

Box 797

Greenland, NH 03840-0797

Toll free: 1-800-582-3337

TTY: 1-800-843-3557

Fax: 1-866-921-4510

Apply online

G. National Operations Center Branch Of Employee Benefits Services (NOC BEBS)

BEBS does not process FLTCIP. The survivor will need to contact FLTCIP directly.

H. Regulations And Authorities

5 CFR Part 875 – Federal Long Term Care Insurance Program
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APPENDIX 17 – SOURCES OF RECOGNITION

A. Law Enforcement Personnel

1. American Police Hall Of Fame

Categories: Awards in 19 different areas including bravery, lifesaving, and K-9 

American Police Hall of Fame

3801 Biscayne Blvd.

Miami, Fl. 33137 

APHF Website

Reference applicable State Law Enforcement and Fire Associations; California 

example shown below.

2. California Peace Officers Association

Categories: Award of Valor, Award of Distinction

Eligibility: Anyone in a Law Enforcement-related job (sworn or non-sworn) within 

the organization. Do not have to be a member of CPOA.

California Peace Officers Association 1455 Response Road

Sacramento, CA 95815 

Email: cpoa@cpoa.org

CPOA Website

3. Federal Law Enforcement Officers Association (FLEOA)

a. Heroism Award: Any Federal, State, or local Law Enforcement officer 

whose actions showed such concerns for others that the nominee’s safety was 

placed in jeopardy while providing assistance to the victim of a crime or in 

apprehension of a suspect.

b. Bravery Award: Recipient can be any Federal, State, or local Law 

Enforcement Officer whose actions showed outstanding courage and valor in 

a life-threatening situation.

c. Investigative Excellence Award (FLEOA Member): Member in good 

standing whose action led to arrest of a notorious subject, or prosecution of a 

significant criminal conspiracy.

d. Group Achievement Award: Groups of three or more officers who together 

conducted a particularly noteworthy investigation or other Law Enforcement 

achievement.

FLEOA National Awards 8459 US 42
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PMB 308

Florence, KY 41042 

FLEOA Website

4. International Association Of Women Police

Categories: Officer of the Year and Medal of Valor Center for Criminal Justice and 

Law Enforcement

IAWP Awards Chairperson 

1380 Energy Lane, Suite 104 

St. Paul, NM 55108

IAWP Website

5. National Association Of Police Organizations

Category:Top Cops Awards

Eligibility: Must be a sworn Law Enforcement Officer from any Federal, State, 

County, or local agency within the U.S. Nomination must be submitted by a sworn 

Law Enforcement Officer through a short essay on why nominee should be 

considered.

National Association of Police Organizations 

Attn: Top Cops Awards

750 First Street, Suite 920

Washington, DC 20002-4241

NAPO Website

6. National Law Enforcement Officers Memorial Fund (NLEOMF)

Category:Officer of the Month. Officers who distinguish themselves through 

exemplary service and devotion to duty.

Eligibility: Both full and part time Law Enforcement Officers. 

NLEOMF

605 E Street NW

Washington, DC 20004

NLEOMF Website

7. Women In Federal Law Enforcement (WIFLE)

Category:Julie Y. Cross award: Officers who displayed an unusual degree of 

courage, stamina and willingness to go above and beyond the call of duty, resulting 
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in an exceptional heroic achievement in Law Enforcement.

Eligibility: All sworn full-time Law Enforcement Officers. 

WIFLE

PMB-204 Suite 102

2200 Wilson Blvd

Arlington, VA 22201 

WIFLE Website

8. Women Peace Officers’ Association Of California

Categories: Member Merit Award, Award for Professional 

Achievement/Management, Award for Professional Achievement/Line

Woman Peace Officers Association 

7355 Dayton Avenue

Hesperia, CA 92345 

WPOACA Website

B. Other

1.National Fallen Firefighters Foundation

National Fallen Firefighters Foundation

P.O. Drawer 498 

Emmitsburg, MD 21727 

Phone: (301) 447-1365 

Fax: (301) 447-1645

‘

NFFF Website

2.Wildland Firefighter Foundation

Wildland Firefighter Foundation 

2049 Airport Way

Boise, ID 83705 

WFF Website

3.Carnegie Hero Fund Commission

Eligibility: Any civilian who voluntarily risks his/her own life, knowingly, to an 

extraordinary degree while saving or attempting to save the life of another person is

eligible.

