"You've got to know when to hold 'em, know when to fold 'em, know when to walk away, and know when to run." Kenny Rodgers - The Gambler
When handling your DBA case, nothing matters more than the honest truth. Nothing. You must be straightforward and honest about your case. I have seen many instances where a client will sugarcoat their injury and the courts throw out the case. Why? All because they were not honest from the get go.
The DBA insurance company is not on your side. They have traps laying around for you to fall in. And bet on it, if you do not follow the proper steps with your DBA case, you will fall right in.
The Next Step
Remember the DBA insurance company is not your friend. I strongly suggest you order a free copy of my book, Win Your Defense Base Act Case: The Ultimate Straight Talk Roadmap To The Medical Treatment and Money You and Your Family Deserve. Trust me. My only goal here is to make sure honest hard working folks like you, do not get ripped off by these companies.
The book has plenty of great 5 Star reviews on Amazon, written by folks like yourself. I wrote it as a guide to only help you succeed in your case.
Also you can check out my podcast at DBAradio.com where i cover important DBA issues.
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Heart Condition - Rheumatoid Arthritis - A DBA Case Study
I try and follow the court decisions regarding Defense Base Act claims. In this post I discuss a recent case that was not handled by my office. I am being simplistic with the evidence in order to provide clarity.
A civilian contractor worked at Kandahar Air Field in Afghanistan. He suffered from bronchitis. He was evacuated and had severe mitral regurgitation. He had open heart surgery and following the surgery he had arm and wrist pain and was diagnosed with rheumatoid arthritis (RA).
He filed a Defense Base Act claim for the heart condition and the rheumatoid arthritis (RA). His case goes to trial. He carries his 20(a) Presumption. Meaning he has medical evidence linking his heart ailments and RA to his working conditions in Afghanistan.
However, the trial judge found that his employer rebutted the presumption with substantial evidence showing that the civilian contractor’s heart condition is due to congenital mitral valve disease and that the civilian contractor’s employment in Afghanistan did not aggravate this condition.
The administrative law judge also found that the employer presented substantial evidence that the civilian contractor’s RA was not a consequence of his open heart surgery or aggravated by his work in Afghanistan. The trial judge determined, based on the record as a whole, that the civilian contractor’s heart condition and RA were not caused or aggravated by his employment in Afghanistan.
The trial judge denied the claim for compensation under the Defense Base Act.
The civilian contractor appealed. The appeal was denied. Meaning, the civilian contractor lost the claim. In essence, the appeals court held that the trial judge is entitled to weigh the medical evidence and to draw her own inferences therefrom; she has the prerogative to credit one witness or medical opinion over that of another and is not bound to accept the opinion or theory of any particular medical examiner.
So, in essence, the trial judge believed the insurance company doctor’s opinion that the heart condition and RA were not related to the work in Afghanistan.
Based upon the decision, it is difficult to say where the case was lost. But here are some take away points:
First, the more believable you and your story are the more chance you have of winning. I am not saying that this civilian contractor isn’t credible, I don’t know, but I do know that the more credible you are - the better chance you have of winning.
Second, you need good medical evidence linking your medical condition (being caused and/or aggravated) by conditions overseas. Here, the insurance company apparently had convincing evidence that the heart condition was due to a congenital heart defect that was not aggravated by his employment in Afghanistan and that the RA was not caused or aggravated by his employment.
Third, as Kenny Rogers says: "You got to know when to hold 'em, know when to fold 'em." Meaning, maybe settling this claim might have been the better option.
Fourth, I am not suggesting heart cases can’t be won at trial or settled. Because they can. Rheumatoid arthritis appears to be more problematic. That is, proving that they are work related.
Going to Trial
Please understand, I am in no way criticizing the lawyer in this case or the Judge in this case. I like this Judge. I am just trying to help you learn more about the Defense Base Act and DBA cases in general.
But - from what I see - about 50% of all DBA cases are lost at trial. (I am talking all DBA cases - not the cases handled by my office). I realize the “good cases” get settled more often, because they have good facts. But it appears that the DBA insurance companies have a fairly decent shot of beating you at trial.
So, if you do decide to take your DBA case to trial - it should be based upon the strength of your case - not because you aren’t happy with the settlement offer. Stated differently, you should be taking your case to trial if you have a good case. The “not so good cases” should probably be settled, if at all possible. And sometimes that isn’t possible. Then you might not have a choice.
Disclaimer: Please understand these discussions and/or examples are not legal advice. All legal situations are different. This testimonial, endorsement and/or discussion does not constitute a guarantee, warranty, or prediction regarding the outcome of your legal matter, your particular case/ situation and/or this particular case/ situation. Thanks, Bill Turley