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» General description
» Duty to report - Notice of injury
» Medical treatment
» Average Weekly Wage
» Nature and extent of injury
» Return to work - Vocational rehabilitation
» Statute of limitations - Claim for benefits
» Attorney fees and expenses
» Occupational disease » Third party claims
» Other applications and extensions of the Longshore Act
LONGSHORE AND HARBOR WORKERS'
COMPENSATION ACT
The Longshore Act traditionally
applies to injured workers in the maritime industry, primarily
those who are involved with shipbuilding, ship repair
work or the loading and unloading of vessels. The Act allows the
injured worker to receive medical attention and compensation benefits
during
the period of disability irrespective of any negligence or fault
on the part of the injured worker’s Employer.
If you have been injured
on a job that is covered by the Longshore Act there are several important
issues that must be addressed to protect
and evaluate your rights to benefits:
DUTY
TO REPORT — NOTICE OF INJURY
The Longshore Act requires
that the injured worker notify his or her employer in writing that
an injury has occurred within thirty days after
the date of the injury. On many occasions, an injured employee is
unsure whether the injury is anything significant and decides to “work
it off” until his or her condition worsens. Sometimes, in an
effort to avoid filing a compensation claim, Employees might file
job injuries
under their health insurance coverage. Either of those choices could
result in the delay or denial of benefits under the Act. It is usually
the best decision to immediately report a job injury to insure the
Employer has received prompt notice. The Employer should have this
notice in order
to properly investigate the claim and to provide appropriate benefits
without unnecessary cause for delay or reservation about the claim.
While the Act technically
requires a written notice of injury by the Employee, the typical
practice is for the Employee to simply tell his
or her supervisor that an injury occurred. Most Employers have a
policy in place for reporting job injuries. An accident report is
usually completed
with the person who handles compensation claims for the Employer,
which results in compliance with the “written notice” requirement.
An injured Employee should not delay reporting an injury so as to avoid
any misconception that the injury occurred on the job. If the injured
worker has any doubt that a written accident report has been completed,
then he or she should provide written notice that an accidental injury
occurred and deliver that notice to the Employer.
Click
here to view and download a Notice of Employee's Injury or Death,
Form LS-201.
MEDICAL TREATMENT
The Act states that: “The employer shall furnish such medical,
surgical, and other attendance or treatment, nurse and hospital service,
medicine, crutches, and apparatus, for such period as the nature of the
injury or process of recovery requires.” However, the charges
for medical treatment must be both reasonable and necessary for the
Employer
to be responsible for payment. Mileage reimbursement to and from
the doctor is also recoverable directly to the injured worker.
One of the most important, and frequently overlooked rights of an injured
worker claiming benefits under the Longshore Act is his or her right
to select an attending physician. Unfortunately, Employees are not always
aware of that right.
The Department of Labor
has confirmed that injured workers are frequently not advised of
their right to select a doctor of their choice for medical treatment:
"A random survey of Longshore
claimants around the country revealed that most claimants were satisfied
with the service provided by our district
offices. However, there were some concerns expressed in the following
areas:
Claimants are not always
being advised by their employers at the time of injury that they
have a free choice of physician under the provisions
of the Longshore and Harbor Workers' Compensation Act."
http://www.dol.gov/esa/owcp/dlhwc/lscsp.htm
First and foremost, an injured worker is concerned about being restored
to health and returned to work. The healing process is affected by many
factors, but one consideration is the trust the patient has in his or
her doctor.
Unlike lay witnesses who
can only testify about facts, doctors are considered “expert” witnesses,
allowing them to provide opinion testimony: that is, a physician can
provide admissible evidence based on what he or she “thinks.” For
example, the treating physician can state that he thinks an injured
worker can return to work at a point in time with or without restrictions
and
the extent, if any, that the symptoms the patient is experiencing
have any relation to the claimed job injury. Consequently, it is
critical
that the physician chosen to provide that testimony is one with whom
the injured worker has trust.
The right to medical benefits is never subject to the statute of limitations
(see STATUTE OF LIMITATIONS); therefore, an injured worker may seek payment
of medical benefits from his or her Employer even if the time for filing
a claim for compensation benefits has run. The Employee still has to
demonstrate the condition for which he or she is seeking treatment is
related to an injury that occurred on the job.
Even if the claim only involves
the pursuit of medical benefits that have been denied, the injured
worker’s attorney can be entitled
to an award of fees and expenses from the Employer in addition to
the benefits obtained on behalf of the injured worker for payment
of the
contested medical treatment. (See ATTORNEY FEES AND
EXPENSES)
AVERAGE WEEKLY WAGE
Compensation benefits for
the period during which an injured worker is unable to return to
work are calculated as two thirds of the worker’s
average weekly wage. The section of the Longshore Act that sets out the
method of determining average weekly wage and the corresponding amount
of weekly compensation benefits is not absolute. Because it allows for
different methods to evaluate an injured worker’s compensation
rate, the Employee may benefit from legal advice as to whether he
or she is receiving the maximum benefit allowed by law.
Even if the claim only involves
the pursuit of an underpayment of incorrectly calculated benefits,
the injured worker’s attorney can be entitled
to an award of fees and expenses from the Employer in addition to
the amount owed to the Employee for obtaining payment of the corrected
compensation
amount. (See ATTORNEY FEES AND EXPENSES)
NATURE AND EXTENT OF INJURY
Job injuries can result
in lost time from work or otherwise have an impact on an employee’s ability to earn a living. The “nature
and extent” of disability considers a combination of medical
and economic factors, as well as the duration (temporary or permanent)
and magnitude (total or partial) of the injury.
