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The Defense Base Act
(Under the Longshore and Harborworkers’ Compensation Act)
Frequently Asked Questions (FAQ)

What should I do if I am injured?

First thing you should do when you are injured is to report the injury immediately to your supervisor. Once that is done, medical treatment is generally offered.

Does my injury have to be my Employer’s fault?

No. Under the Longshore and Harborworkers’ Compensation Act (LHCA), you are entitled to benefits even if the injury was not the fault of your Employer. In fact, under most circumstances, you are entitled to benefits even if you are injured as a result of your own negligence.

Am I required to give notice of my injury in writing?

It is always a good idea to give notice of the injury in writing as soon as possible. You must file a claim with the Department of Labor Office of Workers’ Compensation Programs within one (1) year of the date of injury. However, in cases where you do not give written notice and the claim was not filed within one year, you may still have a valid claim.

How long do I have to file a claim?

As stated above, generally, the Claimant must file a LS-203 (Employee’s Claim for Compensation) within one (1) year of the date of injury. However, there are exceptions to this rule and you should seek legal advice before abandoning your claim if you have not filed a claim within one (1) year.

How do I file a claim?

A claim is generally filed on Form LS-203, generally, in the District Office where the Claimant resides. Claim forms may be printed from the web site below.

Do I have to be a U.S. citizen to be entitled to benefits?

No, you do not need to be a U.S. citizen to be entitled to benefits.

Where can I find Workers’ Compensation forms?

Where should I file my claim?

Generally, in the District Office, Department of Labor, where you reside. In the Atlanta area, the district office is in Jacksonville, FL. However, many non-appropriated fund cases were automatically filed in the District Office in New York. The rule has recently been changed and the filings will occur in the district where the Employee resides. For a list of district offices, please see, www.dol.gov./esa/owcp_org.

If I cannot work, how long does it take to get workers’ compensation benefits?

Under the Longshore and Harborworkers’ Compensation Act, there is only a three (3) day waiting period. Benefits should be payable almost immediately thereafter. However, if the Employer or Insurer does not know that you are unable to work, they may not begin benefits. Therefore, when you see a doctor regarding your claim, make sure that you get a disability slip from him and get a copy of that document to your Employer or its Insurer. Benefits are payable within 14 days of their due date.

After I return home, am I allowed to see a doctor of my choice?

Generally, yes. If you are injured outside the US, your medical choices are limited. Therefore, if you know that you are coming back to the US, you should not sign any documents choosing a doctor overseas. Wait until you have a legitimate choice of doctors before exercising your one time right to choose a physician.

How will my income benefits be calculated?

As a general rule, your average weekly wage is calculated by taking your income from the previous year and dividing it by 52 to determine your average weekly wage. However, if you have not substantially worked the entire year, there are several other alternative methods in determining in your average weekly wage. Some Employers/Insurers have attempted to reduce the average weekly wage by adding the lower state side earnings to a much higher wage while over seas. In our opinion, this does not properly compensate the injured worker who is at risk and his job over seas. If you feel that you are being unpaid, please contact us. After the average weekly wage is established, you will receive 2/3rds of that figure as compensation with a maximum which is currently set at $1,160.36 per week. The minimum compensation is $290.09 per week. For a table indicating the minimum and maximum compensation rates, click here

What if I have been on the job a short period of time?

While the length of employment may have some effect on your average weekly wage and compensate rate, it does not effect whether or not you have a valid claim.

What can I do if I believe that I am entitled to benefits and the insurer will not pay me?

If you believe that you are entitled to benefits, you should contact an attorney IMMEDIATELY. However, if you choose to attempt to resolve the matter on your own, you may contact your adjuster to determine his or her position regarding payment of benefits. If the issue cannot be resolved, you can also request an Informal Conference by writing to the District Office in which your claim is located. While I am on benefits, am I entitled to cost of living increases?

While I am on benefits, am I entitled to cost of living increases?

Unless your case has been determined to be “permanent and total”, your compensation rate generally does not increase due to cost of living increases. However, after receiving benefits for permanent and total disability, you are entitled to yearly cost of living increases.

If I am getting Social Security Disability benefits, can I also get benefits under the Defense Base Act?

