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These are the possible benefits/funeral payments available to the surviving family of Officer James Jones (fictitious name), Mobile Police Department.WORKERS’ COMPENSATIONWorkers’ Compensation benefits are payable to the beneficiaries of Officer Jones for a period of five hundred (500) weeks following the death of Officer Jones. The Department of Industrial Relations, Division of Workers’ Compensation, is the office to contact for the Workers’ Compensation filing. ___(contact)___ can be reached at ___(phone number)___.In the case of Officer Jones, the benefits paid through Workers’ Compensation of Alabama are as follows:$6,500 Funeral Expense Benefit66 2/3% (of average weekly wage) per week until minor child/children attain eighteen (18) years of age. If Officer Jones has no dependents the employer shall pay a one-time lump sum payment of $7,500 to Officer Jones estate.In order to file for Workers’ Compensation benefits, the below listed forms/certificates are needed:Marriage License.Certified copy of Death Certificate.Certified copy of minor child/children Birth Certificate.Physician’s Statement.CITY LIFE INSURANCELife insurance benefits paid to the beneficiaries in this matter are based on double annual salary figures calculated at double indemnity rate. Again, ___(contact)___ is the contact person.Insurance benefits are as follows:Annual Salary$__________Double Annual Salary$__________Double Indemnity$__________Total City of Mobile Insurance Benefit$__________POLICE PENSIONOfficer Jones was a veteran officer with _____ years and _____ months service to the Mobile Police Department. This length of service entitles the following pension benefit to this widow for the remainder of her lifetime. Pension standards set forth in: Employee with ____ years’ service and age _____ or above entitles to _______% of salary in pension benefits; based on last three (3) years average income.In the event of employee’s death prior to retirement, pension benefits are reduced by 10%. Beneficiary is then entitled to one-half (1/2) of remaining percentage of pension benefit. See listing below.Last three (3) years average income$__________Pension benefit (_____%)$__________Pension benefit reduced by 10% ( ___% )$______________% pension benefit to beneficiary$__________Bi-weekly pension benefit to beneficiary$__________SOCIAL SECURITYBecause Officer Jones paid into Social Security for five (5) years prior to joining the police department, the widow and family are eligible for Social Security benefits. _____(contact)_____, _____(phone)_____, is the contact person for Social Security benefit coordination. Benefits available to the widow and family of Officer Jones are as follows:One-time death benefit: $_______.Minor child benefit payments until age 18: $_______.Forms needed for filing Social Security survivors’ benefits are:Certified copy of minor child/children Birth Certificate.Notarized copy of Marriage License.All __year__ W-2 earnings form.Certified copy of Death Certificate.ALABAMA STATE BOARD OF ADJUSTMENTAlabama law provides for a one-time death benefit payment of $100,000 for the survivors of public safety officers killed in the line of duty, adjusted on January 1 of each year to reflect any increase in the previous year in in the consumer price index. The compensation shall be paid to the dependent spouse for the benefit of the spouse and any dependent children or, if none, to other dependents as designated by statute and in the exercise of the discretion of the awarding authority. All claims for compensation shall be presented to the awarding authority within one year from the date of death. For more information, Contact the Alabama State Board of Adjustment Office at (334) 242-7175 or visit their website: bdadj.. PUBLIC SAFETY OFFICERS’ DEATH BENEFITFederal statute provides a one-time $343,589.00 death benefit to the survivors of a public safety officer who is killed in the line of duty. Forms are completed by the local agency and submitted to the U.S. Department of Justice for processing and payment. Contact: Public Safety Officers Benefit (PSOB), 810 7th ST NW, Washington, DC 20531, (888) 744-6513.(Exclusions to this benefit would come if there was misconduct on the part of the officer, intoxication, performing duty in a grossly negligent manner, or if claimant was a substantial contributing factor to the death of the officer. Military law enforcement officers are excluded from this benefit.)BENEFITS FOR NON-FEDERAL LAW ENFORCEMENT OFFICERSU.S. Department of Labor, Officer of Workers’ Compensation Programs (OWCP)(Law enforcement agency should check with the Department of Labor to see if death circumstances meet criteria for filing this benefit. If circumstances do not meet the criteria, either leave off benefit information or state that “This benefit is not due to the family of Officer Jones.”) Benefits are provided for any non-federal law enforcement officers who are killed under one of the following