Benefits

Wisconsin EMS Honor Guard

Association, Inc.

​​The purpose of this page is  to provide families and agencies with general information about benefits to families in the event of a line-of-duty death. This is not a legal document nor is it intended to serve as a legal interpretation of existing statues. In fact, information on the death benefits listed may have been changed through legislation or contract negotiations without our knowledge. This document is for information only.


Designation of Beneficiaries Form for U.S. Department of Justice Public Safety Officers' Benefits (PSOB) Program. 
PSOB website click here
 Download & Apply Your Department Letterhead:
»
Designation of Beneficiaries Formfor PSOB Program (MS Word)

 PSOB Notification of Death form

  PSOB Claim form

We encourage departments to distribute to their EMT's and Paramedics for completion and filing with your department.

Reason for Completing This Form: If there are no spouse or children, then the individual(s) designated by the EMT/Paramedic on the PSOB beneficiary form on file with the EMT's/Paramedics agency will receive benefits if the claim is approved.


This checklist can be used to keep track of the status of the various benefit applications being submitted on behalf of survivors.


Death Benefit Payment(s):

PSOB Survivor Death Benefits Provider: US DOJ - BJA - Public Safety Officers Benefits Program
Amount: $333,604 for officers killed on or after October 1, 2013
Phone: (888) 744-6513
Contact's Name: _____________________________________
Website


Social Security Benefits Provider: United States Social Security Administration
Amount: Varies
Phone: (800) 772-1213
Contact's Name: _____________________________________
Website


Wisconsin Death Benefit Payment Provider: Wisconsin Department of Workforce Development
Amount: 75% of primary death benefit, but not less than $50,000
Phone: (608) 266-1340
Contact's Name: _____________________________________
Web: http://dwd.wisconsin.gov/wc/


Woodmen of the World 1st Responders Benefit Provider: Woodmen of the World
Amount: $10,000
Phone: (800) 225-3108
Contact's Name: _____________________________________
Web: http://www.woodmen.org/inside.cfm?sub_menu_id=29&main_menu_id=6&page_id=27



Education Assistance:
PSOB Education Benefits Provider: US DOJ - Public Safety Officers Benefits Program
Amount: Varies
Phone: (888) 744-6513
Contact's Name: _____________________________________
Web: http://www.ojp.usdoj.gov/BJA/grant/psob/psob_main.html


Knights of Columbus Scholarship Provider: The Knights of Columbus
Phone: (909) 343-0460
Contact's Name: _____________________________________
Web: https://www.kofc-ca.org/?t=t_home&m=m_home


Purple Heart Educational Benefits Provider: Military Order of the Purple Heart
Phone: (352) 250-9555


Burial Assistance

Dignity Memorial Funeral Benefits Provider: Dignity Memorial Funeral, Cremation, & Cem.
Phone: (800) 344-6489
Contact's Name: _____________________________________
Web: http://www.dignitymemorial.com/dm20/en_US/main/dm/community/public-servants-program.page?


Free Burial Vault Provider: Wilbert Funeral Services
Amount: Varies
Phone: 800-323-7188
Contact's Name: _____________________________________
Web: http://www.wilbert.com/commemorating-first-responders/about-the-program/


Pension

United States Armed Forces Veterans Pension Provider: U.S. Department of Veterans Affairs
Phone: (800) 827-1000
Contact's Name: _____________________________________
Web: http://www.va.gov/


Wisconsin Pension Provider: Wisconsin Department of Employee Trust Funds
Amount: Varies
Phone: (608) 266-0301
Contact's Name: _____________________________________
Web: http://etf.wi.gov/


Health Insurance

COBRA Health Insurance Requirements Provider: U.S. Department of Labor
Phone: (866) 487-2365
Contact's Name: _____________________________________
Web: http://www.dol.gov/index.htm


Workers Compensation

Federal Workers Comp for Non-Federal Law Enforcement Officers Provider: U.S. Office of Workers Compensation Programs
Amount: Varies
Phone: (202) 513-6800
Contact's Name: _____________________________________
Web: http://www.dol.gov/owcp/

Wisconsin Worker's Compensation Provider: Wisconsin Department of Workforce Development
Phone: (608) 266-1340
Contact's Name: _____________________________________
Web: http://dwd.wisconsin.gov/wc/


Vital Records

Wisconsin Vital Records Provider: Wisconsin Department of Health Services
Phone: (608) 267-8810
Contact's Name: _____________________________________
Web: http://www.dhs.wisconsin.gov/vitalrecords/


Peer Support

AARP Peer Support Provider: American Association of Retired Persons
Phone: (202) 434-2277
Contact's Name: _____________________________________
Web: http://www.aarp.org/


ADEC Peer Support Provider: Association of Death Education & Counseling
Phone: (203) 232-4825
Contact's Name: _____________________________________
Web: http://www.adec.org//AM/Template.cfm?Section=Home#


Compassionate Friends Peer Support Provider: The Compassionate Friends, Inc.
Phone: (312) 990-0010
Contact's Name: _____________________________________
Web: http://www.compassionatefriends.org/home.aspx


National Victim Center Peer Support Provider: National Victim Center
Phone: (703) 276-2880
Contact's Name: _____________________________________
Web: http://www.victimsofcrime.org/

NOVA Peer Support Provider: National Organization for Victim Assistance
Phone: (202) 232-6682
Contact's Name: _____________________________________
Web: http://www.trynova.org/

Parents of Murdered Children Peer Support Provider: Parents of Murdered Children
Phone: (513) 721-5683
Contact's Name: _____________________________________
Web: http://www.pomc.com/