If you suffered an on-the-job injury while working in a traditional maritime occupation, like harbor construction or shipbuilding, you may be entitled to compensation under the Longshore Harbor Workers' Compensation Act (LHWCA).
The attorneys at Simien & Simien are well-versed in the many parts of this comprehensive federal law. We can help you through every step of the process of applying for benefits, working to secure you all of the compensation you deserve for medical treatment and other expenses. We want you to have the financial help you need to make the best recovery possible, given your medical issues.
Our skilled lawyers offer a free, no obligation consultation where you can discuss your injury and we can determine if you have a legitimate claim. If we take your case, we will work on a contingency fee basis, which means we will not charge for our services unless you receive compensation.
Employees Covered by the Law
Traditionally, workers who are injured while at work are covered through workers’ compensation. However, maritime workers are not covered by on-shore workers’ compensation laws. Because of this, special laws, such as the LHWCA, have been enacted to provide injured maritime workers with many of the same benefits as on-shore workers.
The LHWCA applies to anyone who is employed in a maritime occupation, including longshoremen and others engaged in longshore operations and harbor workers like shipbuilders, ship repairmen and ship-breakers.
Your job is covered by the LHWCA if it meets two criteria:
- A significant part of your work has something to do with marine transport or the water. Truck drivers who transport shipping containers away from ships would qualify since they contribute to the maritime nature of their employer's business.
- You must work on, near or adjacent to navigable water. If you spend part of your workday on a pier, wharf, dry dock, terminal or other place used by an employer for the loading, unloading, fixing or building of a vessel, you are likely covered under the law.
Over the years, three laws were passed that expanded the LHWCA to cover other types of employment besides traditional maritime jobs. The three laws include:
Defense Base Act
This extension of the LWHCA covers:
- People who work for private employers on U.S. military bases or lands used by the U.S. for military purposes outside of the county, including U.S. territories and possessions
- Work performed on public contracts with U.S. government agencies, such as construction or service contracts related to national defense or war activities
- Work performed on contracts funded by the Foreign Assistance Act
- Work for American employers who are providing welfare or similar services outside the U.S. for the benefit of the Armed Services
Outer Continental Shelf Lands Act
This applies to those working on the outer continental shelf of the U.S. to explore and develop natural resources, such as off-shore oil drilling rigs.
Non-Appropriated Fund Instrumentalities Act
This act applies to civilians employed in non-appropriated fund instrumentalities of the Armed Forces. Examples include military base exchanges and welfare and recreational facilities.
The Longshore and Harbor Workers' Compensation Act lawyers at Simien & Simien know how to determine if you are eligible for benefits under this law.
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Employees Not Covered by the LHWCA
In 1984, an amendment was made to the LHWCA to exclude employees in the following types of jobs if they were covered by their state's workers' compensation system:
- Employees in security, secretarial, clerical or data processing jobs
- Employees of clubs, camps, recreational operations, restaurants, museums or retail outlets
- Employees of a marina who are not engaged in construction or expansion
- People employed by suppliers, transporters or vendors
- People who are doing temporary work on the premises of maritime employers
- People who are doing work normally performed by people employed by an employer covered by the act
- People who do aquaculture work
- Employees who build recreational vessels less than 65 feet in length
- Employees who repair recreational vessels or dismantle any part of the vessel in connection with performing repairs
- People who work on small vessels, if they are exempt by certification from the Secretary of Labor
The LHWCA also excludes the following employees:
- Those employed by the U.S. government or a state or foreign government
- Employees who suffered injuries primarily caused by being intoxicated
- Employees who suffered injuries due to willful or intentional acts designed to harm themselves or others
Contact our Longshore Harbor Workers' Compensation Act lawyers today. (800) 374-8422
Employees Covered by the Jones Act
The LHWCA also excludes employees who are covered under the Jones Act, also called seamen or those who do work that contributes to the function of the seafaring vessel or the accomplishment of its mission. This includes:
- Commercial fishermen
- Crew on seafaring vessels
- Port workers
- Barge operators
Simien & Simien's Louisiana maritime lawyers handle these claims.
What Types of Injuries are Covered by the LHWCA?
Under the LHWCA, covered employees can recover compensation for injuries that arise out of and in the course of employment.
Employees can also recover compensation for diseases or infections that naturally arise out of employment or are a natural or unavoidable result of an accidental injury. These are also called occupational diseases.
Occupational diseases are caused by exposure to harmful substances or conditions at the workplace. Examples of these diseases include:
- Pulmonary diseases
- Mesothelioma from asbestos exposure
- Asthma caused by exposure to chemicals
- Skin diseases
In some cases, employees do not develop symptoms of an occupational disease until years after they were exposed to a harmful substance. Fortunately, these employees may still be entitled to compensation if they can prove that the disease is related to their employment.
The law also covers injuries caused by the willful acts of third parties that are directed against employees.
What Should I Do After Suffering an On-the-Job Injury?
