Texas Administrative Code › Title 34 - PUBLIC FINANCE › Part 4 - EMPLOYEES RETIREMENT SYSTEM OF TEXAS › Chapter 75 - HAZARDOUS PROFESSION DEATH BENEFITS › Section 75.1 - Filing of Claims

Current through Reg. 49, No. 28; July 12, 2024
(a) Claims for
				benefits under Texas Government Code, Chapter 615, may be initiated by the
				deceased employee's department, any applicant for benefits, if an adult, or by
				the representative of any minor children for whom benefits are being
				claimed.
(b) No claim for benefits
				on behalf of a child born after the death of the law enforcement officer or
				fire fighter will be paid, unless it is accompanied by a certificate of the
				attending physician that the child was conceived during the decedent's
				lifetime.
(c) The following
				documents or copies of the documents shall be submitted in an application for
				benefits under Texas Government Code, Chapter 615, unless the executive
				director or designee waives their submission:
(1) a sworn statement from the person making
				the claim giving the date of death, the name and address of the surviving
				spouse, if there is one, and the names, addresses, and birth dates of all
				surviving children of the decedent. If the decedent left no surviving spouse or
				children, the names and addresses of surviving parents of the decedent shall be
				provided. The names and addresses of any persons caring for minors who may be
				eligible for benefits shall be given;
(2) a certified copy of the death
				certificate;
(3) a certified copy
				of the autopsy report, only if requested by the system;
(4) a copy of the marriage certificate
				showing marriage between the surviving spouse and the deceased;
(5) a certified copy of the birth certificate
				of each surviving child of the deceased;
(6) affidavits from any witnesses detailing
				the facts of the fatality;
(7)
				certified copies of any investigative reports;
(8) a sworn statement from the employer or
				authorized representative of the department detailing the facts and
				circumstances of the fatality, and any information relied upon in making the
				sworn statement. The employer's or department representative's sworn statement
				must also include facts showing that, at the time of the fatal injury, the
				deceased held a position covered by the terms of Texas Government Code, Chapter
				615, and that the death resulted from a personal injury sustained in the line
				of duty, as provided by Government Code §
										615.021;
(9) a copy of the decedent's birth
				certificate, if benefits are being claimed for parents;
(10) a certification from the appropriate
				authority as follows:
(A) if the decedent was
				a paid law enforcement officer, as defined in Texas Government Code, §
											615.003(1),
				a certification from the Texas Commission on Law Enforcement Officer Standards
				and Education that the decedent was a commissioned peace officer certified by
				that commission;
(B) if the
				decedent was a paid fireman, as defined in Texas Government Code, §
											615.003(10)
				or § 615.003(11), a certification from the Commission on Fire Protection
				Personnel Standards and Education that the decedent was certified by that
				commission, or a certification from the head of the state agency or political
				or legal subdivision of the state for whom the decedent worked that aircraft
				crash and rescue fire fighting were the decedent's principal duties at the time
				of his or her death;
(C) if the
				decedent was a member of an organized volunteer fire department, as defined in
				Texas Government Code, §
											615.003(12),
				a certification from the head of the organized volunteer fire department that
				the decedent was a member of an organized volunteer fire department that
				conducts a minimum of two drills each month, with each drill being at least two
				hours long, and decedent rendered fire fighting services without
				remuneration;
(D) if the decedent
				was a paid probation officer, as defined in Texas Government Code, §
											615.003(2),
				a certification from the district judge or district judges who appointed the
				decedent or for whom the decedent worked that the decedent had the
				qualifications and duties set out in the Texas Code of Criminal Procedure,
				Article 42.12, §10, 1965, as amended;
(E) if the decedent was a paid parole
				officer, as defined in Texas Government Code, §
											615.003(3),
				a certification from the executive director of the Board of Pardons and Paroles
				that the decedent was an officer of the division of parole supervision and had
				the qualifications and duties set out in the Texas Code of Criminal Procedure,
				Article 42.12, §§26-29, 1965, as amended;
(F) if the applicant alleges that the
				decedent was within the protected class defined as supervisory personnel in a
				county jail in Texas Government Code, §
											615.003(7),
				a certification by the sheriff that the decedent was appointed as jailer or
				guard of a county jail and performed a security, custody, or supervisory
				function over the admittance, confinement, or discharge of prisoners, and a
				certification from the Texas Commission on Law Enforcement Officer Standards
				and Education that the decedent was certified by that commission;
(G) if the applicant alleges that the
				decedent was within the protected class defined as performing emergency medical
				services or operation of an ambulance in Texas Government Code, §
											615.003(13),
				a certification by the Texas Department of Health that the decedent was
				certified as at least an "emergency care attendant;"
(H) if the applicant alleges that the
				decedent was within the protected class defined as a chaplain in Texas
				Government Code, §
											615.003(14),
				a certification by the firefighting unit, law enforcement agency, Texas
				Department of Criminal Justice, or a political subdivision of this state that
				the decedent was employed or formally designated as a chaplain.
(11) all newspaper or other media
				accounts, if any, of the fatality;
(12) a copy of the income tax return filed by
				the decedent in the year prior to death, if benefits are being claimed for
				surviving children; and
(13) copies
				of all documents submitted by or on behalf of the decedent or the decedent's
				beneficiary and all notices of decisions related to a workers' compensation
				claim, if a workers' compensation claim has been made related to the illness or
				injury that resulted in the decedent's death.