Law Enforcement, Rescue, and Fire Personnel are also eligible if the rescue is clearly 
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beyond the line of duty.

Carnegie Hero Fund Commission 

425 Sixth Ave.

Suite 1640

Pittsburgh, PA 15219-1823 

CHFC Website

4. United States Coast Guard-Life Saving Medal

Eligibility: Any persons who rescues or endeavors to rescue any other person from 

drowning, shipwreck, or other perils of water.

Information: Contact Commander of Coast Guard District where incident took place. If 

unknown or outside of a District contact:

Commander (G-WPM-3)

Coast Guard Washington, DC 20593-0001 

USCG Website
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APPENDIX 18 – FEDERAL TRAVEL REGULATIONS PART 303-70 AGENCY 

REQUIREMENTS FOR PAYMENT OF EXPENSES CONNECTED WITH THE 

DEATH OF CERTAIN EMPLOYEES

A. Overview

The following Travel Regulations are used to pay expenses related to the death of an 

employee – where the death is not work related – who is on travel or OCONUS at the time 

of death. If the death is work related, expenses are payable under the Federal Employees’ 

Compensation Act (FECA), 5 U.S.C. Section 8134.

Authority: 5 U.S.C. 5721-5738; 5741-5742; E.O. 11609, 3 CFR, 1971-1975 Comp., p. 586; 

Presidential Memorandum dated September 12, 2011, “Delegation Under Section 2(a) of 

the Special Agent Samuel Hicks Families of Fallen Heroes Act.''

B. Subpart A – General Policies

1. §303-70.1

When Must We Authorize Payment Of Expenses Related To An Employee's Death?

You must authorize payment of expenses when, at the time of death, the employee 

was:

a. On official travel status (away from the official station), or

b. Performing official duties OCONUS or in transit to or there from, or

c. Reassigned away from his/her actual place of residence under a mandatory 

mobility agreement, or

d. In direct support of or directly related to a military operation, including a 

contingency operation, or an operation in response to an emergency declared 

by the President as provided in §303-70.600, or

e. Performing official duties as determined by the head of agency and be a 

covered employee as provided in §303-70.700.

2. §303-70.2

Must We Pay Death-Related Expenses When The Employee's Death Is Not WorkRelated?

Yes, provided the requirements in §303-70.1 are met.

3. §303-70.3

Must We Pay Death-Related Expenses For An Employee Who Dies When On 

Leave, Or Who Dies On A Non-Workday, While On Temporary Duty (Tdy) Or 

Stationed Oconus?

Yes, provided the requirements in §303-70.1 are met. However, payment cannot 

exceed the amount allowed if death had occurred while on duty at the TDY station 

or at the official station OCONUS.

4. §303-70.4
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Must We Pay Death-Related Expenses Under This Chapter If The Same Expenses 

Are Payable Under Other Laws Of The United States?

No. When an employee dies from injuries sustained while performing official duty, 

certain death-related expenses are payable under the Federal Employees' 

Compensation Act (FECA), 5 U.S.C. 8134. For further information contact:

Department of Labor, Division of Federal Employees' Compensation 

200 Constitution Avenue, NW

Washington, DC 20210

5. §303-70.5

Must We Pay Death-Related Expenses Under This Chapter To Relocate The 

Immediate Family To Another Location For An Employee Who Dies While At The 

Permanent Official Station?

No, except when the employee dies while performing duties under the provisions of 

Subparts F, G, and H of this Chapter.

C. Subpart B – Allowances For Preparation And Transportation Of Employee Remains

1. §303-70.100

Must We Provide Assistance For Preparation And Transportation Of Employee 

Remains?

Yes, in accordance with §303-70.101 and §303-70.102.

2. §303-70.101

What Costs Must We Pay For Preparation And Transportation Of Employee 

Remains?

You must pay all actual costs including but not limited to:

a. Preparation of remains, including:

b. Embalming or cremation,

c. Necessary clothing,

d. A casket or container suitable for shipment to place of interment, and

e. Expenses necessary to comply with local laws at the port of entry in the 

United States, and

f. Transportation of remains by common carrier (that is normally used for 

transportation of remains), hearse, other means, or a combination thereof, 

from the TDY station, OCONUS location, or CONUS location covered by 

§303-70.1 (e), to the employee's residence, official station, or place of 

interment, including but not limited to:

1) Movement from place of death to a mortuary and/or cemetery,

2) Shipping permits,
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3) Outside case for shipment and sealing of the case if necessary,

4) Removal to and from the common carrier, and

5) Ferry fares, bridge tolls, and similar charges.

