The following two sample applications are for state and federal benefits. Once an officer has died while on duty, the agency needs to contact the retirement system in which the officer was a member of to start the benefit process. If an actual line of duty death occurred, the "Ohio Public Safety Officers Death Benefit Fund" application will be filled out. The Ohio Death Benefit Fund is managed by the Ohio Police and Fire Pension Fund located in Columbus. This application can be acquired by calling them at 1.800.860.9599.

The second application is for the federal benefit "Public Safety Officers Benefit." There are two parts to this application (Claim for Death benefits and Report of Public Safety Officer's Death), and both must be filled out completely with all of the information required. You can contact the PSOB at 1.888.744.6513 to request these forms for your fallen officer.

A LODD is also a workers compensation benefit. Upon the death of an officer, contact the Worker's Compensation Bureau, Claims Section, 30 West Spring St., Columbus, OH 43266-0581, telephone: 800.644.6292.

These state and federal applications are crucial and need to be filled out as soon as possible after an officer's death. It is the department's responsibility to make sure these are completed in a timely fashion.

NOTE OF IMPORTANCE: Upon the death of an officer, we suggest the use of the Critical Incident Response Service. Their phone number is 1.800.367.6524. By calling this number, you can activate a team to assist in your incident. Critical Incident Stress Management is quickly becoming a standard of care in the emergency response field. By calling this team, you will receive immediate care for all of your personnel (officers, dispatchers, and family members). The team only responds when called unless other arrangements are made before an incident occurs.

Sample Forms:

 Ohio Public Safety Officers Death Benefit Fund
 Report of Public Safety Officer's Death
 Claim for Death Benefits

Additional Paperwork to be filled out after a LODD

• The first is the "Analysis of Law Enforcement Officers Killed and Assaulted." This form is used specifically by the FBI to report circumstances regarding law enforcement officers of your department who were killed or assaulted and injured with a firearm or a knife or other cutting instrument. This report is for statistics only and has nothing to do with benefits.

   Analysis of Law Enforcement Officers Killed and Assaulted

• The second form is "Concerns of Police Survivors." This form will be sent to your department once COPS learns of the death of your officer. COPS works in conjunction with the state chapter, Ohio COPS, in gathering information about your officer, co-workers, and family members. COPS co-sponsors National Police Week activities, and it is imperative that they have all the information about your officer so the proper paperwork and registrations can be sent out for all of the national memorial events, seminars, and programs offered by them.

   Concerns of Police Survivors form

• The third form is the "NLEOMF Officer Data Form." This form needs to be filled out so your officer will be considered for inclusion on the wall in Washington, DC. Once all the criteria is met surrounding your officer's death, his/her name will be engraved on the National Law Enforcement Officers Memorial Wall, and the name will be read at the annual candlelight vigil held each May 13th.

   National Law Enforcement Officer Memorial Fund Officer Data Form