On the Edge.

Imagine if you were unable to:

  • bury or cremate a loved one,
  • arrange an out-of-state funeral,
  • activate a life insurance policy,
  • access or close a bank account,
  • pay your mortgage or utility bill,
  • sell your house or car,
  • probate a will,
  • or settle an estate

…all while grieving the loss of a loved one and teetering along the balance beam of family and work life. These are examples of what many families and caretakers endure when a death certificate is delayed 1, 2, 3 .

On a regular basis, responsibility for the certification of a natural death is deferred to the medical examiner or coroner (ME/C) when the physician of record or the pronouncing physician declines to certify the death 4.  In these instances and because many ME/C offices still do not have access to electronic medical records, a request for records will be necessary. These include records from hospitals, hospice facilities, nursing homes, short- and long-term care rehabilitation facilities, and clinics. While records are received by fax and increasingly by email, days or weeks may transpire before they are received, further delaying the certification of the death.  It may be necessary to issue a pending death certificate within the mandated time frame as required by state law. Once received, records will be reviewed and interpreted by the forensic pathologist or the physician medical examiner or coroner followed by determination of the cause of death with completion of the final death certificate. The performance of any postmortem testing may cause additional delay to completion of the final death certificate.

Over-burdened, understaffed ME/C’s offices already struggle with timely certification of jurisdictional deaths in the face of the current opioid crisis and an uptick in the number of homicides in some locales and are acutely aware of the hardships faced by families waiting for the death certificate to be completed 5.


  1. http://fox59.com/2015/03/19/fox-59-investigates-death-certificate-delay-costing-family-thousands/
  2. http://www.kctv5.com/story/34324924/kansas-city-widow-waits-6-weeks-for-death-certificate
  3. http://medicaleconomics.modernmedicine.com/medical-economics/news/modernmedicine/modern-medicine-feature-articles/death-certificate-process-and?page=full
  4. https://www.bostonglobe.com/business/2014/06/16/grieving-families-face-insurance-financial-problems-from-delays-state-death-certificates/CdqKPttNPvoDncewrajliN/story.html
  5. http://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2017/07/06/opioid-overdose-deaths-swamp-medical-examiners

A wise fortune teller sees a Practice Pearls in the crystal ball of your future. Stay tuned!


Game on! Show what you know and take the “5 for 5 Challenge Book Giveaway” with direct access by this link: https://www.linkedin.com/pulse/5-challenge-book-giveaway-erica-j-armstrong-md/ and win a FREE postage paid one of these!


Hint: Information pertinent to  the questions (aka-the answers) can be found in the Practice Pearls posts from July 2, July 16, Sept. 10 and Sept. 24.


Seriously, you’d pass on a freebee?!?

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