Note to § 303-70.101: Costs for an outside case are not authorized for transportation by 

hearse. Costs for transportation by hearse or other means cannot exceed the cost of 

common carrier (that is normally used for transportation of remains).

3. §303-70.102

Are There Any Limitations On The Place Of Interment?

No. You may pay expenses to transport the remains for interment at the actual 

residence, the official station, or such other place appropriate for interment as 

determined by the head of your agency.

D. Subpart C– Escort of Employee Remains

1. §303-70.200

Under What Circumstances May We Authorize An Escort For The Remains Of A 

Deceased Employee?

You may authorize the escort of remains when the employee's death occurs:

While in official travel status away from the official station inside CONUS,

While assigned to official duties OCONUS or in transit thereto or therefrom, or

While reassigned away from actual place of residence under a mandatory mobility 

agreement.

2. §303-70.201

How Many Persons May Be Authorized Travel Expenses To Escort The Remains Of 

A Deceased Employee?

You may authorize travel expenses for no more than two persons.

3. §303-70.202

What Travel Expenses May We Authorize For The Escort Of A Deceased 

Employee's Remains?

You may authorize any travel expenses in accordance with Chapter 301 of this Title 

that are necessary for the escort of remains to:

a. The home or official station of the deceased, or

b. Any other place appropriate for interment as determined by the head of your 

agency.

E. Subpart D – Allowances for Preparation and Transportation of the Remains of Immediate 

Family Members

1. §303-70.300
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When An Immediate Family Member, Residing With The Employee, Dies While 

The Employee Is Stationed Oconus, Must We Furnish Mortuary Services?

Yes, if requested by the employee and when:

a. Local commercial mortuary facilities or supplies are not available, or

b. The cost of available mortuary facilities or supplies is prohibitive as 

determined by your agency head. Note to § 303-70.300: The employee must 

reimburse you for all furnished mortuary facilities and supplies.

2. §303-70.301

When An Immediate Family Member, Residing With The Employee, Dies While 

The Employee Is Stationed Oconus, Must We Pay Expenses To Transport The 

Remains?

Yes, if requested by the employee, you must pay to transport the remains to the 

residence of the immediate family member. The employee may elect an alternate 

destination, but it must be approved by your agency head or his/her designated 

representative.

3. §303-70.302

When An Immediate Family Member, Residing With The Employee, Dies While 

The Employee Is Stationed Oconus, May We Pay Interment Expenses?

No. You may not pay interment expenses when an immediate family member, 

residing with the employee, dies while the employee is stationed OCONUS.

4. §303-70.303

When An Immediate Family Member, Residing With The Employee, Dies While In 

Transit To Or From The Employee's Duty Station Oconus, Must We Furnish 

Mortuary Services and/or Transportation Of The Remains?

Yes, you must furnish transportation if requested by the employee. You must follow 

the guidelines in §303-for transportation expenses. You must furnish mortuary 

services only if the conditions in §303-70.300 are met.

F. Subpart E – Transportation of Employee's Baggage and Privately Owned Vehicles (POV) 

From Official Temporary Duty (TDY) Station

1. §303-70.400

Must We Pay Transportation Costs to Return the Deceased Employee's Baggage 

from an Official TDY Station?

Yes, you must pay transportation costs to return the deceased employee's baggage to 

his/her official station or residence. However, you may not pay insurance of, or 

reimbursement for, loss or damage to baggage.

2. §303-70.401

Are There Any Limitations On The Baggage We Must Transport From An Official 

TDY Location?
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Yes. You must only transport Government property and the employee's personal 

property, including professional books, papers, and equipment (PBP&E).

3. §303-70.402

Must We Pay Transportation Costs To Return the Deceased Employee's POV from

the TDY Location?

Yes. You must pay costs associated with returning the POV from the TDY location 

to the employee's permanent official station, but only if the agency had authorized 

the use of the employee's POV at the TDY location as more advantageous to the 

Government than other means of transportation.

G. Subpart F – Transportation of Immediate Family Members, Baggage, Household Goods, 

and Privately Owned Vehicles (POV)

1. §303-70.500

When The Employee, On A Service Agreement Or A Mandatory Mobility 

Agreement, Dies At Or While In Transit To Or From His/Her Official Station 

Oconus, Must We Return The Employee's Immediate Family, Baggage, POV, And 

Household Goods To The Former Actual Residence, New Official Station In Conus, 

Or Alternate Destination?

