“When I seek out professional advice, I don’t want B.S. I want it straight up, with no double talk. I figure do also. I always use plain English, with no sugarcoating no B.S lawyer talk, and no double talk- just old fashioned, unsweetened, unvarnished truth-just the way that I would want it.” - Defense Base Act Lawyer Bill Turley
If you're a seriously injured overseas civilian contractor, you didn't sign up for a Defense Base Act case. But the "Defense Base Act" world is your new reality. In this article, I provide answers to many of your most common questions about the DBA. You'll see that this is a very different website about the Defense Base Act, on many different levels. First, because of my frank brutal, "tell it like it is," style. Defense Base Act workers compensation straight talk is what I am all about.
How to get Defense Base Act benefits
Second, I give you an insider's view of the DBA. An eye-opening view of why DBA insurance companies deny DBA claims and how they defend DBA claims. The whole purpose of this website and my book - Win Your Defense Base Act Case is just that. That is, help you win your DBA case and beat the insurance company. It's all about you getting Defense Base Act benefits. The book is designed to help you get Defense Base Act workers compensation benefits
I suggest that you never lose sight of two things when researching your DBA case: you now have a court case and the DBA insurance company is going to pull out all the stops to attack your credibility and character. Because of the insurance company's attacks on you, you must never say or do anything that is going to affect your credibility. Therefore, you need to the the truth about everything.
So, I suggest you pull up a chair. Stay awhile. Because you're not going to to hear what I'm going to tell you anywhere else. I realize this is a really long article. But it's packed with information that is going to help you. Some of it may taste bad. Meaning, you may not want to hear what I'm telling you. But, oftentimes the best medicine is that way.
Top 10 Most Common Defense Base Act Questions:
1. What is the Defense Base Act?
2. Do I really need a lawyer for my DBA claim?
3. Will the Defense Base act insurance company get upset if I hire a lawyer?
4. Isn't it better to have a local lawyer for my DBA case?
5. Do I even have a DBA case?
6. How much does a Defense Base Act lawyer cost?
7. When do I have to file my DBA claim? (Is it too late to file my DBA case?)
8. Can I get disability under the Defense Base Act?
9. What should I do if my defense base act benefits get cut off?
10. What is my Defense Base act case worth?
11. What is the biggest myth about the Defense Base Act?
12. How should I interact with the DBA insurance adjuster?
13. What happens if DBA insurance company won't authorize my medical treatment?
14. What does "injury" mean under the DBA?
15. What injuries are covered under the Defense Base Act?
16. What if my employer doesn't have DBA insurance?
17. What if I don't have an incident report?
18. What are the benefits under the Defense Base Act? What benefits can I get from my DBA case? - Defense Base Act benefits
The First Thing You Must Do - ALWAYS tell the truth
Before I answer these Top 10 Defense Base Act questions, there are a few things you need to know and do. The first thing you must do is always tell the truth. No matter what it is you are worried about, you must always be honest and never try and hide something or be evasive with the judge or your attorney. If you do, then you will lose your case. Trust me, I have seen it time and time again. Don't be that guy or gal.
Nothing is more important than your credibility. The DBA insurance company is hoping you will lie, fudge, exaggerate, etc.. Because if you do, then you just got caught in one on their traps. You will usually lose your case when this happens.
Avoiding these common traps is one of the main reasons why I wrote the book - Win Your Defense Base Act Case.
Now, don't go thinking, "I'm honest, I'm good." Not so fast.
Good, decent , honest folks - just like you - fall for the insurance company's tricks and traps all the time. The insurance adjusters are trained to get you to screw up your case. Depend on it.
Before you even think about signing any forms from the DBA insurance company, you need to do read my book. Before you talk to the adjuster, you need to read my book. Before you hire the wrong lawyer, read my book.
Don't believe me?
I don't blame you. You shouldn't trust most things you read on lawyer websites.
But here is the proof: read all of these 5 Star reviews of my book - Win Your Defense Base Act Case on amazon.com.
You can order my free book, Win Your Defense Base Act Case: The Ultimate Straight Talk Roadmap To The Medical Treatment and Money You and Your Family Deserve. It is full of useful information that will only benefit you in your battle against the insurance company.
