DEATH IN LINE OF DUTY
Prepared by Alabama Association Of Volunteer
this MS Word document.
Table of Contents
What To Do First
Preparing Claims - General
Preparing Federal Claims
Preparing State Claims
Brief Summary of Federal Law/Rules
Brief Summary of State Law/Rules
Samples of Statements
We gratefully acknowledge the cooperation of:
Mr. Richard J. Condon, Bureau of Justice
Assistance, Washington, DC
Mr. Clay Crenshaw, Attorney, State of Alabama Board of Adjustment
First Printing July 1989
Third Printing August 1992
(Revised pages 7, 12, and 16)
Fourth Printing October 2002
Copies may to ordered from:
Alabama Association of Volunteer Fire Departments, Inc.
660 Adams Avenue, Suite 345
Montgomery, Alabama 36104-4373
This book concerns Federal and state benefits that may be available
in the event of the death in the line of duty of a firefighter/EMT,
and has been prepared by the Alabama Association of Volunteer Fire
The words in this book are ours and do not necessarily reflect
the opinion or policies of either the Bureau of Justice Assistance
or the Alabama State Board of Adjustment. In preparing claims, if
there is any conflict between this book and instructions received
from either the Federal or State agency named, their instructions
must be followed.
We hope that you will never have to use the information in this
book for that would mean that a firefighter has been lost in the
line of duty. But this tragedy has happened before and may happen
again. Each fire department should be prepared to deal with the
possibility and to fully assist the survivor(s) of the firefighter
in the submission of claims. See Sample Form A for your use now.
Sample Forms B and C may assist later.
Federal and State laws on the subject are not precisely the same.
A separate claim must be submitted to each and on their forms. Too,
the benefits are not like an insurance policy; they are not paid
on an automatic basis. Each benefit is separate, the burden of proof
of eligibility is on the claimant, and each claim is decided on
the basis of evidence that is submitted as part of the claim.
In this book, we suggest what to do first, give you some information
that will help in filing a claim, and have furnished a brief summary
of both the Federal law and the Alabama law.
WHAT TO DO FIRST
If death is obvious, immediately notify law enforcement officials.
They will notify the medical examiner/coroner. These personnel must
be notified if the individual dies en route to or at a medical facility.
Fire departments are responsible for ensuring that the medical
examiner/coroner and the State Forensic Lab are IMMEDIATELY informed
of the first paragraph, page 6, which begins “Toxicological
Coordinate with law enforcement officials and/or the medical examiner/coroner
concerning immediate notification of the family. This should be
done as soon as possible to avoid a casual, though well-meant, word
reaching the family through others. Each department should have
one or more “Chaplains” who could help to notify the
immediate family of a death.
Immediately notify the Alabama Association of Volunteer Fire Departments
through one of our officers, or have your county association do
If the injury, which caused death, was associated with a fire,
notify the State Fire Marshal’s office; they will determine
whether circumstances cause the case to fall within their jurisdiction.
Coordinate before calling; some law enforcement jurisdictions prefer
to make that call.
Have someone begin at once writing down the name, address, and
phone number of anyone who may have to be contacted later for information
or to make a statement. That includes witnesses, law enforcement
officers, rescue squad members, and ambulance personnel.
BACK TO TOP
PREPARING CLAIMS - GENERAL
Claims must be submitted within one year of the death of the individual.
The burden of proof for establishing eligibility for the award
of a benefit rests with the claimant.
An individual cannot name beneficiaries.
All official documents which have to be submitted as part of a
claim (e.g., marriage certificate, birth certificate, death certificate)
must be signed by the custodian of those records and a raised seal
of that office must be placed upon the paper.
Photocopies of documents where signatures and seal are copies,
even if certified as a true copy by a notary public, are not acceptable.
Statements by individuals, investigative reports, and other documents
must be notarized and the notary’s raised seal placed upon
Federal claims are submitted in one (1) copy; State claims are
submitted in three (3) copies. The documents accompanying each of
those copies must adhere to the requirement for signatures, notarized,
and raised seals. One (1) additional copy should be retained permanently
by the fire department assisting with the claim. Thus, a minimum
of five (5) copies are required; a sixth if you intend to furnish
an “original copy” to the claimant. Otherwise, any additional
copies could be photocopies without the need for original signatures
or raised seal.
Documents furnished with a claim should not be originals that the
family may have. You must assume that no documents will be returned.
Toxicological examinations: The report of results is furnished
by the Alabama Department of Forensic Science as soon as possible.