Yes. Travel and transportation must begin within one year from the date of the 

employee's death. A one-year extension may be granted if requested by the family 

prior to the expiration of the one-year limit. The agency head or designated 

representative may approve the immediate family's relocation to one of the 

following:

a. The place of the employee's former residence at the time of assignment to 

duty OCONUS, or

b. The new CONUS location if in transit, or

c. An alternate destination as approved by the agency.

2. §303-70.501

Must We Continue Payment Of Relocation Expenses For An Employee's Immediate 

Family If The Employee Dies While In Transit From Oconus Official Station To 

His/Her New Official Station Within Conus?

Yes, if the immediate family chooses to continue the relocation, you must continue 

payment of relocation expenses for the immediate family, provided the immediate 

family was included on the employee's relocation travel orders (see §303-70.503)

3. §303-70.502

Must We Continue Payment Of Relocation Expenses For An Employee's Immediate 

Family If The Employee Dies After Reporting To The New Official Station Within 

Conus, But The Family Was In Transit To The New Official Station Or Had Not 

Begun Its En Route Travel?
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Yes, if the immediate family chooses to continue the relocation, you must continue 

payment of relocation expenses for the immediate family, provided the immediate 

family was included on the employee's relocation travel orders (see §303-70.503)

4. §303-70.503

What Relocation Expenses Must We Authorize For The Immediate Family Under 

§303-70.501 And §303-70.502?

When the immediate family chooses to continue the relocation, the following 

expenses must be authorized:

a. Travel to the new duty station or alternate destination as approved by the 

agency,

b. Shipment of household goods not to exceed 18,000 pounds net weight to the 

new duty station, or to an alternate destination selected by the immediate 

family and approved by the agency,

c. Storage of household goods not to exceed 60 days with an additional 90 days 

extension, if approved by the agency, not to exceed a total of 150 days,

d. Reimbursement of real estate expenses incident to the relocation unless 

relocation is to the former actual residence,

e. Temporary quarters subsistence expense (TQSE) not to exceed 60 days, to be 

paid at the per diem rate for an unaccompanied spouse or domestic partner, 

and immediate family, if the TQSE was originally authorized in the 

relocation travel orders, and

f. Shipment of one POV to the new duty station, or to an alternate destination 

selected by the immediate family and approved by the agency, if the POV 

shipment was originally authorized in the relocation travel orders.

H. Subpart G – Transportation of Immediate Family Members, Baggage, Household Goods, 

and Privately Owned Vehicles (POV) For Employees Assigned To Contingency Operation 

or an Operation in Response to an Emergency Declared By the President

1. §303-70.600

When An Employee Dies While Performing Official Travel Duties Directly 

Supporting Or Directly Relating To A Contingency Operation Or An Operation In 

Response To An Emergency Declared By The President, Must We Provide 

Transportation For The Employee's Immediate Family, Baggage, And Household 

Goods From The Current Official Station To The Former Actual Residence Or An 

Alternate Destination?

Yes. However, the employee must have died as a result of disease or injury incurred 

while performing official duties:

a. In an overseas location where the employee was performing such official 

duties,

b. Within the area of responsibility of the Commander of the United States 

Central Command, and
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c. In direct support of or directly related to a military operation, including a 

contingency operation (as defined in 10 U.S.C. 101(a) (13)) or an operation 

in response to an emergency declared by the President.

2. §303-70.601

What Relocation Expenses Must We Authorize For The Immediate Family Under 

§303-70.600?

When the immediate family selects to relocate to the former actual residence or 

alternate destination as approved by the agency, you must authorize the following 

expenses:

a. Transportation of the immediate family,

b. Transportation of household goods of the immediate family, including 

transporting, packing, crating, draying, and unpacking, not to exceed 18,000 

pounds net weight, and

c. Storage of household goods moved pursuant to subparagraph (b) of this 

section, not to exceed 60 days with an additional 90 days extension, if 

approved by the agency, not to exceed a total of 150 days.

3. §303-70.602

Must We Pay Transportation Costs To Return the Deceased Employee's POV from

the TDY Location or From an Official Station Oconus Under

§303-70.600?

