Survivor pension benefit entitlement before September 1, 2018

Call the dependent spouse or adult interdependent partner or next of kin (if there is no surviving spouse/partner) to gather information to determine dependency status to arrange for the appropriate benefits. 

Discuss and confirm:

• The age of the spouse and medical conditionAny medical condition that may impact their ability to become gainfully employed., their education and employment history.
• If the worker has dependent children including children not living with the worker or spouse/partner at the time of the worker's death (e.g., from another marriage or non-martial relationship, children the worker was a guardian for, etc.).
• Age of each dependent child.

• Whether the dependent child(ren) where wholly or partially dependent on the worker's earnings.

   

Information needed to confirm dependency status

To determine dependency status, request the following information be submitted:

• A copy of the worker's birth certificate.
• A copy of the birth certificate for the dependent
  • Spouse or partner.
  • Each dependent child.
• A copy of the marriage certificate, if applicable.
• Court documentation for children who did not live with the worker at the time of death to confirming the worker was responsible for child support.
• A completed statutory declaration for dependent spouse benefits or partner that has been commissioned or notarized.

If the dependent is identified as a partner or a common-law spouse, ask them to submit the following for review:

• A completed Statutory Declaration of Adult Interdependent Partner form that has been commissioned or notarized.
• Proof of that they were living together for at least three continuous years relationship or that there was a permanent relationship (e.g., there is a child by birth or adoption) or that they entered into an adult interdependent agreement.
• Evidence to support the relationship may included:
  • Joint income tax filings
  • Joint property ownership or rental agreements.
  • Joint insurance or listed as the beneficiary on each other's policies.
  • Bills or bank statements showing shared finances or responsibilities.
  • A written statement from someone confirming the relationship or the living arrangement.

Information required to determine gainful employment  

If the worker had dependent children, information required to confirm gainful employment is not needed at this time. Continue the next step. Note: Gainful employment status will be confirmed at a later when the last dependent child turns age 18.

If the worker had no dependent children or none of the worker's dependent children live with the spouse/partner, ask the following questions to determine if the spouse/partner is gainfully employed:

• Current employment status - Full time, part time, casual, self-employed or unemployed. If employed confirm number of hours worked per week.
• Earnings/income - Current wages or salary, other employment-related income (e.g., commissions, self-employment earnings). Verify the income by requesting a copy of paystubs, T4s or tax returns, self-employment records (e.g. invoices, financial statements).

If the spouse/partner is not employed or not gainfully employed, also discuss:

• Employment capacity - Ability to work (considering health, caregiving responsibilities, etc.)
• Health status - Medical conditions or disabilities that affect the ability to work.
• Skills, education and experience -Work history, level of education or training, and transferable skills.
• Age and employability factors - Age in relation to typical workforce participation. Ability to retrain or transition to other work.

Monitor the claim for receipt of the requested documentation to confirm dependency status. Once the information is received, continue to the next step.

Assess dependency status

Once the information is received, determine if the individual identified as a dependent meets the criteria of a dependent at the time of the worker’s death. 

Verify the relationship

For each individual identified as a dependent, review the documentation submitted to confirm the relationship to the worker (legal or biological connection). Documentation to support the relationship may include birth certificates, marriage certificates, adoption papers, etc.

For a partner, confirm the couple lived together continuously for at least three years or were in a relationship of some permanence. A Refer to step 1 for factors that may support the relationship.

If there is more than one person claiming to be a spouse or partner (i.e., there is both a legal spouse and a partner/common-law spouse of the worker), confirm whether the spouse is a dependent spouse. If they are not, then the partner is eligible for the monthly pension benefit. Refer to Policy 04-08, Part II, Application 4, Questions 3 and 4. 

For dependent children who did not live with the worker at the time of death, review court records or documents to confirm the worker was paying or financially responsible to pay child support.

Assess gainful employment status, if applicable

For a dependent spouse/partner with dependent children living with them continue to the next step. Gainful employment status will be confirmed when the last dependent child turns age 18.

For a dependent spouse/partner with no dependent children living with them, continue this step to assess gainful employment status for the dependent spouse/partner.

Based on the information submitted, determine if the dependent spouse/partner is working. If they are, review the earnings and confirm if their net earnings are equal to or exceed 75% of the worker's full pension or 100% of the minimum pension for permanent total disability (PTD), whichever is greater. Refer to Appendix F of the policy manual for the minimum pension.

