37 Tex. Admin. Code § 138.3 - Filing the Claim
(a) Upon determination
by the Department that assistance is payable to an eligible survivor under
Section
615.024 of the Texas
Government Code, and verification of beneficiary information, the Department
shall certify the following information on agency letterhead and submit the
certification to Employees Retirement System (ERS) to initiate the payment
process:
(1) Name of decedent;
(2) Date of death;
(3) Status of decedent at the time of death
(i.e., State Active Duty and Specific Mission);
(4) Line of Duty determination: Yes/No;
and
(5) Certification of
Eligibility: Yes/No
(b)
The Adjutant General or designee will serve as the certifying official for
purposes of the Department certification.
(c) In addition to the Department
certification, the following documentation must be submitted to ERS:
(1) a copy of the decedent's state active
duty orders;
(2) a certified copy
of the death certificate;
(3) a
copy of the decedent's United States Department of Defense Form DD-93 for an
individual in the Texas National Guard; or for the Texas State Guard, a Texas
Military Department Record of Emergency Data form that provides emergency data
comparable to that on the United States Department of Defense Form DD-93;
and
(4) the name(s) and contact
information for the beneficiary or beneficiaries to receive payment.
(d) Claims submitted to ERS by the
Department will be processed for payment to the eligible beneficiary in
accordance with Texas Government Code Chapter 615 and, as applicable, ERS Rule
related to the filing of claims, 75 TAC §75.1.
Notes
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