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Rules and Regulations of the State of Georgia
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Chapter 292-3 APPLICATION FOR BENEFITS

Rule 292-3-.01 Application for Benefits

(a) An application for indemnification benefits may be made by:
1) any emergency medical technician, firefighter, law enforcement officer, prison guard, and emergency management rescue specialist who is permanently disabled in the line of duty as specified in O.C.G.A. 45-9-80et seq. or by
2) the administrator or executor of the estate of any emergency medical technician, firefighter, law enforcement officer, prison guard, and emergency management rescue specialist who is killed in the line of duty as specified in O.C.G.A. 45-9-80et seq. or by
3) a law enforcement officer or firefighter injured in the line of duty as specified in O.C.G.A. 45-9-101et seq.
(b) An application for benefits shall be made on forms provided by the Department of Administrative Services. Any person who believes that they may be entitled to an indemnification benefit should request an application from the Department of Administrative Services.
(c) In all cases, the Department of Administrative Services will require a complete copy of the workers' compensation records of the emergency medical technician, firefighter, law enforcement officer, prison guard, or emergency management rescue specialist who is killed or permanently disabled in the line of duty as set forth in O.C.G.A. 45-9-80et seq. or a complete copy of the workers' compensation records of the law enforcement officer or firefighter seeking supplemental temporary disability compensation pursuant to O.C.G.A. 45-9-101et seq.
(d) In cases involving an emergency medical technician, a firefighter, a law enforcement officer, a prison guard, or an emergency management rescue specialist who is killed in the line of duty, the Department of Administrative Services will always require 1) a certified copy of the death certificate of the individual and 2) proof that the person submitting the application is the administrator or executor of the estate of the individual.
(e) In cases involving an emergency medical technician, a firefighter, a law enforcement officer, a prison guard, or an emergency management rescue specialist who is permanently disabled in the line of duty, the Department of Administrative Services will always require 1) proof of permanent disability and 2) proof that the person submitting the application is the individual who was permanently disabled in the line of duty.
(f) In cases involving an emergency medical technician, a firefighter, a law enforcement officer, a prison guard, or an emergency management rescue specialist who is permanently disabled in the line of duty and the permanent disability results in the incapacitation of the individual, the Department of Administrative Services will always require 1) proof of disability and 2) proof that the person submitting the application is authorized to act on behalf of the individual who was permanently disabled in the line of duty.
(g) In cases involving a law enforcement officer or firefighter seeking benefits pursuant to O.C.G.A. 45-9-101et seq., the Department of Administrative Services will require a sworn statement that the applicant has disclosed all sources of compensation described in O.C.G.A. 45-9-103(c)as well as authorization from the applicant for the Department of Administrative Services to review records associated with such sources of compensation.
(h) In all cases, the Department of Administrative Services may require or obtain additional information if necessary.

Rule 292-3-.02 Applications by Other Designated Beneficiaries

Any designated beneficiary of any person as defined in Ga. Laws 1978, p. 1914, et seq., as amended, killed in the line of duty or any officer disabled in the line of duty shall make application on forms supplied by the Commission. Such application or other suitable notice must be filed with the Commission as set forth in Rule 292-3-.01 next preceding.