And before you do, check out the great 5 Star Amazon Reviews. I promise you will not be disappointed. These reviews were written by folks like yourself who wanted to learn about their case.
Need help right now?
If you need help now, give us at call at 619-304-1000.
The Defense Base Act and You
If you are injured in-theater / in-country as a private overseas military contractor the Defense Base Act applies to you.
My name is Bill Turley I literally wrote the book on the Defense Base Act.
What you are going to see is that you have just traded one war for a whole new different war. Make no mistake about it - once you are seriously injured while overseas - you are at war with the insurance company. What I don't want to see is you making a potentially case-ending mistake by falling for one of the insurance companies tricks or traps.
Avoiding the insurance company tricks and traps
I take pride in providing military contractors just like you the crucial information and resources you need to ensure you are not taken advantage of or left up a creek without a paddle. My mission is to help keep you from falling for one of the insurance company's tricks or traps.
Believe it or not, I don't believe in sugar coating things. Everything you hear from me is straight-up information you need to know so that you can protect the well being of both you and your family.
I am tired of seeing people get taken advantage of by the insurance companies when they are injured overseas simply because they are unaware of the process of the Defense Base Act or the tricks the insurance company attorneys use to trip you up!
It's my goal to help YOU know what is coming so you are NOT one of the folks that fall victim to their all too real games. Only it's not a game when we're talking about your family's economic future.
It's not a game when folks end up being homeless due to not getting the money benefits they are entitled to under the law.
And now on to the Top 10 Defense Base Act Questions ...
1. What is the Defense Base Act?
The Defense Base Act (42 U.S.C. 1651) is a workers compensation system for workers on overseas at U.S. military bases, under U.S. Government contracts, U.S. military contracts and/or U.S. State Department contracts.
The Defense Base Act initially applied to persons working on American military bases abroad. The DBA was then broadened to cover most federal contractors working outside of the United States.
The Defense Base Act provides benefits to employees working for defense contractors outside the continental United States. In recent years, there have been thousands of Defense Base Act workers seriously injured in Iraq and Afghanistan.
If you are an employee of a civilian contractor injured while working under a U.S. Government contract in Iraq, Afghanistan, Kuwait, or anywhere in the world, your claim probably falls under the DBA. Civilian employees of contractors that support military and State Department operations worldwide usually fall under the Defense Base Act. The Defense Base Act is a federal workers compensation program for the employees of these civilian contractors.
The DBA requires that federal government contractors and subcontractors provide workers’ compensation insurance for their employees who work outside of the United States. The DBA also covers both United States citizens and foreign nationals.
Basically all types of service contracts are covered under the DBA. Workers that work for contractors performing service contracts, even those, which do not directly provide for construction, alteration, removal or repair are included in the definition of public work.
* For more in-depth information on what the Defense Base Act is Check out pages 12-16 of the "Win Your Defense Base Act Case” book.
2. Do I really need a lawyer for my DBA claim?
The emphatic answer is YES - you must have a lawyer if want to survive your DBA claim. Not having a lawyer for your DBA claim is like going to a gunfight with a toothbrush. Seriously. I'm not telling you this so you hire me as your lawyer. Whether it is me or one of the other big name Defense Base Act lawyers - you need the best, honest DBA lawyer that will agree to take your case.
But can't I just represent myself for my Defense Base Act claim?
Yes, you can. But, it's not smart.
Many seriously injured overseas civilian contractors figure they can represent themselves in their Defense Base Act case. They figure they can save money on attorney fees by not hiring a Defense Base Act Lawyer. It is entirely understandable why these folks think they will be saving money. After all it’s only a DBA claim, what can be so difficult? Why would I need a Defense Base Act Lawyer?
When the other side has a lawyer, you need one, too. Too often, injured workers are out-lawyered by the insurance company. You need a lawyer that can go toe to toe with the big DBA insurance company lawyers.
You need a lawyer that knows the ins and outs of gathering medical evidence, filing well-documented DBA claims, and appearing at hearings. You need a lawyer that knows how to protect you from insurance company attempts to poke holes in your case.
While you aren’t required to have a Defense Base Act attorney to file for DBA benefits, it is always in your best interest to do so. If you are about to file for DBA benefits, if your claim has been denied, or your benefits have been reduced or terminated don’t wait - consult with a Defense Base Act lawyer today.