Some injuries entitle the
injured worker to compensation irrespective of whether he or she
can return to work while other injuries, to be
compensable, must result in an impact on the injured worker’s
ability to earn.
Issues having to do with the nature and extent of injury are often
the most difficult to ascertain. However, they are usually the most
critical in determining the amount of compensation that is owed to
an injured worker.
RETURN
TO WORK — VOCATIONAL REHABILITATION
Under the best of circumstances, an injured worker realizes a full
and complete recovery following his or her injury and is able to return
to the same job at the same rate of pay. Unfortunately, in many instances
the injured worker is left with permanent restrictions that preclude
returning to work in the same employment.
By working closely with the Office of Workers Compensation Programs
and its Vocational Rehabilitation Services, clients have the opportunity
at no expense to them or their employer, to seek retraining, job placement
and otherwise enhance their ability to earn a decent wage despite the
severity of their injuries.
In the past, injured workers could only utilize OWCP sponsored Vocational
Rehabilitation Services while receiving compensation benefits. Now,
permanently disabled workers can qualify for vocational services under
the Longshore Act whether or not they are receiving benefits or even
if they have settled their claim.
Department of Labor Notice No. 113, issued August 5, 2003 provides:
“Effective immediately,
permanently disabled workers who settle their Longshore claims may
continue to receive rehabilitation services
after settlement. If there is an approved rehabilitation plan already
in effect, services covered under the plan may continue until completion
or until case closure by the OWCP rehabilitation Specialist. At the
discretion of the district director, new rehabilitation services may
be initiated after settlement of the claim, if the services are reasonable
and necessary to assist a permanently disabled worker to return to
the workforce in a suitable job.”
Consequently, any permanently disabled worker who desires to enhance
his or her earning capacity through re-education, retraining or other
appropriate vocational services, may call upon the Department of Labor
to do so.
STATUTE
OF LIMITATIONS — CLAIM FOR BENEFITS
In the event of a sudden accidental injury where the injured worker
readily knows the date and time it occurred, he or she has one year from
the date of injury within which to file a written notice of claim with
the Employer and the Department of Labor. Failure to do so could result
in the forfeiture of any compensation benefits otherwise owed to the
injured worker. If the injured worker receives compensation benefits,
the year begins to run from the last payment of compensation. A claim
for death or disability due to an occupational disease, which does not
immediately result in disability or death, will be timely if filed within
two years after the employee or claimant becomes aware, or in the exercise
of reasonable diligence, or by reason of medical advice should have been
aware of the relationship between the employment, the disease, and the
death or disability, or within one year from the date of the last payment
of compensation, whichever is later. In an occupational disease claim,
the filing period does not begin to run until the employee is disabled,
or in the case of a retired employee until a permanent impairment exists.
The right to reasonable medical treatment necessitated by the job injury
is not subject to the statute of limitations.
If the injury results in death, the appropriate survivors for death
benefits must make a separate claim, even if the injured worker had filed
a claim for compensation prior to death.
Filing a written Claim for
Benefits is distinguishable from providing Notice of Injury. The
Claim for Benefits must be made in writing and
clearly state that the injured worker is claiming all benefits to
which he or she is entitled under the Longshore Act for injuries
received on
a specific date with a particular Employer. The Claim for Benefits
should be delivered to the Employer and the Deputy Commissioner in
the District
where the claim occurred. The addresses for the various Districts
can be found here. The form recognized by the U.S. Department of
Labor, Office
of Workers Compensation Programs, for the purpose of filing the Employee’s
Claim for Compensation is called an LS-203. A claim for death benefits
is filed on form LS-262.
ATTORNEY FEES AND EXPENSES
The decision to seek legal
representation often involves the cost/benefit issue of having
a lawyer involved with dispute resolution. Unlike most
compensation statutes, the Longshore Act allows the attorney who
successfully prosecutes a claim on behalf of an injured worker to
assess attorney
fees and costs against the Employer in addition to the benefits owed
to the injured worker. Attorney’s who represent injured workers
under the Longshore Act do not claim a percentage of the benefits
paid to their clients, as is the case with most State compensation
litigation.
Attorneys claiming fees
and expenses under the Longshore Act are required to submit an hourly
fee
application that itemizes the nature of the work
performed and the corresponding time involved with resolving issues
on behalf of their clients. The law also allows an attorney to claim
his
time as a lien against the Employee’s compensation. No attorney
fees can be assessed or paid without the written approval of the
Department of Labor.
OCCUPATIONAL DISEASE
If you have questions having
to do with Hearling Loss, Asbestosis, Silicosis and/or symptoms from
exposure to Welding Rod fumes, please
contact us directly for specific information about your rights and
remedies.
THIRD
PARTY CLAIMS
In the event that an injury is caused by the negligence of a person
or entity other than the injured worker's Employer, there may be a
remedy against a Third Party. Unlike the recovery for compensation
under the Longshore Act, claims against third parties can include damages
such as pain and suffering.
Please contact
us directly for further information about your rights
and remedies for Third party Claims.
OTHER
APPLICATIONS AND EXTENSIONS OF THE LONGSHORE ACT
The provisions of the Longshore Act can apply to other types of employment:
Defense Base Act
Outer Continental Lands
Shelf Act
Non-Appropriated Funds
Instrumentalities Act
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