King County requires, by King County code 2.35A.100*, that the King County Medical Examiner review all deaths. This regulation went into effect on January 1, 2008 in order to prevent destruction of evidence in death investigations. This code requires that all King County deaths be reported to and receive authorization from the Medical Examiner prior to releasing the body for disposition, regardless of where disposition is to occur.

We owe it to the families to be able to tell them what happened to their loved one. We do not want suspicious or accidental deaths to go uninvestigated or unaccounted for.

How the program works

The KCMEO reviews all deaths that occur in King County. Before a death certificate is certified, the DA program reviews each cause of death identified on the death certificate to verify that the cause (what the person died from) and manner (natural, homicide, suicide or accident) do not indicate the need to assume jurisdiction. Deaths that fall within the jurisdiction of the KCME include accidental deaths, homicides and suicides. If an unnatural death is discovered before the body is buried or cremated, then law enforcement and KCME can conduct an investigation.

Information for funeral homes

How to request a Disposition Authorization

1. Download and complete the King County Medical Examiner Request for Disposition Review..
   
   
2. Download an APPROVED Proof Copy of the death certificate from EDRS. If this is not included or incomplete, we will not be able to process the request.
   1. Tip: Rather than printing the death certificate, save a copy for an e-mail attachment.
      
      
3. Send to the DA team at DA.KCMEO@kingcounty.gov.
   1. For easier searching, please enter the name of the decedent in the “Subject" line as LAST NAME, FIRST NAME.
   2. Attach the DA form and Proof copy of the death certificate.  They may be sent together or as two separate documents. 

How much it costs

The cost is $70.00 per request as mandated by the King County Council. If you do not already have a credit account with Public Health – Seattle & King County, you will need to contact the Medical Examiner’s office to discuss methods of payment or the procedure for setting up an account. If you have an account, which is also used for purchasing certified death certificates, King County will invoice your funeral home.

How long it take to get a disposition authorization approved

Requests are processed within a 24 hour period on business days (M-F), except holidays. Requests received after 2:30 pm will be processed the next business day.  If you have not received any information from the Medical Examiner's office within 24 hours of submission, please call the office. Please do not re-email your request as this could potentially cause you to be billed twice.

Possible delays when processing your request

The Medical Examiner's office makes every effort to process and approve all disposition requests as efficiently as possible. Your request could be delayed for a number of reasons mentioned below. The single most important step you can take to prevent a delay is to assure that all sections of the authorization form and death certificate are complete prior to submission to the Medical Examiner. While not addressing all possible problem areas, the following list will hopefully help to ensure a more efficient and prompt approval process.

In order to avoid a delay in processing please ensure the following:

An underlying disease process or etiology has been listed in sections 34/35 of the death certificate. For example: "pneumonia" is not acceptable and needs further clarification. "Cardiac arrest" and "respiratory failure" are mechanisms of death, not causes of death. An underlying disease process is needed.

All non-natural causes of death, including fractures, must be reported to and certified by the Medical Examiner.

Intracranial hemorrhages must be clarified with specific bleed site and etiology, or whether the bleed was "spontaneous" and hypertensive.

Death certificates should meet the Washington State Department of Health (DOH) death certificate guidelines, available at the DOH website.

How the review works with the King County Indigent Remains Program

Applications for indigent requests require approval prior to the disposition authorization being granted. Indigent applications must be submitted by mail or in person. Please direct indigent application questions to the Indigent remains program at 206-731-3232, ext. 5.

How to tell when your request has been approved

The Medical Examiner's office will enter the disposition authorization number into the comments section of EDRS. This number must be provided to the local registrar of Vital Statistics before the death certificate can be filed.

Success rates of the DA program

The State predicted the Cremation Review program would catch 25 Medical Examiner Cases per year; in the first year alone, KCMEO caught 94 cases. In 2015, the DA review process caught 86 KCME jurisdictional cases that would have otherwise gone unexamined. Since this law was enacted in 2008, over 155,000 deaths have been reviewed, resulting in over 1,500 new cases that were identified through the review.