XII. Expenditures

Guide to Financial Operations

XII.6.H Paying an Accidental Death Benefit

XII. Expenditures
Guide to Financial Operations


Effective April 1, 1985, an Accidental Death Benefit Program was instituted for the following employee groups.

Code Bargaining Unit
01 Security Services Unit
02 Administrative Services
03 Institutional Services
04 Operational Services
05 Professional, Scientific and Technical Services
06 Management Confidential
07 State Troopers
17 Commissioned and Noncommissioned Officers
18 State Police-Management Confidential
46 Military and Naval Affairs-Management Confidential
47 Military and Naval Affairs
61 Security Supervisors Unit
62 Investigators and Senior Investigators
67 Rent Regulation Services

Note: Employees in specific bargaining units whose survivors receive full payment pursuant to the Federal Public Safety Officers Benefit Act of 1976 are not eligible for this accidental death payment.

These accidental death benefit payments provide for the State to pay a death benefit in the amount of $50,000 to an employee’s surviving spouse and/or children. The benefit is paid only if an employee’s death is a result of an accidental, on-the-job injury pursuant to the Workers’ Compensation Law. The Accidental Death Benefit will be paid to the beneficiaries in the same proportion, as evidenced on the Workers’ Compensation Board Accidental Death Benefit, Notice of Decision (EC-23 form).

Process and Transaction Preparation:

In the event of an accidental death, the appropriate Business Unit must submit a payment through the Statewide Financial System (SFS). Business Units must create a Single Payment voucher using Vendor ID ‘0400000005’ (Statewide Death Benefits) and entering the Account code ‘60001’, in accordance with Section 5 - Agency Payment Preparation and Submittal of this Chapter. The Recipient(s) will receive a Form 1099-R Distributions From Pension, Annuities, Retirement or Profit Sharing Plans for this payment for the reporting year.


Business Units are required to attach the following to the Single Payment Voucher: Workers’ Compensation Board (WCB) Notice of Decision (EC-23 form) or WCB Notice of Award in Death Cases (EC-68 form); a letter of certification from the WCB, stating there are no outstanding appeals affecting this decision; and evidence verifying the deceased employee’s bargaining unit. Bulkload Business Units can forward the above mentioned documents to the Voucher Audit Team at [email protected]. In addition, the Business Unit must forward a New York State Substitute Form W-9 (AC 3237-S) completed by each beneficiary receiving a payment, to the Federal Reporting mailbox at [email protected], before the voucher can be approved for payment.

Questions relative to the payment process should be directed to the Bureau of State Expenditures’ Customer Service Help Desk at (518) 474-4868, or by email addressed to [email protected].

Guide to Financial Operations

REV. 12/30/2014