If you suffered an injury at work, there are several steps you should take to improve your chances of receiving compensation:
Seek Medical Treatment Right Away
The LHWCA does not restrict your choice of healthcare providers so you can obtain treatment from whatever doctor or medical facility you want.
If your claim is approved, you will receive compensation for reasonable and necessary medical expenses from your treatment. The only requirement is that you receive care from someone who fits the LWHCA definition of a physician. According to the LHWCA, this includes:
- Clinical psychologists
- Osteopathic practitioners
You may receive treatment from a chiropractor, but you will only receive reimbursement for manual manipulation of the spine to correct subluxation that is shown on an x-ray. Any other treatments will not be covered.
Notify Your Employer
Submit Form LS-201, Notice of Employee's Injury or Death to your employer. The law states that you must notify your employer in writing of your injury within 30 days of when the injury occurred, or 30 days of when you became aware that you had an injury or disability related to your employment.
Failing to meet the 30-day deadline does not necessarily bar you from receiving benefits. The Office of Workers' Compensation Programs (OWCP) may excuse your lateness if you have a good reason, or the employer does not have a problem with it. However, it is best to make sure you meet the 30-day deadline.
Fill Out Form LS-1
When you notify your employer, ask for Form LS-1, Request for Examination and/or Treatment and have your doctor fill it out. The doctor will note if the injury is related to your job and detail the treatments you received.
File a Written Claim for Compensation
If you want to obtain benefits for a work-related injury, you must submit Form LS-203, Employee's Claim for Compensation, to the OWCP within one year of the date you suffered an injury.
If you fail to submit a claim before the deadline, your employer may decide to object and deny compensation.
If you have an occupational disease, you must file a claim for compensation within two years from the date you became aware or should have become aware of the disease with the exercise of due diligence.
The Longshore and Harbor Workers' Compensation Act lawyers at Simien & Simien are ready to assist you.
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Types of Benefits Available
If your Longshore and Harbor Workers' Compensation Act claim is approved, you will receive one or more of the following forms of compensation:
Temporary Total Disability
This is reserved for employees who have an injury that temporarily prevents them from doing any work. The employee will receive two-thirds of his or her average weekly wage (AWW). The AWW is calculated by dividing the employee's average weekly earnings by 52.
Your specific amount of compensation is subject to the minimum and maximum rates set by the Department of Labor (DOL) each year on Oct. 1. For the 2017 fiscal year, the maximum amount of compensation is $1,436.48 and the minimum is $359.12.
If your AWW is above the maximum, you will be paid the maximum amount. If your AWW is less than the minimum, you will be paid the minimum.
You will receive this benefit for as long as you have the disability or injury.
Temporary Partial Disability
This is for employees who have a medical condition that temporarily prevents them from doing the same job they were doing before the injury. However, the employee is able to do a different job with the same employer or a new company.
You will receive two-thirds of your lost earning capacity. This is calculated by taking two-thirds of the difference between your AWW and the amount you are able to earn after the injury. For instance, if your average weekly wage is $500 but you can only earn $400, you would receive $264.
You can receive this benefit for a maximum of five years.
Permanent Total Disability
This refers to a condition that is not expected to improve and prevents the employee from performing any type of work.
If you have a permanent total disability, you will receive two-thirds of your average weekly wage for as long as you are disabled. Your amount of compensation may be adjusted each year based on changes in the minimum and maximum rates set by the DOL.
Permanent Partial Disability
This is a condition that is expected to be permanent but it still allows the employee to do some type of job, even if there are less responsibilities or hours.
There are two types of permanent partial disability (PPD) benefits:
- Scheduled PPD – This is reserved for impairments listed in Section 8(c) of the LHWCA, including permanent impairment in the arm, hand, fingers, eyes, ears, feet or toes. You are entitled to this form of compensation when your injury improves to the highest level possible and you are able to return to work. You will receive 66 and two-thirds percent of your AWW for a certain number of weeks, depending on your disability. For instance, compensation will be paid for 12 weeks if you lost the use of an arm.
- Unscheduled PPD - This is similar to scheduled PPD, except it is reserved for injuries not listed in the schedule in Section 8(c). Compensation is two-thirds of your loss of earning capacity. This is determined by calculating the difference between your AWW at the time of the injury and what you can earn after the injury. For example, if you used to earn $750 per week and now earn $250 per week, the difference is $500 and two-thirds of that is $330. Unlike scheduled PPD, you will receive compensation for as long as the disability continues. However, benefits will not be adjusted when there are changes in minimum and maximum rates.
Permanent Partial Disability for Retirees
If you developed an occupational disease after retirement, you may be able to receive PPD benefits under the LWHCA. The amount of compensation you receive is dependent upon your percentage of impairment, according to guidelines from the American Medical Association Guides to the Evaluation of Permanent Impairment.
However, if you retired within a year of your diagnosis, the amount of compensation you receive will be based on your AWW.