The well paid lawyers hired by the DBA insurance companies have the ways and means to twist things around. By the time you get to court they may have you second-guessing yourself. That is what they do.
These insurance company shark lawyers get paid a lot of money to get you all mixed up. Don’t think for a minute that it can’t happen to you. This happens every day to hard working folks with legitimate injuries, just like you.
I get calls all of the time from folks that have tried to represent themselves. Sometimes I have to tell them that it is too late for even me to fix their case. Sometimes I just can't get humpty-dumpty back up on that wall. It stinks when I have to tell folks this.
If you're seriously injured it is never too early to lawyer-up. I suggest that you immediately get a copy of my free book - Win Your Defense Base Act Case. In the book I cover how to hire the best, honest DBA lawyer.
The problem with the Internet is that anyone can call themselves a seasoned DBA lawyer. I urge extreme caution about hiring a lawyer based upon their pretty website. You need to research them a little first.
For example, you can read all about me and my book in the review section of amazon.com. There are dozens and dozens of 5 Star reviews.
In my book, I lay out for you how to find the best, honest DBA lawyer and how to vet ( Read: to evaluate for possible approval or acceptance) the lawyer.
Know this: the only reason why you are going to get full value for your DBA claim is for the DBA insurance company to know that your lawyer has the skill, courage, resources and ability to bring your DBA claim to trial and win.
3. Will the DBA insurance carrier get pissed off and stop my benefits if I hire an attorney?
"I'm afraid my DBA benefits will be stopped if I hire a lawyer (or I won't get my benefits if I hire a lawyer)"
I have heard folks say this. This a very common question and concern. I get it. You don't want to rock the boat. If you're getting you're DBA benefits, you might be thinking, let's not piss off the insurance carrier.
But based upon my experience (and I have been doing this a long time); I don't know of a single instance where the DBA insurance company has either stopped paying benefits or not paid DBA benefits due to the Claimant (the injured overseas civilian contractor in a DBA case) hiring a lawyer. It just doesn't happen.
We have a very professional relationship with the DBA insurance companies, the insurance adjuster and their lawyers. I advocate maintaining a good working relationship with them. Even though they are the "enemy" - treating them with respect, courtesy and decency is always recommended. By both you and our office.
While I understand some folks being afraid they will upset the DBA insurance company if they hire a lawyer, you should know that we have been successfully handling case with these insurance companies for years.
If you read the section just before this, you know why you need a lawyer. Your biggest job (other than always telling the truth and not falling for one of the DBA insurance company's tricks or traps - is finding the very best DBA lawyer for you case.
4. Can't I just hire a local lawyer to handle my DBA case?
It is important for you to hire a seasoned Defense Base Act Lawyer. Not some local attorney that comes well recommended by your accountant or friend.
The local lawyer may do fine with other types of injury or workers’ compensation cases - - but the last thing you want is your local lawyer to get steam-rolled by one of the big city DBA insurance company hired guns. In other words, you don’t want a lawyer that is learning on the job, so to speak.
The Defense Base Act (DBA) is very, very different than State workers’ compensation programs. Many DBA employees make the mistake of hiring a local workers’ compensation attorney to represent them for their Defense Base Act case. This is usually a big mistake.
The most important single thing you can do if you are a seriously injured Defense Base Act employee is to hire a seasoned Defense Base Act attorney.
Don’t get lulled into thinking that just because your claim is “legitimate” that you won’t need an experienced Defense Base Act lawyer. The DBA insurance companies depend on folks like you making this mistake, again and again. You don’t want to go there.
* Discover more common misconceptions about the Defense Base Act on pages 25-29 of the “Win Your Defense Base Act Case” book.
5. Do I even have a Defense Base Act case?
This is a very common and understandable question. A lot of folks don't want to go through the hassle of hiring a lawyer and putting up with the DBA insurance company shenanigans only to find out that they really don't have a valid DBA case after all. I certainly understand this concern.
Do I have a good (or even decent) Defense Base Act case?
These are all very real concerns. I'm not going to blow smoke up your skirt and guarantee you that you have a great case or that you will get any money for your case. If anyone tells you that they guarantee that you will win your DBA case, you need to run. Fast.
Here are few things I can tell you. We screen our cases carefully. We may not take your case. We can't take everyone's case.