It needs to be emphasized that the levels of carbon monoxide and
of alcohol, as well as any other finding of substance(s), must be
shown in a precise percentage. For example, Blood alcohol level
of .089%; Carbon Monoxide level .06%. Toxicology reports which state
vague or generalized levels, such as “positive for alcohol”,
“Carbon Monoxide normal”, or “Carbon Monoxide
less than 10%” could result in claim denial. A precise carbon
monoxide level is particularly important to claim eligibility in
a heart or stroke related death. It is recommended in such deaths
that the medical examiner/coroner be reminded that a precise percentage
of carbon monoxide is needed for benefits purposes even though that
percentage may fall below “non-injury level”. If the
medical examiner/coroner is confused by this request, suggest he
or she call the Bureau of Justice Assistance and ask for the PSOB
Office to receive further advice.
Clearly identify any opinion stated as an opinion. If certain facts
are not known, say so. If it is necessary to include circumstantial
evidence, do not attempt to draw any conclusions from it in your
Stress, physical exertion, and/or strain, by themselves, are NOT
All documents requested by either the Federal or the State agency
must be furnished with the claim.
The brief summary of Federal and State Law/Rules found in this
book are not verbatim or precise. If such accuracy is needed, one
should consult the applicable law.
PREPARING FEDERAL CLAIMS
On the first business day, during business hours (Eastern Time),
call the Bureau of Justice Assistance (BJA) at 888-744-6513 and
report the death. Be prepared to give: name of the deceased, name
of fire department, brief circumstances of death, date of injury,
date of death, name and address of widow, children’s ages,
type of children (natural, adopted, step, illegitimate), whether
children 19 or older are full time students or physically or mentally
handicapped, and where there is no widow or child, the names and
addresses of surviving parents. The fire department should appoint
a member to handle the Federal claim and that member should make
the notification of death to BJA. Forms and filing instructions
are not provided by BJA until a death occurs.
The BJA will send copies of two different forms: one, Form 3650/5,
which is the survivors’ claim; and Form 3650/6, which is completed
by the fire department. Both forms, together with all supporting
papers, should be submitted in one package to:
Bureau of Justice Assistance
Public Safety Officers Benefit Program
810 Seventh Street NW
Washington, DC 20531
Carefully read “Preparing Claims – General”
earlier in this book.
The following pages consider parts of the two forms. The documentation
identified on pages 8 through 11 may vary from claim to claim depending
on circumstances of death and the makeup of a deceased’s family;
it is described only to give an idea of what MAY be required. DO
NOT try to document a Federal claim without first notifying the
BJA of the death and seeking their advice as to specific documentation
DETAILS ABOUT FORM 3650/6 "Report of Public Safety Officer's
Form is completed by the fire department where the deceased was
a member and is certified in Item 17 by that department's Fire Chief.
Form reports the death, and together with documents submitted with
it, should establish:
- That the deceased was a firefighter in a legally organized fire
- That the deceased was obligated by law, regulation, rule or
condition of employment to be involved in the activity where traumatic
injury led to the death.
- That an occurrence resulted in injury to the deceased and that
the injury resulted in the death of the individual.
- The names of possible claimants.
Part II of the form asks for copies of reports. Include a copy
of the police report signed by the investigating officer(s) and
notarized to include raised seal of the notary.
Part IV of the form asks the same questions about claims for benefits
as does Part IV-A of Form 3650/5; the answer to both questions,
for a volunteer firefighter is “no”.
As a minimum, several documents must be submitted with Form 3650/6:
DETAILS ON FORM 3650/5 “Claim for Death Benefits”:
- Statement by the Fire Chief clearly but concisely stating what
happened, including events leading up to, or following, the injury
to the deceased, signed and notarized.
- A copy of the Fire Report (“Run Report”) or other
document, which clearly shows the activity in which the deceased
was injured was an official activity; signed by the Fire Chief
- Copy of the toxicology report (which will include blood and
urine analysis), signed by the toxicologist or by the medical
examiner’s custodian of records with the medical examiner’s
raised seal or notarized to include notary’s raised seal.
If such a report was not made, submit a statement to that effect
signed by the medical examiner or by the Fire Chief; statement
must be notarized.
- Copy of death certificate with raised seal of the Health Department
or the medical examiner.