conditions: While engaged in the apprehension or attempted apprehension of any person—Who has committed a crime against the United States, orWho at the time was sought by a law enforcement authority of the United States for the commission of a crime against the U.S., orWho at the time was sought as a material witness in a criminal proceeding instituted by the U.S.While engaged in protecting or guarding a person held for the commission of a crime against the U.S. or as a material witness in connection with such a crime. While engaged in the lawful prevention of or lawful attempt to prevent the commission of a crime against the U.S.Questions concerning this benefit should be directed to DC Department of Employment Services, Labor Standards Bureau, Office of Workers' Compensation, 64 New York Avenue, NE, 2nd FL, Washington, DC 20002, (202) 671-1000.EDUCATIONAL BENEFITSUnder Alabama Law Act 82-277, payment of tuition and textbooks costs in a state junior college, technical college or university is made for the dependent children under 21 (natural or adopted) and spouses, if not remarried, of a law enforcement officer killed in the line of duty. The spouse must utilize the benefit within 5 years of the death. A letter from the agency head, together with a certified copy of the marriage license, death certificate, and a birth certificate(s) of child/children are required. For more information or to obtain application forms, contact the Alabama commission on Higher Education Office at (334) 242-1998. Or visit their website: bdadj.. PERSONAL LIFE INSURANCE BENEFITSClaims for insurance benefits available through this source are filed by the family with any assistance needed from the department. In the case of Officer Jones, ___ policies, with ___(names of companies)___ were in effect at the time of his death.ALABAMA PEACE OFFICERS' ANNUITY AND BENEFIT FUNDMembership in the Alabama Peace Officers' Annuity and Benefit Fund entitles death benefits to officers' survivors in the form of a one-time $2,500 death benefit payment for death from any cause plus, in the case of line-of-duty death, the return of all contributions during membership. Forms can be obtained from the Alabama Peace Officers' Annuity and Benefit Fund, 514 South McDonough Street, PO Box 2186, Montgomery, AL 36102, (334)242-4079.ALABAMA PEACE OFFICERS' ASSOCIATIONThe Alabama Peace Officers' Association offers survivors of deceased active members a $500 death benefit for death from any cause. Survivors of active members killed in the line of duty receive a $10,000 benefit. Contact the Alabama Peace Officers' Association, 940 Pelham Street, Montgomery, AL 36104. Office: (334)269-4328. Or visit their website: ORDER OF POLICE The Alabama State Fraternal Order of police (FOP) or other labor/fraternal groups may provide a one-time death benefit to family members of a deceased member officer. Contact your local lodge for information. You can find a list of all Alabama FOP lodges at the Alabama State Lodge Fraternal Order of Police website: CLUBLocated in Mobile, The 100 Club is an organization of 100 area businessmen who contribute a one-time $1,000 payment to the surviving family members of personnel of the Mobile Police Department killed in the line of duty. (Members of these organizations usually wish to remain anonymous; therefore, someone in the department should act as a contact person for the family. It is important that the police department encourage payments to be made to both survivors of felonious and accidental loss.)ALABAMA CRIME VICTIMS COMPENSATION 15-23-1.Victims of violent crime are often reduced to bereft and destitute circumstances as a result of the criminal acts perpetrated against them, that the financial or economic resources of such victims and their dependents are in many instances distressed or depleted as a result of injuries inflicted upon them by violent criminals.The Alabama Crime Victims Compensation Fund intends to provide a means whereby victims of violent crime and their dependents may be provided compensation in the amount of actual expenses incurred as a direct result of criminal acts of other persons. For more information, Contact the Alabama Crime Victims Compensation Commission, Mailing Address: PO Box 231267, Montgomery, AL 36123. Office: (334) 290-4420. Or visit their website: acvcc.state.al.us/ SOUTHERN STATES POLICE BENEVOLENT ASSOCIATION, INC.The PBA member’s beneficiary will receive their base salary for one year if they are killed accidentally or intentionally while performing their law enforcement duties (maximum payout: $60,000). The beneficiary will receive $5,000 if it is not an occupational death or if you are a retired or reserve member. Any active Southern States PBA member in good standing and dues current will receive this benefit. For more information Contact: Southern States Police Benevolent Association, Inc., 2155 GA-42, McDonough, GA 30252, (770) 389-5391 or visit . ................
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