A DIA form 510 in a death case must be filed unless the employer has actual knowledge that:

• A. The deceased left a surviving minor child
• B. The employee left a totally dependent spouse
• C. The employee left a partially dependent spouse
• D. The employee left a former spouse

Answer: (B)

In death cases, the DIA form 510 is the notice used to identify dependents for survivor benefits and to prompt the Division of Industrial Accidents to determine who may be entitled to benefits. The form must be filed unless the employer actually knows that the employee left a totally dependent spouse. That specific knowledge is the key exception: if there is a spouse who is entirely dependent on the decedent for support, the dependency status is already established, so there’s no need for the employer to submit the form to confirm dependents.

When there isn’t such clear knowledge of a totally dependent spouse, the form is needed to uncover whether other dependents exist (like minor children or partially dependent spouses) and to help apply the proper priorities for survivor benefits. The other potential dependents described in the options would require gathering information to determine eligibility, so the form would typically be filed in those circumstances.