- If deceased received more than first aid medical treatment,
a statement by the medical personnel/ambulance attendants must
be submitted, to include anything administered (e.g., oxygen)
and the amount(s); statement must be notarized. A copy of hospital
records or the physician’s report must be submitted also,
signed by the custodian of hospital records or by the physician,
as applicable; statements must be notarized.
- A notarized statement by the head of local government clearly
stating that the fire department is legally organized and is authorized
by that governmental body to act on its behalf by providing fire
service to the (community) (area) of (name).
- Certified copy of department’s non-profit corporation
charter or a copy of the minutes of a local government meeting
which show that the local government established the department
or encouraged citizens to establish it and function as that area’s
(Form is completed for the spouse and/or child(ren); if no spouse
or child, complete the form for the parent(s).)
Item 5 is the name and address of the fire department that filed
the Form 3650/6.
Part IV-A of form asks, “Has claim been filed for benefits
under: (1) Federal Employees Compensation Act..? and (2) D.C. Retirement
and Disability Act..?” The answer to both, for a volunteer
firefighter, is “no”.
Part IV-B asks for statement of financial need. If found to be
critical enough, an advance of up to $3,000 may be made while the
remainder of the processing of the claim is done. Should any advance
be made, the amount would be subtracted from the total benefit due
before final payment is made. If claim is denied, claimant could
expect to return any sum advanced.
Documents have to be submitted showing the relationship of the
claimant to the deceased:
- 1. For a spouse: copy of marriage certificate must include
raised seal of office issuing the copy. If either the deceased
or the spouse making the claim was married previously, copy of
the divorce decree(s) or copy of the death certificate of the
previous spouse must be submitted; each document bearing raised
seal of issuing office.
- For any child(ren): copy of birth certificate(s) showing the
deceased as a parent, or if applicable, adoption papers with the
deceased’s name as adoptive parent; each copy with raised
seal of issuing office.
- For parent(s): a copy of deceased’s birth certificate
or, if applicable, adoption papers showing the claimant(s) as
natural or adoptive parent(s), together with documents that clearly
show they are qualified individuals to make a claim; must bear
raised seal of issuing office. (NOTE: If either a spouse and/or
child(ren) files a claim, a parent may not receive any benefit.)
The Form 3650/5 is signed by the individual making the claim; should
be notarized to include notary’s raised seal.
PREPARING STATE CLAIMS
On the first business day, during business hours, call the Board
of Adjustment at 334-242-7175, in Montgomery, and they will send
you copies of their forms.
Carefully read “Preparing Claims – General” earlier
in this book.
The claim must be submitted in triplicate, all three copies identical.
Claim must be signed by the claimant and must be notarized.
You will find that, excepting the actual claim form, which is sent
to you, the documents sent to the Board of adjustment could be exactly
those sent in support of the Federal claim. Read the form and any
accompanying instructions carefully to ensure you do include all
items they require.
BACK TO TOP
BRIEF SUMMARY OF FEDERAL LAW/RULES
The Federal law, the Public Safety Officer’s Benefit (PSOB)
Act, is contained in the Public Safety Officer’s Act of 1976,
42 U.S.C. 3796, as amended, and is administered by the Bureau of
Justice Assistance, US Department of Justice, Washington, DC.
Federal law provides a $250,000 benefit to the eligible survivor(s)
of a public safety officer whose death is the direct and proximate
result of a traumatic injury sustained in line of duty. A cost of
living allowance is added each year.
Further, the amended law provides that parents do not have to be
financially dependent upon the deceased.
Coverage includes firefighters serving a public agency, with or
without compensation, as officially recognized or designated members
of a legally organized fire department. A volunteer fire department
must be acting on behalf of a public agency providing fire service
to all citizens within its jurisdiction without regard to membership
or require fee for services. Departments, which are not formed by
local government as a unit of that government, are required to provide
proof that they are legally organized (e.g., certified copy of their
state issued non-profit corporation charter or a copy of the minutes
of a local government meeting where that local government took official
action to encourage citizens to organize a volunteer fire department.)
Volunteer departments and fire brigades formed by a private entity
are not covered. Federal civilian firefighters are covered; military
are not. However, off-duty military personnel who are volunteer
firefighters in a community are eligible if the injury causing death
happens during activity with a volunteer fire department and otherwise
If an off-duty firefighter comes upon an emergency and acts on
his own, to be covered, he must be within his own jurisdiction or
in a jurisdiction where his department has a mutual aid agreement.
In addition, his death must result from an emergency action that
would normally be required of him while on duty.
