Skip to Top Main Navigation Skip to Left Navigation Skip to Content Area Skip to Footer
Texas Department of Insurance
Topics:   A B C D E F G H I J K L M N O P Q R S T U V W X Y Z All

Disputes about death benefits

Esta información también está disponible en español.

Insurance carriers may pay death benefits to family members (beneficiaries) of an employee who died because of a compensable work injury. These benefits help families replace some of the income lost after an employee’s death.

If there is a dispute about a claim, it can be resolved through DWC’s dispute resolution process.

Why a claim for death benefits may be disputed:

An insurance carrier may dispute a claim for death benefits if it believes:

A claim is compensable if the insurance carrier accepted liability for the claim or DWC determined the claim is compensable during the dispute resolution process.

Learn more about compensable injury disputes:

Need help?

  • Call DWC Customer Service at 800-252-7031, Monday through Friday, 8 a.m. to 5 p.m., Central time;
  • The Office of Injured Employee Counsel (OIEC) is a state agency that offers injured employees free help with workers’ compensation claims. If you do not have an attorney and want help from an ombudsman, contact OIEC at 866-393-6432, ext. 44186;
  • If you want an attorney and need help finding one, contact the State Bar of Texas at 800-252-9690.

When does a claim for death benefits need to be filed?

File a claim for death benefits with DWC no later than one year from the date of the death.

If the insurance carrier disputes a claim because of a missed deadline, a beneficiary may still be able to get death benefits if:      

  • There was a good reason (good cause) for not asking for the benefits earlier.
  • The request is for a person under 18 years old.
  • The request is for a person who is not able (competent) to request benefits for themselves.

Learn more about filing requirements for death benefits in Texas Labor Code §409.007 and 28 Texas Administrative Code §122.100.

Who is a legal beneficiary?

A legal beneficiary is a family member who can show they are one of the following:
  • The spouse of the employee who died.
  • A child or stepchild of the employee who died and is:
    • under 18 years old;
    • 24 years old or younger and going to school full-time; or
    • a dependent adult child with disabilities.
  • A dependent parent or other family member, including a grandchild, who relied on the employee who died for at least 20% of their monthly support.
  • A parent or stepparent who was not a dependent. This is only allowed in limited cases.

Learn more about beneficiary status in Labor Code §§408.181-184 and in Chapter 132 of 28 TAC.

What burial benefits may be paid?

An insurance carrier is required to pay the reasonable cost of burial expenses.
If there is a dispute about burial benefits, you may need to show:

  • a claim for burial benefits was filed with the insurance carrier within one year of the employee's death;
  • the cost for the burial expenses (up to $10,000 may be reimbursed); and
  • the cost for moving the body.

Learn more about burial benefits in Labor Code §408.186 and 28 TAC §132.13.

If there is a dispute, gather information to prove why benefits should be paid.

If the dispute is about compensability, you will need information that shows:

  • The injury resulting in death was caused by work activities.
  • The claim for death benefits was filed with DWC on time.
  • The insurance carrier’s reasons for denying the benefits do not apply.

If the dispute is about beneficiary status, then the following may be helpful:

  • General records:
    • death certificate
    • information that shows dependency status
    • other information about the dispute
  • If the request is for a spouse:
    • certified copy of marriage license
    • divorce decree
    • financial statements and bills
    • tax returns
    • lease or mortgage records
    • other information that may show a marriage
  • If the request is for a child or grandchild:
    • certified copy of birth certificate or adoption decree
    • other information that shows proof of relationship
    • school records
    • information that shows disability and dependency of an adult child
  • If the request is for a parent or other family member:
    • certified copy of marriage license
    • certified copy of birth certificate or adoption decree
    • financial statements and bills
    • other information that shows dependency

Learn more about death benefits, including:

  • calculation of the benefits and
  • determination of dependency, eligibility, duration, and distribution of the benefits.

If the dispute is about burial benefits, then you will need information such as:

  • records that show when the request for burial benefits was filed with the insurance carrier
  • bills for burial expenses

This information is an overview of what might be helpful for a dispute. Other information may be needed.

Learn more about:

Last updated: 9/13/2023