Yes. LHCA/Defense Base Act benefits are not effected by SSDI benefits. However, the reverse is not true. Your social security benefits are off-set by a formula which takes into account the amount which you are receiving under a worker’s compensation plan whether it be state or federal.

How long will my income benefits last?

Benefits for permanent, total disability may be payable for life as may survivor’s benefits in a death claim. The length of time you receive benefits depends upon your ability to return to work, your medical condition and the availability of jobs which you are physically able to do.

How long will my medical benefits last?

As long as your injury requires treatment, you are entitled to medical benefits.

How much of the medicals will the Insurer pay?

Under the Longshore & Harborworker’s Compensation Act, the Insurer does have the right to reduce the medical expenses pursuant to a Fee Schedule. The Fee Schedule is located at www.dol.gov/esa/regs/feeschedule/fee.

Am I responsible for the balance of the medical bills that are partially paid?

No. Generally, if a medical provider accepts a workers’ compensation claim, it accepts the payment of the bills pursuant to the Fee Schedule and you cannot be billed for what is written off.

Other than doctor’s visits, what other medical costs are payable?

Medications, physical therapy, mileage back and forth to medical facilities and medical equipment, if recommended by an authorized doctor will be covered. In certain situations, the Insurer may be responsible for modifications to assist an injured worker in adapting to life after injury.

Am I entitled to a second opinion?

You may request a second opinion and it needs to be approved by the workers’ compensation programs. So, if the Insurer agrees, you may obtain a second opinion without approval from the OWCP.

What is maximum medical improvement?

Maximum medical improvement is a term in the medical professional which basically means that your medical condition has stabilized and your condition will not be improved in the future.

Why is maximum medical improvement significant in a DBA case?

In certain situations if an injured worker is at maximum medical improvement and he can perform some work, entitlement to temporary total disability benefits may cease. Also, where a determination as to what further benefits the injured worker is entitled to.

What is a scheduled award?

For injuries to certain parts of the body, permanent partial benefits may be payable. For example, if an injured worker is at maximum medical improvement and has a 20% impairment rating to the leg, he or she would be entitled to a 10% rating to the leg, 28.8 additional weeks of benefits after total disability benefits end. See our Permanent Partial Disability Calculator for more on calculating a Scheduled Award.

The Insurer wants to start “vocational rehabilitation”, what is it?

Vocational rehabilitation in its purest form is an attempt to restore the injured worker to suitable employment. However, it if often used by Employers/Insurers to simply stop benefits after the injured worker receives maximum medical improvement. This can be done by the use of Labor Market Surveys (explained below) and scheduled awards.

Am I required to cooperate with a vocational rehabilitation counselor?

Yes, within reason. Failure to cooperate may jeopardize your benefits.

Can my attorney be present when I meet with a vocational rehabilitation counselor?

Yes, absolutely.

What is a Labor Market Survey?

A Labor Market Survey is done by a vocational rehabilitation expert normally hired by the insurance company. The purpose of the Labor Market Survey is to identify certain jobs within the injured worker’s medical restrictions. However, there are requirements under the Act as to how the Labor Market Survey must be done and you and your attorney should pay close attention to those requirements and the manner in which the vocational rehabilitation expert performed the Labor Market Survey to determine its validity.

Am I required to apply for jobs identified in the Labor Market Survey?

Sometimes you are required to apply for jobs which are suitable, according to your medical restrictions and your doctor in order to prevent the insurance company from terminating your benefits. However, before applying for any job, you should discuss the same with your doctor and your attorney if you have retained one.

After I am at MMI and the Labor Market Survey has been completed, are my benefits going to be stopped?

Not necessarily. If you can show that, even though jobs exist within your medical restrictions, you have made a diligent effort to find suitable work without success, the Administrative Law Judge or the Department of Labor and thereafter, the Office of Administrative Law Judges may choose to continue your benefits.

Can my case be settled?

Yes. However, Longshore cases are very complex and you should obtain advice from a qualified expert before giving up your rights.

If I hire an attorney, how is he or she paid?

Generally, if your attorney handles your case and wins, he is entitled to reasonable attorneys’ fees from the Employer/Insurer. Similarly, if the case is settled, the Employer/Insurer most of the time has to pay an additional sum directly to your attorney. However, every case is different and you should discuss the fees in detail with your attorney when you retain him and have an understanding of who will pay the fee and who pays the fee if the case is not resolved.

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