What I can tell you is that if you talk to our folks we will give you a good idea about whether you have a decent shot at winning your Defense Base Act case.
We only get paid if you win your case. If you don't recover money, (either a weekly compensation award or a lump sum settlement); then we work for free.
As you might expect, we like to get paid for what we do. Just like I'm sure you do when you work.
What I am suggesting is that we won't take your case unless we think you have a good chance to win your case. Again, there are no guarantees in life or law. But we've been doing this for a long time and we can get a pretty good idea after we learn a little about your situation.
Either way, by talking to us (which is free, by the way); you'll get piece of mind about whether you have a case or not.
After all, there could be hundreds of thousands of dollars (money owed to you because you have a legitimate DBA case) at stake. You owe it to yourself and your family to put a little effort into find out if you have a decent DBA case or not. Don't you think?
6. How much will a Defense Base Act attorney charge me?
Or - How much will I have to pay to hire a Defense Base Act lawyer?
You should never, ever pay a Defense Base Act lawyer directly. If a lawyer asks for money to represent you in your DBA case, you need to say, "No." In fact, it is against the law for a lawyer to charge you to represent them in your DBA case.
All attorney fees under the Defense Base Act have to be first approved by the Judge and/or the Department of Labor.
The Defense Base Act insurance company should be paying your attorney fees. At the end of your case, the DBA insurance company will send you a check for a lump sum settlement and send your lawyer a separate check for their attorney fees and costs.
Can I pay my Defense Base Act lawyer with a contingency fee agreement (a percentage of my settlement)?
Many of you may be familiar with personal injury lawyers that charge a percentage of the money they recover for you. For example, they get paid 33% of your settlement money.
This is not how your attorney should be charging you for your Defense Base Act case. You shouldn't be paying your attorney a percentage of your settlement award.
Instead, your attorney should be paid separately by the Defense Base Act insurance company based upon the work they put into your case.
7. When do I have to file my DBA claim?
Generally, you should file your claim within one year of the date of your injury. If you are approaching the one year point, you should get your claim on file before the one year date. It is even better if you file your claim within 30 days of your injury.
However, if you are past the one month or even past the one year date you can still prevail and win your DBA claim.
Here is a article on Statute of Limitations under the DBA.
Again, if you are within the one year - you should file before the one year after your injury.
One other thing you should know about the Defense Base Act is DBA claims are exceedingly slow. This is mainly because Defense Base Act claims fall under the Longshore Act. In many ways the system is broken. The system simply wasn’t ready for thousands of seriously injured Defense Base Act workers coming home from Iraq, Afghanistan and other places around the world. In the simplest terms - there are way too many claims and not enough Judges.
Because of this, you need to make sure your DBA claim stays on track. In order to do this, you - or more importantly your Defense Base Act Lawyer - need to understand where your claim is and what steps are necessary in order to first get your case to trial and then win your DBA trial.
Is it too late to file my Defense Base Act case?
No. If you haven't filed your Defense Base Act case, you should do so asap.
I am not guaranteeing that you will win your case or overcome the statute of limitations defense. I am just saying that, all things being equal, file as soon as possible.
There are ways to get around the statute of limitations defense (meaning, that you filed late, even years late).
I cover this in my free book - Win Your Defense Base Act Case.
Even if you're years late, don't hesitate to contact us. We have pulled monkeys our of hat before. You should at lest get some piece of mind to see if you still have a viable case.
You should also know that there is no time limit to getting medical treatment under the Defense Base Act.
8. Can I get disability under the Defense Base Act?
Under the DBA, there are four different and distinct categories of disabilities:
1. Temporary Total Disability (TTD)
2. Temporary Partial Disability (TPD)
3. Permanent Total Disability (PTD)
4. Permanent Partial Disability (PPD)
Temporary Total Disability (TTD) You are entitled to Temporary Total Disability (TTD) benefits if you are unable to perform your usual and customary DBA employment and your doctor has not declared you have reached maximum medical improvement. Stated in its simplest terms, if you can’t work and your doctor hasn’t released you yet you should be getting a workers’ compensation check (a TTD check) during that time period.
How Much Weekly TTD should I be getting?
