Medical examiner
The official who investigates and certifies certain deaths — and whose sign-off everything else waits on.
What it means
Most deaths are certified by the doctor who was treating the person. A defined category is not: a death that was sudden, unattended, violent, suspicious, or that happened in custody or at work, is reportable, and it goes to a medical examiner or a coroner instead.
The two titles describe different offices. A medical examiner is a physician, usually appointed. A coroner is an elected official who may or may not be a physician and who works with one. Which a county has is a matter of that state's law and, often, of history.
For a family, the consequence is time. Nothing can be registered until the certifier signs, and nothing else — the permit, the funeral, the certified copies, the insurance claim — can begin until the death is registered. Where a case is under investigation the certificate may issue with the cause recorded as pending, and be amended later once toxicology or an autopsy is complete.
Cremation is separately gated in most states: because it is irreversible, a medical examiner's clearance is generally required before it, even where the death was ordinary and certified by a treating doctor.
Why it matters
It is the answer to "why can we not have the certificate", and the answer is usually that nobody has signed rather than that anything is wrong.
A cause recorded as pending is not a finding. Insurers understand it; families reading it for the first time usually do not.
When you are likely to meet it
- When a death was sudden, or nobody was present.
- When the funeral home says it is waiting for a release.
- When the certificate arrives with the cause of death left open.
How this varies by state
Whether a county has a medical examiner or a coroner, which deaths must be reported, and what is required before a cremation are all set by state law.