If the spouses net earnings:

• are equal to or exceed 75% of the worker's full pension or 100% of the minimum pension for PTD, they are considered gainfully employed.
• are not equal to or exceed 75% of the worker's full pension or 100% of the minimum pension for PTD, they are not gainfully employed.

When the dependent spouse/partner is not gainfully employed, consider if they are capable of gainful employment. Consider the following:

• Health status - Medical conditions or disabilities that affect the ability to work.
• Skills, education and experience -Work history, level of education or training, and transferable skills.
• Age and employability factors - Age in relation to typical workforce participation. Ability to retrain or transition to other work.
• Caregiving responsibilities - Responsibility for dependent children or others that may limit ability to work.
• Labour market considerations - Availability of suitable employment based on skills and experience.

Call the dependent spouse/partner, the next of kin, or the guardian for any dependent children under the age of 18 to explain their eligibility for survivor pension benefits and next steps.

Dependency status

When it is determined that an individual is not a dependant (for example a child who is older than 18 or someone claiming to be a spouse or partner), discuss the information that was considered and the reason why they are not considered to be a dependant. Explain that other supports that may be available in the community and whether they would like to be referred to Community Support Services. If they agree, make the referral. Send the appropriate letter to communicate the decision.

When it is determined that an individual is a dependant, explain the next step to calculate and obtain approval for survivor pension benefits payable for the dependent spouse/partner and any dependent children not living with the spouse/partner. Refer to the Supporting information section to confirm the type of benefits available. 

When there are dependent children under the age of 18 who do not live with the spouse or, when there is no surviving spouse, explain to the child's guardian that an account will be set up with the Office of the Public Trustee (OPT)The Office of the Public Trustee exists to protect and administer property and assets for minor children and deceased persons, when there is no one else able to act. for each dependent child under the age of 18. Complete and submit the application. Once the application is process processed, the OPT will fax an account number for the dependent children. 

If there are no dependent children, continue this step to discuss gainful employment status with the dependent spouse/partner.

If there are dependent children, continue to the next step. Gainful employment status will be confirmed a when the last dependent child turns age 18.

Gainful employment status

Discuss with the dependent spouse/partner whether they are considered gainfully employed or not gainfully employed. Clearly explain the how the decision was reached including a review of their earnings and consideration of relevant factors (e.g., health, caregiving, employability). 

Explain how this determination affects their benefits or entitlement. Answer any questions they may have about the decision

If the spouse/partner is not gainfully employed but is capable of gainful employmentA spouse is capable of gainful employment when after considering all relevant factors (age, medical status, education, skills, experience, etc.) they could reasonably obtain employment earning at least 75% of the worker's full pension or 100% of the minimum PTD, whichever is more., advise them of available re-employment or vocational support services (e.g., job search support, training, return-to-work planning. Explain that participation while in receipt of the five-year term pension is voluntary. Confirm their interest in participating.

Discuss next steps, including obtaining approval to set up survivor pension benefits and referrals for re-employment services, if they are interested in participating now (while their five-year pension is being paid).

Before requesting approval, ensure all relevant documents are on file confirming dependency status. Refer to step 1.

Submit a proposal to the supervisor requesting approval to implement the survivor pension benefits for the dependent spouse/partner and any dependent children who do not live with the spouse/partner. If applicable, include information related to the dependent spouse/partner's gainful employment status, whether vocational services have been offered and their interest in participating or if their gainful employment status will be considered at a later date.

Refer to the Supporting information section to confirm the type of benefits available. 

The supervisor will review the recommendation and approve or not approve payment of survivor pension benefits.

If approved, continue to the next step.

If not approved, action the supervisor's recommendations, as appropriate. Repeat this step until approval is obtained.

Send a request to the Payment Unit to calculate the monthly pension.  Include the following information:

• Reference the applicable Policy 04-08 for the survivor pension benefits payable for the date of accident.
• Name of the dependent spouse/partner and or child(ren) to which the benefits are payable.
• The Public Trustee account number, if applicable.
• The effective date for the pension and the length of time the benefits are payable.

The payment specialist calculates the pension amount and sends the calculation details to the fatality case manager and actuarial analyst for review and approval. The actuarial analyst reviews the compensation rate and the pension calculations and notifies the Payment Unit and the fatality case manager if the pension benefit is approved or not approved.