Yes. You must pay costs associated with returning the POV from the following:

a. TDY location to the employee's permanent official station, if the agency had 

authorized the use of the employee's POV at the TDY location as more 

advantageous to the Government than other means of transportation; 

b. Or Official station OCONUS to the employee's former actual residence or 

alternate destination as approved by the agency, if the agency had 

determined that the use of the employee's POV was required in accordance 

with part 302-9 of this Title.

I. Subpart H – Transportation of Immediate Family Members, Baggage, Household Goods, 

and Privately Owned Vehicle for Law Enforcement Assignment

1. §303-70.700

When An Employee Dies As A Result Of Personal Injury Sustained While In The 

Performance Of The Employee's Law Enforcement Duties, Either On Official Travel 

Duties Away From The Official Station, Or At The Current Official Station, Must 

We Provide Transportation For The Employee's Immediate Family, Baggage, And 

Household Goods To An Alternate Residential Destination?

Yes, if the head of the agency concerned (or a designee) determines that the 

employee died as a result of personal injury sustained while in the performance of 

the employee's duties, and the employee was:
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a. A Law Enforcement Officer as defined in 5 U.S.C. 5541,

b. An employee in or under the Federal Bureau of Investigation who is not 

described in paragraph (a), or

c. A Customs and Border Protection officer as defined in 5 U.S.C. 8331(31).

2. §303-70.701

What Relocation Expenses Must We Authorize For The Immediate Family Under 

§303-70.700?

If the place where the immediate family will reside is different from the place where 

the immediate family resided at the time of the employee's death, and within the 

United States, then the agency must approve the following expenses:

a. Transportation of the immediate family,

b. Moving of the household goods of the immediate family, including 

transporting, packing, crating, draying, and unpacking, not to exceed 18,000 

pounds net weight,

c. Storage of household goods moved pursuant to paragraph (b) of this section, 

not to exceed 60 days with an additional 90 days extension, if approved by 

the agency, not to exceed a total of 150 days, and

d. Transportation of one privately owned motor vehicle.

3. §303-70.702

Must We Pay Transportation Costs To Return The Deceased Employee's Privately 

Owned Vehicle (POV) From The Temporary Duty (TDY) Location Or From An 

Official Station Oconus Under §303-70.700?

a. Yes. The agency must pay costs associated with returning the POV from the 

following:

b. TDY location to the employee's permanent official station, if the agency had 

authorized the use of the employee's POV at the TDY location as being 

advantageous to the Government, or

c. Official station OCONUS to the employee's former actual residence or 

alternate destination as approved by the agency, if the agency determined 

that the use of the employee's POV was required accordance with, part 302-9

of this title.

J. Subpart I – Policies and Procedures for Payment of Expenses

1. §303-70.800

Are Receipts Required For Claims For Reimbursement Under This Part?

Yes. Receipts are required for claims for reimbursement under this part.

2. §303-70.801

To Whom Should We Make Payment?
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You should:

a. Pay the person performing the service, or

b. Reimburse the person who made the original payment.
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APPENDIX 19 – TEMPLATES AND FORMS

A. Survivor Intake Form (Fillable Form) 

Information about survivors and their wishes. (To be completed by notifier.)

(This form is to be filled out at the time of notification and retained by thenotifier.)

Name of survivor: (ENTER HERE)

Person providing information (if different): (ENTER HERE)

Address of survivor: (ENTER HERE)

Community: (ENTER HERE)

Zip Code: (ENTER HERE)

Relation to the deceased: (ENTER HERE)

Telephone: (ENTER HERE) (Home)(ENTER HERE) (Work)

Name of funeral home to which the body of the deceased should be sent: (ENTER HERE)

If the survivor has no preference in funeral homes would he or she like the medical examiner to 

choose one?

☐ Yes ☐ No

Do any survivors wish to see the body of the person who has died?

☐ Yes ☐ No ☐ Will decide later

Are there any special items that might have been in the possession of the person who died (such 

as jewelry or a donor card)? If so, list: (ENTER HERE)

Others to be contacted by notifier (other kin, unmarried partners, roommates, etc.)

