Notice To Beneficiary Of Entitlement To Benefits{5332}

NOTICE TO BENEFICIARY OF ENTITLEMENT TO BENEFITS. This form is used to inform and guide a beneficiary—typically a dependent of a deceased worker—on how to claim their workers’ compensation benefits. The form outlines eligibility and application procedures for receiving direct benefit payments starting at age 18, which continue through the beneficiary's 19th birthday. Additionally, it explains that the beneficiary may be eligible for up to 48 more months of benefits between the ages of 19 and 26 while pursuing secondary education, a GED, college, university, or vocational/technical training. To receive these extended benefits, the beneficiary must submit documentation proving current school enrollment, such as transcripts or enrollment letters. The form also includes sections for providing personal and school information, and must be returned to the designated insurer or employer. Assistance is available from the insurer, the Workers' Compensation Division, or the Ombuds Office for Oregon Workers. www.FormsWorkflow.com