In early April, FEMA will begin providing financial assistance for funeral expenses incurred after January 20, 2020 for deaths related to coronavirus to help ease some of the financial stress and caused by the pandemic. The policy was finalized on March 24, and FEMA is implementing this funeral assistance program nationwide.

In some cases, medical examiners and coroners should anticipate receiving calls from families about why COVID-19 was not listed on a death certificate, FEMA said. They may also receive calls from clinicians about amending a death certificate.

An applicant may receive funeral assistance for actual funeral costs up to $9,000 for each COVID-19 related funeral. An applicant must be a US citizen, non-citizen national, or qualified alien who incurred funeral expenses after January 20, 2020. Currently, there is no deadline to apply. The official death certificate must attribute the death to COVID-19 and shows that the death occurred in the United States. The death certificate must indicate the death “may have been caused by” or “was likely the result of” COVID-19 or COVID-19-like symptoms. Similar phrases that indicate a high likelihood of COVID-19 are considered sufficient attribution.

FEMA has provided the following points to share with families and certifying clinicians as needed:

• Families who believe a death was due to COVID-19 but was not certified as such, should be referred to the person who certified the death. This person is responsible for any amendments. Funeral directors have been briefed on the assistance plan and are willing to help. Since they are aware of the rules and procedures in individual jurisdictions, they are a good resource to direct families to about specific reimbursement questions and death certificate procedures. Families will need a copy of the death certificate attributing the death to COVID-19, an itemized funeral expense receipt, and proof of other funds received (Required Documents).
• As most non-medical examiner, non-coroner death certifiers rarely amend death certificates, vital record offices should anticipate calls from certifiers about how to amend a certificate and may want to prepare guidelines for assistance.
• Families may not understand that just because a person tested positive for COVID-19 that this does not mean the person died from COVID-19. Viral COVID-19 RNA shedding has been detected for up to three months after the initial infection.
• In order for COVID-19 to be listed on the death certificate, the infection must have caused or contributed to death. There are circumstances in which “probable” may be used despite the absence of a positive COVID-19 test. (CDC Guidelines).
• Delayed COVID-19 deaths can be challenging. This scenario is similar to the approach for the certification of delayed traumatic deaths. If there is a direct pathologic link between the original infection and death, then the infection is included on the death certificate. The "but for" question may be useful. But for the COVID-19 infection, would this person have died at this time?