Name/Phone: (ENTER HERE)

Name/Phone: (ENTER HERE)

Persons contacted by notifier to provide support to survivor:

Name/Phone: (ENTER HERE)

Name/Phone: (ENTER HERE)

Notifier Signature Date

Adapted from “In Person, In Time” – Recommended Procedures for Death Notification” Crime 

Victim Assistance Division, Iowa Department of Justice and reprint and distribution permission 

from Concerns of Police Survivors, Inc.
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B. Memorandum to Chief Financial Officer (Fillable Template)

Memorandum

To: Chief Financial Officer, NAME OF STATE State

From: State Director, NAME OF STATE State

Subject: Public Law 104-208 – Death Gratuity Payment Authority

Section 651 of Public Law 104-208 the Omnibus consolidated Appropriations Act, effective 

September 30, 1996, provided authority to pay up to $10,000 as a death gratuity to the personal 

representative of an employee who dies from an injury sustained in the line of duty. According to 

the National BLM Service Death Gratuity Policy, when the agency administrator determines the 

employee death to be “in the line of duty,” and designates who the personal representative is, a 

death gratuity payment of $9,000 will be paid out to that designated personal representative.

Accordingly, I have determined that DECEASED EMPLOYEE’S NAME, TITLE, AND UNIT, 

died on DATE OF DEATH from an injury sustained in the line of duty and that PERSONAL 

REPRESENTATIVE’S NAME, is the personal representative designated to receive the death 

gratuity payment of $9,000.

PERSONAL REPRESENTATIVE’S NAME, PERSONAL REPRESENTATIVE’S 

RELATIONSHIP TO THE DECEASED and estate executor of DECEASED EMPLOYEE’S 

NAME, has been notified of this payment and that if the Department of Labor does not pay a 

total of $1,000—$200 under 5 U.S.C. Section 8134 (a) and $800 under 5 U.S.C. Section 

8133(f)—in conjunction with the death, we will process an additional payment to bring the total 

death gratuity, including any payments from the Department of Labor that were received from 

the above, and this initial $9,000 death gratuity payment, to $10,000, which is the total amount 

authorized under P.L. 104-208. This additional payment will be processed once the personal 

representative submits the application for additional payment.

We are attaching the obligation transmittal sheet and supporting documents and are requesting 

your assistance in processing the payment. If you need additional information, please contact 

HRO CONTACT NAME, TITLE, AND PHONE NUMBER.

State Director, NAME OF STATE State

Attachments
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C. Sample Letter to Personal Representative (Fillable Template)

Dear PERSONAL REPRESENTATIVE’S NAME:

Pursuant to Public Law 104-208, Section 651, and the Bureau of Land Management Death 

Gratuity Policy, you have been designated by the State Director of the NAME OF STATE State 

as the personal representative of NAME OF DECEASED EMPLOYEE who died on DATE OF 

DEATH, as a result of an injury sustained in the line of duty. The personal representative of the 

deceased employee is generally the formally designated executor or the administrator of the 

employee’s estate under State law, or other entity as deemed creditable by the agency. In all 

instances, the law indicates that the final determination of the personal representative lies with 

the agency. It is the policy of the Bureau of Land Management to provide you with a death 

gratuity payment of $9,000 to assist during this difficult time.

The Department of Labor may also pay:

• $200 for reimbursement of the costs of termination of the decedent’s status as an 

employee of the United States; and

• Up to $800 for funeral and burial expenses in cases of employees who die as a result of 

an injury sustained in the performance of duty.

You will need to work your benefits coordinator NAME AND PHONE NUMBER, to process 

these two payments.

The death gratuity payment, pursuant to Public Law 104-208, cannot exceed $10,000. If the 

Department of Labor did not pay, in full, the two payments listed above, you can complete the 

enclosed application for additional death gratuity payment and return it to the address indicated 

on the application.

The additional death gratuity payment will be calculated by subtracting the Bureau of Land 

Management death gratuity payment of $9000 and any Department of Labor payments from the 

two benefits list above from the $10,000 maximum benefit payable. Any remainder may be 

payable upon receipt of the completed application for additional death gratuity payment.

We request that you complete the form and return it to ENTER NAME Human Resources 

Officer, Bureau of Land Management, NAME OF STATE State – ADDRESS. If you have any 

questions, please contact the HRO OFFICE NAME at HRO PHONE NUMBER.

