ARS Online Manual
Deceased
An employee who is out of work due to a Workers' Compensation incident passed away. The death was not a result of the injury or illness reported. Is it necessary to inform the New York State Insurance fund (SIF)?
Yes, since the employee will no longer be eligible for regular compensation benefits, a C-11 form needs to be sent to SIF indicating the employee passed away. When completing the C-11, on the Employment Status page under Remarks, indicate the death is unrelated to the workers' compensation case for the injured employee.