When a worker dies from a work-related injury or disease, their dependants may be entitled to workers compensation. Dependants are members of the deceased worker’s family who would have been wholly or partially dependent on the earnings of the worker, had the worker not died from a work-related injury or disease.
Compensation can include:
- weekly wage payments
- lump sum payment
- compensation for the worker’s medical expenses
- compensation for counselling costs
- compensation for burial or cremation costs.
Non-dependent family members
When a worker dies from a work-related injury or disease and there are no dependants, family members who are not dependent can claim for burial or cremation costs. Non-dependent family members can also claim for reasonable counselling costs.
More information about dependants and entitlements is included in the Dependants of Deceased Workers Claim Form (see below).
How to make a claim as a dependant or family member
If you are a dependant or non-dependent family member of a deceased worker, you can claim for workers compensation by completing a Dependants of Deceased Workers Claim Form. Claims must be made within 6 months of the date of the deceased worker's death.
Access the Dependants of Deceased Workers Claim Form below. You have two options:
Option 1 – Print and fill in the form by hand:
1. Use the link below to open the form.
2. Print the form and answer all relevant questions in the claimant section using a pen.
3. See Next Steps below for what to do next.
Dependants of Deceased Workers Claim Form (Printable) (PDF, 559.7 KB)
Option 2 – Digitally fill in the form (then print and sign it by hand):
Note: This option may not work well on a phone/tablet.
1. Use the link below to download/save the form to your computer.
2. Using your mouse, click into the answer box you need to fill in and type an answer. You can also use the tab key on the keyboard to move to each answer box. Click on the circle buttons to show your selection for Yes/No answers. Complete all relevant questions in the claimant section.
3. See Next Steps below for what to do next.
Dependants of Deceased Workers Claim Form (Fillable)
Next steps
When you have completed (and signed) the claimant section of the Dependants of Deceased Workers Claim Form:
- Give the form to the deceased worker’s employer. Find out who you need to forward the form to at the employer, and how. For example, find out who you should deliver them to in person, or what address to post them to, or if the employer agrees, which email address to send them to. If in doubt, post to the employer’s usual business address.
- Keep a record of your submitted Dependants of Deceased Workers Claim Form.
- The deceased worker’s employer will complete the employer section of the form. The processing of your claim will then start.
Help completing the form
- If you need help, you can phone WorkSafe Tasmania on 1300 366 322.
- You can also talk to the deceased worker’s employer.
- Worker Assist Tasmania offers free, confidential advice about workers compensation. Call Worker Assist on (03) 6216 7677.
WorkSafe Tasmania resources
Provide feedback on the Dependants of Deceased Workers Claim Form
Workers Compensation Handbook: The Basics (PDF, 295.3 KB)
A Guide to Workers Rehabilitation and Compensation in Tasmania (PDF, 598.0 KB)
After a workplace death: A support guide for families, friends and work colleagues (PDF, 1.7 MB)