Sincerely,

Human Resources Officer

HRO OFFICE NAME
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D. Application for Additional Death Gratuity Payment (Fillable Template)

Deceased Employee’s Name: (ENTER HERE) SSN: (ENTER HERE)

Office Where Employed: (ENTER HERE) Date of Death: (ENTER HERE)

Office of Worker’s Compensation Claim No: (ENTER HERE)

NOTE: If there is no approved Office of Workers’ Compensation Programs claim as a result of 

the employee’s death, please provide an explanation regarding the circumstances of death and 

provide documentation which supports that the death was related to the performance of official 

duty:

Personal Representative’s Name: (ENTER HERE)

Address: (ENTER HERE)

Social Security Number: (ENTER HERE)

Telephone Number/Area Code: (ENTER HERE)

Please indicate the date received for all payments already received in conjunction with this 

claim:

• $200 payable under 5 U.S.C. Section 8134(a)(termination of decedent’s status as a 

Federal employee) ‘

Date Received: (ENTER HERE)

☐ $800 or $ENTER AMOUNT payable under 5 U.S.C. Section 8133(f) (funeral and 

burial expenses (OWCP)

Date Received: (ENTER HERE)

☐ Other Payments from the United States Government DETERMINE WHAT THIS 

AMOUNT IS

Date(s) Received: (ENTER HERE)

Describe: (ENTER HERE)

[Include a copy of the letter designating you as the personal representative.]

Signature of Claimant Date Signed
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E. Letter to Personal Representative Regarding Additional Death Gratuity Payment (Fillable 

Template)

Dear PERSONAL REPRESENTATIVE’S NAME:

We have processed the paperwork for your Application for an additional death gratuity payment. 

As discussed in my letter to you dated PROVIDE DATE, I indicated that under Public Law 104-

208, Section 651, the agency could pay up to a $10,000 gratuity payment to the personal 

representative of an employee who died due to an on-the-job injury.

You submitted the required form and supporting documentation and we have requested an 

additional payment in the amount of $AMOUNT. This payment was calculated by subtracting 

the $9000 death gratuity payment already issued by the Bureau of Land Management, and the 

Department of Labor payments as indicated on your application, from the $10,000 maximum 

payable death gratuity under Public Law 104-208.

The check will be sent separately. If you do not receive the check within the next 4 weeks or if 

you have any questions, please contact this office at PHONE NUMBER.

Sincerely,

HRO CONTACT NAME

Human Resources Officer

NAME OF STATEState Office
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F. Flag Lowering (Fillable Template 1)

This is a fillable templet of a memo written by the Deputy Director of the BLM authorizing 

flags to be lowered at all BLM facilities.

ENTER DATE

MEMORANDUM

To: State Directors

From: NAME OF DEPUTY DIRECTOR

Subject: Authorization of American Flags to be flown at Half-staff at BLM Facilities Nationwide

In honor of NAME OF INDIVIDUAL, at NAME OF UNIT, I have ordered all American flags to 

be flown at half-staff at all Bureau of Land Management areas, from SPECIFIC DAY OF WEEK 

AND DATE, until further notice UNLESS SPECIFIC DATE OF INTERMENT IS KNOWN.

FIRST NAME OF EMPLOYEE, who served as a IDENTIFY SPECIFIC POSITION at NAME 

OF BLM UNIT for LENGTH OF TIME AT BLM, died on DATE OF DEATH while 

DESCRIBE HOW EMPLOYEE LOST HIS/HER LIFE. BE SPECIFIC.
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G. Flag Lowering (Fillable Template 2)

This is a fillable template of a memo written by a State Director authorizing flags to be 

lowered at the state level for a Line-of-Duty Death within their particular state.

ENTER DATE

MEMORANDUM

To: District Managers, STATE

From: State Director, STATE

Subject: Authorization of American Flags to be flown at Half-Staff at STATE BLM Facilities

By order of the State Director and effective immediately, until sunset SPECIFIC DAY OF 

WEEK AND DATE, flags in the STATE NAME State of the Bureau of Land Management are 

to be lowered to half-staff in honor of NAME OF EMPLOYEE. FIRST NAME OF EMPLOYEE

served as a DESCRIBE EMPLOYEE’S POSITION and DESCRIBE WHAT HAPPENED TO 

EMPLOYEE on DAY OF WEEK AND DATE.
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H. Benefits Counselor Checklist

Immediate (within the first 8 hours)

☐ Human Resource Officer notifies the Branch Chief of Branch of Employee Benefits Services 

(BEBS) of the death and provide the employee’s name, title, duty location, and the date of death. 

The Benefits Counselor will contact a family member or Family Liaison. Provide the Family 

Liaison with your name and telephone number. Let the Family Liaison know that three death 

Secondary (within 8 to 36 hours) 

☐ Coordinate with the Family Liaison officer to personally meet with the family upon request a few 

days after the funeral to discuss the benefits they might receive.