You are entitled to 2/3’s of your average weekly wage (AWW) up to the maximum weekly compensation rate. For example the maximum compensation rate for injuries occurring between 10/01/2013 and 09/30/2014 is $1,346.68. If you were injured between 10/1/2014 and 9/20/2015 the maximum compensation is **. If you were injured from 10/1/2015 and 09/20/2016 the maximum compensation rate is ***.
What if I am not getting paid Temporary Total Disability (TTD) benefits by the DBA insurance company?
First off, you need to understand that the DBA insurance companies deny claims left and right even when the Claimant (the person bringing the DBA claim is called the "Claimant") has all the necessary documentation. But oftentimes, the reason why the DBA insurance company is denying benefits is because there is not proper documentation.
You are going to need your doctor to write a report (it can be in handwriting) that says you were injured due to your DBA employment (meaning while you were overseas) and you are currently unable to work (or do your customary DBA employment) due to your injuries.
Here it is important for your doctor to understand your work. Being able to work a desk job or even at Wal-Mart is far different from wearing body armor and having to run for a shelter in the middle of the night.
It is time to do something
If the DBA insurance company is not providing you with weekly compensation benefits (i.e. a workers’ compensation check), then the insurance company will usually file an LS- 207 - Notice of Controversion with the US Department of Labor and you will be sent a copy. If the DBA insurance company has sent you an LS-207 - Notice of Controversion, you need to make sure you read it and get the documentation necessary to overcome the reasons why the DBA insurance company is denying your claim.
This is no time to dilly-dally. You need to get the evidence needed to win your case. Meaning, a doctor’s report (see Part X Medical Benefits). Second, you need to immediately request an Emergency Informal Conference. Then you must have Recommendations issued by the OWCP claims examiner. Then you must file a LS-18 in order to get a trial scheduled.
This is a “get in line and wait” system. The quicker you get your case to the Judge’s office and start waiting in line for your trial and then your Decision and Order, the quicker you will get your TTD benefits. Sometimes once you get the necessary documentation (i.e., a medical report), the DBA insurance carrier will start providing you with weekly compensation benefits. Oftentimes, the threat of a trial will get the DBA insurance company to provide benefits or settle cases.
If this has happened to you, right about now would be a good time for you hire the best DBA lawyer you can find. Hey, know this - hiring a DBA lawyer doesn’t have to be painful or stressful - and it shouldn’t be.
Temporary Partial Disability (TPD)
Under the DBA, if you are temporarily unable to perform your usual and customary work, the DBA insurance carrier is supposed to pay you 2/3’s of your average weekly wage up to the maximum compensation rate.
Temporary Partial Disability (TPD) comes into play mainly under a rare circumstance. If your employer has work for you that pays less than your regular pay - than you may be entitled to the difference between the less pay you get for the “light duty” work and your compensation rate. The reason why this is rare under the DBA is that you will usually have to come home (for example, the United States) to get medical treatment. Your DBA employer will usually not have work for you do to in your home State. This is why TPD under these circumstances is relatively rare.
Be sure to check out all of the 5 Star reviews of Win Your Defense Base Act Case on amazon.com
9. What should I do if my Defense Base Act benefits get cut off?
I know it is very stressful when your weekly DBA benefits get stopped and/or your medical treatment gets denied. It sucks.
I realize that you may want more information than this. And I will give you more information, but first you need to hear this.
I see my job as having to tell you like it is. So, if your DBA benefits get cut-off, you need to put your efforts into finding and hiring the best, honest Defense Base Act lawyer you can find. I strongly suggest that you read my book - Win Your Defense Base Act Case before you hire an attorney for your DBA case. In my book I tell you how to find and vet your DBA lawyer. If you need help right now, we can UPS you a copy of the book and you can have it the next business day.
Putting that aside, when your DBA benefits get cut-off, you will usually receive an LS-207 Notice of Controversion. I suggest you start with reading the LS-207 to see what reason is stated for you having your DBA benefits stopped.
You next step is for you to gather evidence you are going to need in order to win your case. Here is an excellent article on what evidence you are going to need to win your Defense Base Act case.
At this point, you may just need the evidence needed to get your DBA benefits started again. Try and focus your efforts on getting evidence to persuade the DBA insurance carrier (or the Claims Examiner at the Department of Labor, see below).
