(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.
(d) The executive director or designee may require
any additional information or affidavits as are necessary to establish
the validity of the claim.
(e) Payment on behalf of a minor child will be made
only to a surviving natural parent with custody of the child, to a
surviving adoptive parent with custody of the child, or to a court-appointed
guardian of the child's estate.
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Source Note: The provisions of this §75.1 adopted to be effective September 21, 1981, 6 TexReg 3427; amended to be effective September 12, 1985, 10 TexReg 3324; amended to be effective April 20, 1994, 19 TexReg 2551; amended to be effective September 15, 1997, 22 TexReg 9006; amended to be effective March 18, 2002, 27 TexReg 2058; amended to be effective December 31, 2003, 28 TexReg 11611; amended to be effective May 29, 2005, 30 TexReg 3021; amended to be effective December 26, 2013, 38 TexReg 9373; amended to be effective September 8, 2020, 45 TexReg 6238 |