☐ The Benefits Counselor determines whether the family is entitled to a continuation of health 

benefits.

☐ Be familiar with the Federal benefits entitlement (see examples for reference only) to ensure that 

the survivors receive benefits and entitlements due them.

☐ In coordination with the Family Liaison obtain legal documents, such as birth certificate, 

marriage licenses, etc., needed to process benefit’s claims

☐ Benefits Counselor will prepare all OPM sanctioned benefits i.e. Health, life, TSP, and annuity 

forms for the survivors and pay close attention to turnaround times, specifying when benefit 

payments can be expected. Benefits’ forms are usually mailed to the family by the Benefits 

Counselor. The Benefits Counselor will work with the family/Family Liaison to ensure the family 

Low (within 72 hours) 

☐ Notify affiliated organizations (i.e., OPM, TSP, and OFEGLI) to ensure that any and all 

entitlements, benefits, and assistance are provided to the beneficiary(s).

☐ Prepare a printout of the benefits due the family, listing named beneficiaries, contacts at various 

benefits offices, and the times when they can expect to receive payments.

☐ Meet, when possible in regard to location, with the family to ensure they are receiving the 

benefits in a timely manner.

☐ Make follow-up phone calls to appropriate agencies and departments to ensure that paperwork is 

received and to ascertain status of payments. Keep survivors apprised of any information related 

to benefit payments.

☐ If there are surviving children from a previous marriage, give their guardians a printout of what 

benefits of which the children may be entitled.
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I. Checklist For Processing Benefits

Employee Name: Date of Death: Benefits Contact Name and Number:

Survivor Name(s) and Contact Number: Notes:

STEP #1 – CONTACT BENEFITS

Telephone: Notes:

STEP #2 – BENEFITS INITIATES PERSONNEL ACTION (SF-50)

Completed?

☐Yes ☐No

Notes:

The following benefits will be initiated and processed by BEBS. The benefits coordinator can 

use the below list to help the survivors through the process of completing these forms as needed.

STEP #3 – RETIREMENT (FICA, CSRS, FERS)

Benefit

Applies to 

Employee? Completed? Notes:

FICA Only ☐Yes ☐No ☐Yes ☐No

Annuity CSRS ☐Yes ☐No ☐Yes ☐No

Annuity FERS ☐Yes ☐No ☐Yes ☐No

FERS Lump 

Sum

☐Yes ☐No ☐Yes ☐No

FERS Basic 

Death Benefit 

(BEDB)

☐Yes ☒No ☐Yes ☐No

STEP #4

Benefit

Applies to 

Employee? Completed? Notes:

Surviving 

Children

☐Yes ☐No ☐Yes ☐No

Surviving 

Former Spouse

☐Yes ☐No ☐Yes ☐No

Reemployed 

Annuitant

☐Yes ☐No ☐Yes ☐No

TSP ☐Yes ☐No ☐Yes ☒No
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HEALTH INSURANCE

Benefit

Applies to 

Employee? Completed? Notes:

FEHB ☐Yes ☐No ☐Yes ☐No

TCC ☐Yes ☐No ☐Yes ☐No

FSAFEDS ☐Yes ☐No ☐Yes ☐No

HDHP ☐Yes ☐No ☐Yes ☐No

FLTCIP ☐Yes ☐No ☐Yes ☐No

FEDVIP ☐Yes ☐No ☐Yes ☐No

LIFE INSURANCE

Benefit Applies to 

Employee?

Completed? Notes:

FEGLI ☐Yes ☐No ☐Yes ☐No

The following are not processed by BEBS.

OTHER BENEFITS AVAILABLE

Benefit Applies to 

Employee?

Completed? Notes:

SSA ☐Yes ☐No ☐Yes ☐No BLM does not process SS benefits; however, you can refer to 

general information in this handbook and refer survivors to 

VA h SSA b i ☐Yes ☐No ☐Yes ☐No BLM does not process VA benefits; however, you can refer to 

general information in this handbook and refer survivors to 

h VA b i Travel and 

Transport of 

Remains

☐Yes ☐No ☐Yes ☐No Travel and Transportation of Remains and Household goods 

is determined by type of death, location of death, CONUS vs 

OCONUS, etc.

See Appendix 18 (Federal Travel Regulations Part 303-70 

Agency Requirements for Payment of Expenses Connected 

with the Death of Certain Employees) and OWCP regulations 

 

Notes: