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KANSAS DEPARTMENT OF LABOR www.dol.ks.govDEATH BENEFITS INFORMATION KWC 140 (Rev. 419)The Kansas workers compensation law requires employers or their insurance carriers to pay weekly benefits to surviving

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How to fill out k-wc 140 - death

01

To fill out k-wc 140 - death, follow these steps:

02

Start by entering the decedent's full name, address, and social security number.

03

Provide information about the date and place of death.

04

Include details about the cause of death and any contributing factors.

05

Specify whether an autopsy was conducted and provide relevant information if applicable.

06

Mention if the death occurred due to a work-related incident or occupational disease.

07

Provide the name and contact information of the decedent's spouse or next of kin.

08

Attach any supporting documents, such as medical records or death certificates.

09

Sign and date the form before submitting it to the appropriate authorities.

10

Make copies for your records.

Who needs k-wc 140 - death?

01

K-wc 140 - death is required by the employer or the workers' compensation insurance carrier of the deceased employee. It is used to report work-related deaths and initiate the workers' compensation claims process.

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What is k-wc 140 - death?

k-wc 140 - death is a form used to report work-related deaths to the relevant authorities.

Who is required to file k-wc 140 - death?

Employers or their representatives are required to file k-wc 140 - death in the event of a work-related death.

How to fill out k-wc 140 - death?

k-wc 140 - death should be filled out with all the necessary information about the deceased worker and the circumstances of the work-related death.

What is the purpose of k-wc 140 - death?

The purpose of k-wc 140 - death is to ensure that work-related deaths are properly reported and investigated.

What information must be reported on k-wc 140 - death?

Information such as the name and details of the deceased worker, the date and location of the incident, and the cause of death must be reported on k-wc 140 - death.

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