Submit a form to waive your pre-retirement death (survivor) benefit

Send us a form that allows you, as the spouse of a plan member, to give up your right to receive a pension benefit should your spouse die before retiring.

Submit the form

  1. Download and print the form
  2. Complete it in the presence of a witness and the absence of your spouse (plan member)
  3. Initial the first box in the Waiver section to give up your beneficiary right to receive your spouse's pension benefit if your spouse dies before starting to receive a pension
  4. Mail the form to the WorkSafeBC Pension Plan

You can only complete this form if your spouse (the plan member) has not yet started receiving their pension.

If your spouse is retiring, you must complete a new waiver to waive your right to a minimum 60 per cent lifetime survivor's benefit or beneficiary right to a guaranteed monthly pension if your spouse chose a pension option within a guaranteed time period. You can waive these rights by submitting Form 2.

What you’ll need to complete this form
  • The name, address and provincial registration number of the pension plan
    • WorkSafeBC Pension Plan
      P.O. Box 9460
      Victoria, BC V8W 9V8
    • Provincial registration number P085663
  • A witness to sign the form