Death must result from injury sustained in the line of duty. “Line
of Duty” means any action that the firefighter is authorized
or obligated to perform by law, rules, regulation, or condition
of employment or service.
Act does not cover death resulting from stress and strain, occupational
illness, or chronic, progressive, or congenital disease, such as
heart or pulmonary disease, unless there is a traumatic injury,
which is the substantial factor in the death. Medical proof of the
traumatic injury, such as a blood test of carbon monoxide, may be
essential for coverage in such cases. To be a substantial factor,
the traumatic injury has to be an equal contributing factor to the
death, as is the disease.
“Traumatic injury” means a wound or condition of the
body caused by external force, including injuries inflicted by bullets,
explosives, sharp instruments, blunt objects, or other physical
blows, chemicals, electricity, climatic conditions, infectious diseases,
radiation, and bacteria, but excluding stress and strain. Smoke
inhalation is considered a traumatic injury and a substantial factor
in a heart related death, if the firefighter’s blood carbon
monoxide level is 10% or greater at the onset of his attack; 15%
or greater if the individual was a smoker.
“Spouse” means the husband or wife of the deceased
at the time of death, and includes a spouse living apart from the
deceased at time of death for any reason.
“Child” means any natural, illegitimate, adopted, or
posthumous child or stepchild of the deceased who, at the time of
death, is: 18 years of age or under; over 18 years and a student;
over 18 years and incapable of self-support because of physical
or mental disability.
No benefit shall be paid:
- If death was caused by intentional misconduct of the individual
or by the individual’s intent to bring about his/her own
- If the individual was voluntarily intoxicated at time of death.
Benefits will be denied if post-mortem blood alcohol level is
.20% or greater.
- If individual was performing his/her duties in a grossly negligent
manner at time of death (that is, wanton disregard for one’s
- To any individual who would otherwise be entitled to a benefit
under the Act if that individual’s actions were a substantial
contributing factor in the death.
- To any individual employed in a capacity other than a civilian
- If no one qualifies as a survivor entitled to receive such
"Intoxication" means a disturbance of mental or physical
faculties (1) as evidenced by a post-mortem blood alcohol level
of .20% or greater OR a post-mortem blood alcohol level of at least
.10%, unless convincing evidence is furnished that the individual
was not acting in an intoxicated manner immediately prior to death,
or (2) resulting from drugs or other substances in the body.
The Federal benefit is not reduced by any benefit that may be received
at the State or local level. Conversely, as a result of a US Supreme
Court ruling, compensation of State or local agencies may not be
reduced because Federal benefits are paid.
No benefit paid under this Act shall be subject to execution or
attachment by creditors.
Federal benefits are not subject to Federal income tax (IRS Ruling
No. 77-235, IRB 1977-288). And, since the benefits are not estate
payments, they are not subject to Federal estate taxes.
Provisions also exist for a Federal benefit to be paid if the recipient
was permanently and totally disabled as the result of a catastrophic
injury sustained in line of duty; that is, one that permanently
prevents the individual from performing any gainful work. Disabilities
as a result of occupational diseases or heart attacks do NOT qualify.
Applicants must know: (1) Annual appropriations for this disability
benefit are limited and applicants could receive a prorated (lesser)
amount if appropriated monies do not fully cover all claims eligible
for payment during that period, and (2) receiving this disability
payment will not permit a later payment of a death benefit if the
individual eventually dies as a result of the line of duty injury.
BRIEF SUMMARY OF STATE LAW/RULES
Alabama law is contained in Code of Alabama, Sections 36-30-1 through
36-30-7 (1975). It is administered by the State of Alabama Board
of Adjustment, Montgomery, Alabama.
State law provides a $50,000 benefit to the eligible survivor(s)
of a fireman.
Fireman is defined as a member of a paid, part-paid, or volunteer
fire department of a city, town, county, or other subdivision of
the state or of a public corporation organized for the purpose of
providing fire protection services in the state. Includes chiefs,
assistant chiefs, firemen and all other officers and employees of
such departments who actually engage in fire fighting or rendering
first aid in case of drowning or asphyxiation at the scene of action.
These persons are presumed to be wholly dependent:
- Wife, unless it is shown that she was voluntarily living apart
from her husband at time of his death, or unless it is shown,
the husband was not in any way contributing to her support for
more than 12 months next preceding the occurrence of the injury
causing his death.
- Minor children under the age of 18 years and those over 18,
if physically and mentally incapacitated from earning.
