Death Benefit Table

Date of Injury On or after 1/1/2013 Prior to 1/1/2013
Burial expenses $10,000 $5,000
1 Total Dependent $250,000 $250,000
2 or More Total Dependents $290,000 $290,000
3 or More Total Dependents $320,000 $320,000
1 Total Plus 1 or More Partial Dependents $250,000 plus four times annual support for partial dependents not to exceed $290,000 $250,000 plus four times annual support for partial dependents not to exceed $290,000
1 or More Partial Dependents Eight times annual support not to exceed $250,000 Eight times annual support not to exceed $250,000