If you are still receiving medial treatment and you're still temporarily totally disabled, you are going to need a medical report that states that. I go into more about what you need in a medical report in the article about evidence you need to win your DBA case.
Next, you are going to need to request a Telephone Emergency Informal Conference (TEIC) with the District Office for the U.S. Department of Labor. I suggest you get your evidence together, before you request the TEIC.
You should start considering how you can survive if your benefits don't get started again. I know this is tough to think about. But on the one hand you're trying to get your Defense Base Act benefits re-instated. On the other hand, you need to prepare for the worst. This may mean going to get a job.
Again, I know this is not where you want to be. But what are your sources of income? Do you have enough money to make ends meet? For how long? Can you immediately start to conserve money? In other words, spend less? You may need to stop all discretionary spending.
In the meantime, you really need to lawyer-up.
10. What is my DBA case worth?
Asking, how much money I will get from my Defense Base act case? What is the value of my DBA case? How much should I settle my Defense Base act case for? These are all certainly understandable questions.
It's just in all probability, that neither me now anyone else will be able to give you a straight-up answer without more information. Figuring out the settlement value of your DBA case requires information in order to make an informed opinion and decision.
At some point, you're going to need to answer this question: Should I accept a settlement offer by the DBA insurance company?
Long story short there are many factors that need to be considered in order for you to determine the value of your Defense Base Act case. Your DBA case is a court case. Like it not, (and no none likes it, far as I can tell); the insurance company is going to attack your credibility and character. Knowing this as early as possible and not making the common mistakes that honest folks with legitimate DBA cases make that wreck their case has got to be your number one goal. Which is why you REALLY need to read my book Win Your Defense Base Act Case.
The law calls the insurance company's contentions, "defenses." So in order to evaluate what your case is worth you need to not only assess the relative strength of your evidence, but also the relative strength of the DBA insurance company's defenses. Other than attacking your credibility and character, the Judge is going to make both sides give the other side their evidence and contentions before your trial.
The problem here is that you both are going to have to "show your hands" at the same time. Thus, you are going to have to try and anticipate their defenses and have your evidence ready to respond to their contentions and proof.
11. What is the biggest myth about the Defense Bast Act?
There’s a huge misconception about the Defense Base Act that needs to be dispelled in order for you to understand why you’ll need a seasoned Defense Base Act Lawyer to fight for your DBA benefits:
Just because you have a legitimate injury and cannot work, it does not mean that you will receive Defense Base Act benefits. That’s because benefits are paid by your employer’s insurance company, which has an arsenal of lawyers who are paid to deny your claim.
The fact that you have a legitimate injury means next to nothing when you are going into court asking for money. The only thing that matters is, “What can you prove?” Not, whether you have a legitimate injury.
12. How should I interact with the DBA Insurance adjuster?
If you have a Defense Base Act claim and you have not hired a Defense Base Act Lawyer yet, then you need to know how you should deal with the Defense Base Act insurance adjuster.
Once you have a DBA injury you are at war with the DBA insurance company. No matter how nice the Defense Base Act claims adjuster is to you - - at the end of the day, their job is to keep you from getting the medical benefits and money compensation benefits you are entitled to under the law.
However, just because you are at war with the insurance company does not justify or permit you to be rude or short with the DBA insurance adjuster.
You should be polite when dealing with the adjuster. Remember, at the end of the day, the insurance adjuster decides whether they are going to admit or deny your injuries and/or provide you benefits.
Just as your mother may have once said, “You catch more flies with honey than vinegar.” It is the same with insurance adjusters. They usually have hundreds of files. They have files where they approve the benefits and files where they fight on every issue. Your job is to not give additional incentive to the adjuster to deny your benefits. Be polite. But remember, they are the enemy.
* For more information on how to deal with your DBA adjuster check out pages 41-46 in “Win Your DBA Case” book.
13. What happens if DBA insurance won’t authorize my medical treatment?
Oftentimes, the DBA insurance company adjusters will either not authorize your free choice physician or they will only authorize treatment with a doctor of their choosing. Either way, you need to make a record. Meaning, document what is happening to you.
A letter with a proof of service or an email will do. With email, be sure to send a copy to yourself also, so you can prove you emailed your request to the DBA adjuster.