- Wife, child, husband, mother, father, grandmother, grandfather,
sister, brother, mother-in-law, and father-in-law who were wholly
supported by the deceased at the time of death and for a reasonable
period of time prior thereto shall be considered his dependents
and payment may be made to them.
(Anyone named in subparagraph 3 who regularly derived part of his
support from the deceased at time of his death and for a reasonable
time prior thereto is considered partially dependent and payment
may be made to such individual.)
In the event a fireman, or a volunteer fireman who is a member
of an organized volunteer fire department registered with the Alabama
Forestry Commission, is killed, either accidentally or deliberately,
or dies as a result of injuries received while engaged in the performance
of his duties, his dependents shall be entitled to $50,000, unless
such death was caused by the willful misconduct of the individual
or was due to his own intoxication or his willful failure or refusal
to use safety appliances provided by his employer or his willful
refusal or neglect to perform a statutory duty or any other willful
violation of a law or his willful breech of a reasonable rule or
regulation governing the performance of his duties or his employment
of which rule or regulation he had knowledge.
Any fireman, or volunteer fireman, whose death results proximately
and within 10 years from an injury received while performing his
duties shall, for the purposes of this article, be deemed to have
been killed while in the performance of such duties.
If the State Health Officer determines from all available evidence
that a volunteer fireman, who is a member of an organized volunteer
Department registered with the Alabama Forestry Commission, has
become totally disabled as a result of any injury such fireman received
while engaged in the performance of his firefighting duties and
said disability is likely to continue for more than 12 months from
the date of injury, such fireman shall be entitled to receive $50,000.
All claims must be presented to the state within one year from
the date of death.
There are lengthy specifications as to how benefits will be paid
depending upon the numbers and relationships of survivors.
A hearing is held and the survivor(s) are notified in writing as
to the time, date, and place of the hearing.
SAMPLES OF STATEMENTS
On the next three pages are samples of statements that may be
helpful to a fire department.
Sample A is a statement of departmental regulation
or standing order that should be included NOW as part of your department’s
permanent records. It should be prepared on departmental letterhead
stationery and signed by the Fire Chief. File the original as part
of your permanent records, and one also might be posted on the bulletin
board. All departmental members should be advised of the statement.
Sample B is one way the Fire Chief might certify
a department run report or an activity report to be included with
the other documents forwarded with a claim.
Sample C is one example of how a Fire Chief might
clearly and concisely state the facts concerning an individual whose
injury resulted in death in line of duty.
Sample A - For PERMANENT Department Records
I, _______________ Chief of the __________________ Volunteer Fire
Department, do order ALL members of this department to take appropriate
action at ANY time you may be involved with any fire or other
emergency to which you would normally be alerted. I furthermore
order all members of this department to take appropriate action
when and where they see need for action within the realm of their
training and experience, wherever such action may be required.
All members of this department are directed to attend any and
all firematic meetings, local, county, or state, and other activities
that they are delegated to attend as a delegate or member. Travel
to and from such firematic meetings shall begin and end at the
Typed: (Name and Title)
Sample B - Certifying a Run Report
I certify that the attached Fire Department (Report) (Run Report)
(Fire Report) (or other Title of Document) is an exact and true
copy of the original document, which is on file in this department.
Typed: (Name and Title)
NOTE: This statement must be notarized and include the raised
seal of the notary.
Sample C - Fire Chief's Statement
This is to certify that __(Name)__ , a firefighter of this
fire department, died (at) (about) __(time)__ (am)(pm),
on __(Date)__ as the result of injuries received in the
line of duty at ___Time)__ (am)(pm), __(Date)__
at __(Give the location, town and state)__ .
Firefighter _____(Name)_____ was engaged in (going to)
(participating in) (returning from) __(State what activity
& again include location)__ (use whatever space is required)
as required by standing orders of this department.
Typed: (Name & Title)
NOTE: This statement must be notarized and include the raised
seal of the notary.
AAVFD OFFICE 888-972-2833
Alabama State Fire Marshall 334-241-4166
AAVFD Web Site http://www.aavfd.org
Alabama Code Title 36-30-1 Thru 7
Alabama Code Web Site http://alisdb.legislature.state.al
National Fallen Firefighters Foundation http://www.firehero.org
Firefighter Autopsy Protocol http://www.usfa.fema.gov/pdf/usfapubs/fa-156.pdf
International Assn. of Fire Chiefs http://www.ichiefs.org
this MS Word document.
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