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Virginia Workers’ Compensation Award Form When an Employee Dies

Tragically, some employees die from their work related injuries. When this happens, the family members may be entitled to benefits. An experienced Virginia Workers’ Compensation attorney understands who can claim benefits, what benefits are allowed and how the benefits can be claimed. Claimants must file a Fatal Award Agreement. The agreement should also include copies of the death certificate. Marriage and birth certificates for the dependents of the decedent are also required. An Award agreement may also be needed if the injured worker survived the injuries for any length of time. This form includes:

  • The basic information about the employee and employer including names and addresses.
  • The date of the injury
  • The pre-injury average wage of the deceased worker
  • The employer, statutory dependents and the claims administrator complete the following information and sign the form
  • The date of death of the worker
  • The amount of wages to be paid and the length of payment
  • All relevant medical costs including surgeries and supplies
  • The funeral costs up to $10,000
  • Transportation expenses up to $1,000
  • Each dependent is identified by name, address, date of birth and the relationship to the deceased employee

Virginia Injured Worker’s Lawyer Joe Miller if a Loved One Died due to Work Injuries

Joe Miller knows how tragic it is when a worker dies due to a work accident or occupational illness. He fights for strong justice for the dependents of the deceased employee. He makes sure the right dependents get all that state law allows. If you suffered the loss of loved one, know that we empathize with your pain. We’re here to help you through this difficult time. Phone attorney Joe Miller at 888-694-1671 and ask for me, Joe Miller, or email me at jmiller@joemillerinjurylaw.com. I’m ready to guide you to a just result.

Virginia Beach Office

5500-B Greenwich Rd.
Virginia Beach, VA 23462

Elizabeth City Office
(by appointment only)
507 E Main St #K
Elizabeth City, NC 27907

If you are looking at this site, you or a loved one has probably been hurt. If that's true, you've come to the right place. Helping people who have been hurt is what we do. In fact, it is all we do. Joe Miller Law is a law firm concentrating exclusively on representing people who are injured by the carelessness of others or those hurt on the job. We provide the highest quality legal services to people who have been seriously injured. We practice Personal Injury law and Workmens' Compensation law in both Virginia and North Carolina.