Your letter/ email needs to say something like this:
Re: 11-7-2018 Afghanistan DBA Injury - XYZ Security Co.
Please be respectfully advised that I hereby choose the following physician to be my free choice physician:
Dr. Cindy Hugeheart
101 Hospital Lane City of Anywhere, My State
Please authorize evaluation/ treatment. Please advise.
Dave B. Hurting
What should I do if the DBA insurance carrier won’t approve medical treatment?
When there are factual disputes as to the need for medical treatment under the DBA, the Judge is the one who has to resolve the dispute. Sanders v. Marine Terminals Corp., 31 BRBS 19 (1997).
Thus, if the DBA insurance carrier refuses to provide medical treatment, you should request a Telephonic Emergency Informal Conference (TEIC). As I explain in this article on TEIC’s, you are trying to get Recommendations from the DOL Claims Examiner which recommends the medical treatment.
Assuming the Recommendations for medical treatment are in your favor, and if the DBA insurance carrier agrees with the Recommendations - then you can either agree to the medical treatment with the DBA insurance carrier or the District director will be charged with choosing the treatment option.
If the Recommendations from the TEIC are not in your favor or the DBA insurance carrier refuses to follow the Recommendations, then you will need to file an LS-18 for a trial (read: a formal hearing).
The issue of whether medical treatment is necessary, where the parties disagree, is a factual matter within the administrative law judge’s authority to resolve. See Weikert v. Universal Maritime Service Corp., 36 BRBS 38 (2002); Sanders v. Marine Terminals Corp., 31 BRBS 19 (1997).
Here is a good article on medical treatment under the DBA.
But, as I mention above, you need to lawyer -up. And If you haven't lawyered up, now is the time to do so!
14. What does “Injury” mean under the DBA?
To be entitled to benefits under the Defense Base Act, you must have sustained an injury within the meaning of the Act. And your disability must have resulted from the injury.
The term “injury” means accidental injury or death arising out of, and in the course of, employment. Injuries covered under the Defense Base Act include:
- Tripping and falling on steps and hurting your back
- Automobile collisions causing injuries
- Getting hurt while ducking for cover while under enemy fire
- Injured by IED explosions
- Breaking your ankle playing basketball
- Getting injured playing soccer
- Falling our of your bunk and injuring yourself
If you get hurt in country / in theater then you are most likely covered under the Defense Base Act.
More specifically, if you feel pain or discomfort - - that is probably an injury under the DBA.
Let’s say you are overseas and while lifting a box you feel something strange in your back - - you just suffered a DBA injury. It doesn’t have to be any more complicated than that. If something goes wrong in your body - you have suffered a DBA injury. Whether you are entitled to weekly benefits or medical treatment are different issues under the law.
* For more specific information on what an “Injury” means check out pages 55-61 of “Win Your DBA Case” book.
15. What injuries are covered under the Defense Base Act?
The Defense Base Act is different from almost every other workers ‘compensation scheme. Unlike other workers’ compensation programs, under the DBA, an injury is covered by the Defense Base Act even if your injury didn’t happen while you were actually working.
For example, injuries sustained by DBA workers during recreational activities are covered by the Defense Base Act.
Under the DBA, injuries resulting from reasonable and foreseeable recreational activities in isolated or dangerous locales arise out of a “zone of special danger” and are therefore compensable under the DBA. Thus, injuries sustained while off-duty are covered under the Defense Base Act; including recreational activities, such as exercising, training, etc.
Injuries to DBA workers while they are exercising and/ or training are always compensable under the DBA. For example, I have won DBA cases when the Claimant was injured while playing soccer, playing basketball, jogging, swimming and lifting weights.
* For more information on what types of injuries are commonly covered by the DBA check out pages 47-54 of “Win Your DBA Case” book.
