NC TSERS Employer Form 253: What Gets Reported When a State Employee Dies

When an active TSERS member dies, the Retirement Systems Division sends Form 253 directly to the deceased employee's agency. The family does not fill out this form, does not receive a copy of it, and often does not know it exists — but it controls the calculation of nearly every active-member death benefit.

What Form 253 Certifies

The employing agency uses Form 253 to certify four things:

1. Final compensation: The member's salary at the time of death, used to calculate the $25,000–$50,000 Lump-Sum Death Benefit (highest 12 consecutive months of salary in the 24 months before death)
2. Final month's pay: Determines the last paycheck owed to the member's estate
3. Accrued unused sick leave: RSD records the balance, but unused sick leave does not count toward the 20-year creditable-service test for the Survivor's Alternate Benefit
4. Employment status at death: Whether the member was actively working, receiving Disability Income Plan (DIPNC) benefits, or on Workers' Compensation — this determines whether the 180-day rule applies

Why Sick Leave Matters More Than Families Realize

Unused sick leave is reported on Form 253 but does not count toward the SAB's 20-year eligibility requirement. However, creditable service accrued during employment (including any prior service purchased through buyback programs) determines whether the family receives a monthly annuity or a one-time lump sum.

If the agency's reported sick leave balance is incorrect, the family should ask the HR department to review and correct its records before Form 253 goes back to RSD. Once RSD uses those numbers to calculate benefits, correcting an error adds weeks or months of processing delay.

The 180-Day Rule

The Lump-Sum Death Benefit ($25,000–$50,000) is payable if the member died while in active service or within 180 days of their effective termination date, provided they had not already received a refund of their contributions. This 180-day window captures members who resigned or were terminated but died shortly after — their families still qualify for the salary-based death benefit.

Form 253 establishes the termination date (or confirms the member was active), so the 180-day clock starts from whatever date the employer certifies. If the member was on extended leave without pay or Workers' Compensation, the employer's classification on Form 253 determines whether the member qualifies as "active" for death benefit purposes.

What the Family Should Do

The family does not need to contact the employer about Form 253 — RSD sends it directly. But there are two things the family can do:

Confirm the employer received it: If several weeks pass after the death with no word from RSD, the family can ask the deceased's HR department whether they received and returned Form 253. Delays in employer reporting are one of the most common causes of slow claim processing.

Verify the information: If the family has access to the member's pay stubs or leave balances (through personal records or the employer's portal), compare those against what the employer reported. Discrepancies in final salary or sick leave can affect benefit calculations.

How Long Form 253 Takes

RSD typically receives the completed Form 253 within 15–30 days of the death, depending on how quickly the employing agency processes it. Larger agencies (UNC system, DHHS, Department of Public Safety) handle these regularly and tend to move faster. Smaller agencies or school districts may take longer if the HR staff has less experience with the process.

RSD cannot finalize the claim until Form 253 is on file. This is the main reason active member death claims take 60–90 days versus the 30–60 days typical for retiree death claims — the employer step adds processing time that does not exist in the retiree pathway.

Our NC TSERS Survivor Benefits Guide includes a timeline showing exactly where Form 253 fits in the active member claim sequence, so families know what to expect and when to follow up.

See more North Carolina guides →