1. (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.
2. (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.

3. (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 waives their submission:

   1. (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. (2) a certified copy of the death certificate;
   3. (3) a certified copy of the autopsy report, if any;
   4. (4) a copy of the marriage certificate showing marriage between the surviving spouse and the deceased;
   5. (5) a certified copy of the birth certificate of each surviving child of the deceased;
   6. (6) affidavits from any witnesses detailing the facts of the fatality;
   7. (7) certified copies of any investigative reports;
   8. (8) a sworn statement from the employer or authorized representative of the department 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 was the result of risk or hazard inherent to that position;
   9. (9) a copy of the decedent's birth certificate, if benefits are being claimed for parents;

   10. (10) a certification from the appropriate authority as follows:

       1. (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;
       2. (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;
       3. (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 organized volunteer fire department of which the decedent was a member consists of not less than 20 active members; conducts a minimum of two drills each month, with each drill being at least two hours long and attended by a majority of all active members; and renders fire fighting services without remuneration;
       4. (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;
       5. (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;
       6. (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;
       7. (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;"
   11. (11) a newspaper account, if any, of the fatality; and
   12. (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.
4. (d) The executive director may require any additional information or affidavits as are necessary to establish the validity of the claim.
5. (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.

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.