As a contractor working for the U.S. government at military bases abroad or working under public works contracts, you have special rights under the Longshore and Harbor Workers Compensation Act to compensation if you’re injured. However, this doesn’t mean that once you file your claim under the Defense Base Act (DBA) that you’ll automatically receive your due compensation. In fact, oftentimes employers and DBA insurance carriers may try to deny your Defense Base Act compensation. This denial of rights leads to a disputed claim, which is exactly what happened for one contractor.
On a night in 2009, Edward Jetnil left his work for the day and went out reef fishing to supplement the meals that his employer provided. Jetnil, a citizen of the Republic of the Marshall Islands, was working as a contractor for Chugash Alaska Corporation, on a remote island that was home to the US Army Space and Missile Defense Command’s Ronald Reagan Ballistic Missile Defense Test Site. Since this island was remote, it was customary for contractors and employees to supplement their provided meals with their own food, which was often fish.
On this fateful night, Jetnil’s life would change forever. He cut his foot while reef fishing and, days later, it became infected leading to an amputation below the knee. Jetnil informed his employer of his injury and his plan to file his DBA claim for payment of compensation. But, because of the seemingly controversial occurrence that led to Jetnil’s injury – that of fishing and not directly pertaining to work – his employer sought to deny the claim. What ensued was a long fight for Jetnil’s right to compensation.
Defense Base Act Compensation: What You’re Entitled To
Before setting out to obtain disability pay, compensation for wages lost, and medical treatment reimbursement, you should be aware of what exactly you’re entitled to under Defense Base Act insurance. All covered employees and government contractors who are working overseas that results in an injury or death can file for Defense Base Act compensation. This compensation is based on your medical expenses, both pain and unpaid; any future medical expenses due to further treatment; lost wages, both past and future; and prolonged or total disability.
Because of the Defense Base Act, the Department of Labor (DOL) protects your right to compensation under the Longshore and Harbor Workers Compensation Act. As such, you’re entitled to receive full compensation for your pain and suffering. This compensation does not include your wages, however. Your wages, both past and future lost, will be two-thirds of your Average Weekly Wage up to the current maximum weekly compensation – an average wage that can is calculated by the DOL. As of 2019, the maximum weekly compensation rate is $1,510.76 per week.
In total, you’re entitled to receive full reimbursement for your medical costs and lost wages, plus two-thirds of your average weekly wage up to the maximum.
Reasons For A Dispute
Your due Defense Base Act compensation is a high expense to employers and their insurance carriers. This is why many employers and/or insurance companies may dispute the claim. They’ll deny it entirely or dispute the claim in order to pay you a lower settlement than what you’re entitled to receive.
In the case of Mr. Jetnil, the employer claimed that the injury was not due to his working or employment; that his injury occurred off hours and not in the course of working. They also argued that because Jetnil was technically not working overseas as he was a citizen of the Republic of the Marshall Islands where he was working that he was not covered under the Defense Base Act.
An employer might also think that there’s not enough medical evidence to claim disability. Other reasons include:
- Conflicting or contradictory reports;
- Injury did not occur at work;
- Not covered under the DBA
- More time is needed to investigate more deeply.
Disputed Claims Process: What To Expect
If an employer finds issue with a claim they can file Form LS-207, Notice of Controversion of Right to Compensation, immediately, claiming that they are not responsible for the injury. This was the case for Mr. Jetnil. However, in the majority of cases, an employer will not outright deny a claim but rather dispute the settlement.
After you submit your claim to the Department of Labor’s Division of Longshore and Harbor Workers’ Compensation (DLHWC), they will make recommendations as to what benefits you should and can receive. This is where many disagreements happen, with one party filing a dispute with the Form LS-207 explaining their disagreement.
Once that form is filed, litigation begins where your Defense Base Act attorney represents you and your rights throughout the process. This part of the process is more formal – called the formal adjudication. All parties involved, included witnesses in some instances, will make depositions and answer questions under oath. Other people may be called upon as well, such as doctors, defense experts, and insurance representatives.
All parties will be expected to participate in a formal hearing before an Administrative Law Judge, who will issue an opinion or ruling. Both parties can then accept the opinion or seek an appeal. If you or your employer still disagrees with the decision, an appeal can be made to the Benefits Review Board and then to the U.S. District Court or even the U.S. Court of Appeals. Sometimes, an employer is so adamant about their disagreement that they seek multiple appeals, ending up the Ninth Circuit of Appeals, as was the case for Mr. Jetnil.
Winning A Disputed Claim
Despite their numerous appeals, the Administrative Law Judge overruled Chugash and awarded Mr. Jetnil’s his due compensation. Through the disputed claim Mr. Jetnil was able to prove that his injury was sustained under the terms of his employment and that he was protected under the Defense Base Act.
The key to winning a disputed claim is the same for winning a DBA insurance settlement period: being honest and forthright as well as keeping perfect documentation and records. More importantly, however, is getting someone on your side of the table who understands the Defense Base Act and the law and procedure. A DBA attorney is such a person that can help you from start to finish, giving you the best chance for winning a settlement or a disputed claim. It’s never too early to contact a DBA attorney to help you with your claim. But, it’s also never too late. If you’re just now filing a claim or if you’re in a claim dispute, don’t hesitate to contact the attorneys at Moschetta Law. We’ll fight for your rights and benefits.