Review the payment unit calculations and the recommendations from Actuarial. When additional information is required, obtain it and forward it to the Payment Unit to recalculate the pension benefits. Repeat this step until Actuarial agrees that the pension calculation is correct.

Call the dependent spouse, partner, or the guardian of dependent children not living with the spouse/partner to discuss their eligibility for survivor pension benefits based on the claim circumstance as outlined below. 

Spouse/Partner with no dependent children under 18 living with them 

If the dependent spouse/partner is:

• gainfully employed, explain they are eligible for a five-year reducing term pension.
• not gainfully employed, but capable of becoming gainfully employed, explain that they are eligible to receive up to five years of  full pensionA full pension is the pension the worker would have received if the work accident had resulted in permanent total disability instead of death. benefits, followed by a five-year reducing term pension. Offer vocational services and confirm their willingness to participate. When the dependent spouse/partner:
  • chooses to participate in vocational services, explain that a referral for triage assessment referral will be made.
  • chooses not to participate in vocational services, explain that they are eligible for a five-year reducing term pension.
• not capable of becoming gainfully employed, explain that they are eligible to receive full pension benefits until the worker would have reached age 65, the spouse/partner reaches age 65 or they have received benefits for 24 months, whichever is later. At that time, a retirement adjustment will be applied.

Spouse/Partner with dependent children under 18 living with them

Explain that they are eligible to receive a full pension while dependent children under age 18 are living with them. Discuss that once all dependent children in their care turn 18, their eligibility is reassessed based on their gainful employment status. 

Note: In some circumstances, it may be appropriate to offer vocational services before the last dependent child turns 18 (e.g., when the youngest child is one year away from turning 18). Participation in vocational services at this stage is voluntary and the dependent spouse/partner is not obligated to start early. If they choose to proceed, explain that a referral for triage assessment will be made.

Benefits for dependent children

When dependent children live with the worker’s spouse/partner, the pension paid to the dependent spouse/partner is for the benefit of the spouse/partner and dependent children. 

If there are dependent children who do not live with the dependent spouse/partner, the dependent children are eligible for benefits for care and maintenance as outlined in Policy 04-08, Part II, Application 5, Question 6.

If there are dependent children but no dependent spouse/partner, the full pension is split evenly between the dependent children as outlined Policy 04-08, Part II, Application 5, Questions 3 to 5.

Following the discussion, communicate the decision in writing and make a referral for vocational (re-employment) services, if applicable. 

For additional information on benefits available once the last dependent child turns 18, refer to the Supporting Information section.

Monitoring and follow-up schedule

Develop a schedule to monitor the pension benefits for the dependent spouse/partner and any dependent children not living with the spouse/partner. 

Set up a monitoring schedule based on the specific claim circumstance and needs of the dependent spouse/partner and any dependent children. Follow-up frequency may vary based on the ages of the dependent children and the family circumstance (e.g., offering vocational services to the dependent spouse/partner before a dependent child turns 18).

Contact should occur at key intervals such as:

• One year for initial contact after the pension start date.
• 36 months.
• 60 months.
• One year before the last dependent child turns 18 and again 6 months before the child turns 18.
• Six months before the pension benefit will reduce. 

Note: When a 24-month survivor pension is payable, plan to follow-up in one year and then six months before the pension will reduce.

For each contact, review the benefits in place and address any questions or issues that arise. If the dependent spouse decided not to participate in vocational services because they were not ready, consider when to revisit the offer.

Monitoring requirements

Review continued eligibility for benefits, including confirming any changes in dependency status and the dependent spouse/partner’s employment or income, to assess gainful employment.

Assess and update entitlement as needed, including:

• revising the plan and adjusting benefits in accordance with the legislation and policy in effect for the date of accident; and
• assessing the dependent spouse/partner’s gainful employment status when the last dependent child turns 18. To determine gainful employment, refer to the internal fatality procedures in the resource library.

Transfer the claim to a case assistant for ongoing monitoring, if appropriate. At the time of transfer, provide clear direction on monitoring requirements, frequency of contact, and when the claim should be transferred back to the fatality case manager.

Case assistant

Ensure the claim is returned to the fatality case manager, when:

• a key decision point is approaching (e.g., a dependent child turning 18);
• an assessment of gainful employment is required; or
• consideration or initiation of vocational rehabilitation services is needed.