Ankle injuries (called “lower extremity” injury - scheduled injury)
Arm Injuries (called “Upper extremity” injury” - scheduled injury)
Carpal Tunnel Syndrome (called “upper extremity” injury - scheduled injury)
Concussive blast injuries
Elbow injuries (called “upper extremity” injury - scheduled injury)
Electrical shock injuries
Eye or Vision Problems
Finger injuries (scheduled injury)
Foot injuries (scheduled injury)
Gun shot injuries
Hand injuries (scheduled injury)
Hearing Problems (called “Hearing loss” injury - scheduled injury)
Knee injuries (called “lower extremity” injury - scheduled injury)
Leg injuries (called “lower extremity” injury - scheduled injury)
Multidrug-resistant nosocomial infections
Post Traumatic Stress Disorder - PTSD
Sleep disorders / problems sleeping
Spinal Cord Injuries
Toe injuries (scheduled injury)
Traumatic Brain Injuries
Wrist injuries (called “upper extremity” injury - scheduled injury)
16. What if my employer doesn’t have DBA Insurance?
All Defense Base Act employers are required to secure the payment of compensation. Meaning, they have to have Defense Base Act insurance. If a sub-contractor fails to obtain DBA insurance coverage, then the general contractor is required to provide DBA insurance for the worker.
If the employer fails to obtain DBA insurance, you can sue the employer for civil damages. In uninsured DBA employer cases, the employer cannot defend the claim based upon your injuries being caused by a co-worker, assumption of the risk, or due to your negligence.
17. What if I don’t have an incident report?
When speaking to a Defense Base Act client, one of the first things I ask to see is any incident reports/ injury reports. And, one of the first things the DBA insurance company asks to see is any incident reports/ injury reports. Obviously an incident report goes a long way to documenting your injury.
That is why we both ask to see it. At some point, your DBA Lawyer will either be settling your case or presenting it to the Judge. The more documentation you have which corroborates your injury incident, the better.
Can I still win my Defense Base Act case if I don't have a report for my injury incident?
But what if you don’t have an incident/ injury report? What if your supervisor refused to fill one out? Or maybe you didn’t realize you were as badly hurt as you turned out to be and you just didn’t get an accident report filled out? What then?
We have won a LOT of Defense Base Act cases without an incident report. So, if you don't have one, don't freak out or anything. Don't stress. It will be okay.
That being said, most of the time I would rather have your incident report. So.....
Report your injury
Whatever the circumstances, 99% of the time you should report your injury as early as possible. If you haven’t reported your injury yet, today would most likely be a good day to do so.
Seriously, every day you wait to report your Defense Base Act injury increases the odds of your claim being denied by the DBA insurance company (they deny timely reported claims left and right also), and most importantly, having your claim denied by the DBA Judge.
If nothing else, send an email. Tell a supervisor or someone in the company that is higher in rank than you. “Hey, I got hurt on such and such day when I did such and such.... My back hurts....” You don’t need to provide a huge amount of information: basic details are fine and probably preferable. Send a copy of the email to yourself so you can document that it was actually sent.
* Want more in-depth information on how to report your injury; check out pages 18-19 of the “Win Your Defense Base Act Case” book.
18. Defense Base Act benefits: What are the benefits under the Defense Base Act? What benefits can I get from my DBA case?
The Defense Base Act provides disability, medical, and death benefits to covered employees injured or killed in the course of employment, whether or not the injury or death occurred during work hours. There are two Defense base Act benefits: disabilty benefits and medical benefits.
You are entitled to temporary total disability benefits while you are still treating and recovering and if you can't perform you're usual overseas job. You also may be able to recover permanent disability benefits under the DBA.
Compensation for total disability is two-thirds of your average weekly earnings, up to a current maximum compensation rate. Compensation also is payable for partial loss of earnings.
The DBA has two different types of permanent injuries: scheduled injuries (hand, arm, foot, leg, hearing loss), and unscheduled injuries (everything that isn’t scheduled - neck, back, head, PTSD, internal injuries, etc.). Unscheduled injuries under the DBA are a wage-loss concept.
All disability benefits - whether permanent or temporary are paid on a weekly basis.
You are also entitled to medical benefits under the Defense Base Act. You are entitled to medical treatment for the rest of your life.
Your “free choice” of physician under the Defense Base Act
You are entitled to medical treatment by a physician of your choice, as the injury may require. This is called your "free choice of physician" under the DBA.
This article isn't legal advice
These discussions and/or examples are not legal advice. All legal situations are different. These testimonials, endorsements, photos and/or discussions do not constitute a guarantee, warranty, or prediction regarding the outcome of your legal matter, your particular case/ situation. Every case is different. There are any number of reasons why Defense Base Act cases are not won and/or are not as successful as one might hope.