If your LHWCA claim is approved, you will also be entitled to compensation for reasonable and necessary medical treatment, including:
- Hospital treatment
- Prescription medications
- Diagnostic tests
- Physical therapy
- Prosthetic devices
- Hearing aids
- Attendant care
- Cost of traveling to treatment, such as mileage, parking and tolls
You will receive compensation for as long as you need medical care. This includes treatment for conditions that are caused by the injury.
Medical expenses will be paid at the rate that is customary for the area in which you live. If there is a dispute between an employee and the insurance carrier or employer about the cost of treatment or whether it is reasonable or necessary, the Longshore District Director will attempt to resolve the issue informally.
However, if the dispute cannot be resolved that way, either party can request that the dispute be referred for a formal hearing before an administrative law judge.
While you are permitted to see whatever doctors you choose, your employer's insurance carrier may schedule a medical appointment with a doctor of its choosing. You can choose not to go, but your compensation will be suspended until you complete the medical exam.
The Longshore and Harbor Workers' Compensation Act lawyers at Simien & Simien are committed to ensuring you receive all of the compensation you deserve.
Benefits for Survivors
If an employee dies from an on-the-job injury, death benefits will be paid to survivors of the deceased, which could include the spouse and children or brothers, sisters or grandchildren.
Regardless of who the survivors are, they will receive up to $3,000 for reasonable funeral expenses.
If there is a spouse but no children, the spouse will receive 50 percent of the deceased's AWW. If the spouse remarries, he or she will receive two years of compensation in a lump sum when she gets remarried.
If the spouse has a child or children, an additional 16 and two-thirds percent of the deceased's AWW will be added to the spouse's compensation for each child.
If the spouse dies or remarries and there is just one surviving child, the child's compensation will be increased to 50 percent of the deceased's AWW. If there is more than one surviving child, compensation will be increased to 66 and two-thirds percent of the deceased's AWW. The same formula applies if there is one or more surviving children but no widow or widower.
If there is no widow, widower or children, compensation will be provided to those who were dependent on the deceased at the time of his or her injury, according to the definition of dependent in section 152 of title 26 of the U.S. code.
Dependents will receive 20 percent of the deceased's average wages. Parents or grandparents who were dependent on the deceased will receive 25 percent of AWW. However, the total amount of compensation for these dependents cannot exceed 66 and two-thirds percent of the deceased's AWW.
Schedule a consultation with our Longshore and Harbor Workers' Compensation Act lawyers today.
Does the LHWCA Offer Vocational Rehabilitation?
You may need vocational rehabilitation to be able to return to gainful employment. Under the LHWCA, you are eligible for vocational rehabilitation if:
- You are receiving compensation or are likely to receive compensation due to a work-related disability
- You have a permanent disability that prevents you from returning to your job
- There are return-to-work opportunities within driving distance of your home
Vocational rehabilitation could include:
- Vocational assessment
- Skills testing
- Job development
- Job placement assistance
- Modification of a previous job
If you want to request vocational rehabilitation, you or your attorney can contact the Longshore Rehabilitation Specialist in your district office.
What Happens if my Claim is Denied?
In some cases, a claim is denied not because it is invalid, but simply because required documents have not been submitted. Check with your employer or insurance carrier to find out what you need to submit to have your claim accepted so you can receive compensation.
However, in other cases, your employer or insurance carrier denied the claim because they do not think it is legitimate. If this happens, you will receive a Notice of Controversion of Rights to Compensation. This is a formal notification of the reasons for the denial of your claim.
If you wish to challenge the denial, you or your attorney can contact the district office handling your claim. You will need to provide documentation to support the reasons your claim should be approved, which could include:
- Earnings records
- Wage statements
- Medical records
You should send copies of these documents to your employer and their insurance carrier as well.
The OWCP office will hold an informal conference to resolve the dispute. However, any written recommendation from the office to pay benefits is not binding for either party.
If you are unable to overturn the denial at this stage, you can request a formal hearing before a DOL Administrative Law Judge. This person has the authority to overturn the denial.
You must submit Form LS-18 to request a hearing before an administrative law judge.
At any point during this process, you or your attorney may attempt to negotiate a settlement with the insurance company's claims adjuster. If both sides agree to a settlement, it will have to be reviewed by the director of the district office or the administrative law judge. They will make a decision about the settlement within 30 days of receiving it.
If the settlement is approved, your employer or its insurance carrier must pay the lump sum settlement within 10 days of approval. If you do not receive the payment within that time, you may be entitled to additional compensation for late payment.
The Longshore and Harbor Workers' Compensation Act lawyers at our firm are prepared to help with every step of your appeal. We are committed to building a robust case that gives you the best chance of overturning the denial of benefits.
Contact Simien & Simien today to review your claim.
Longshore and Harbor Workers' Compensation Act Lawyers Ready to Help You
The attorneys at Simien & Simien can guide you through every step of the process of applying for benefits from the Longshore and Harbor Workers' Compensation Act.
We will work to ensure your injury or disability is evaluated correctly so you receive the maximum amount of compensation you deserve. We want you to have the financial stability you need to move forward with your life, and move back into the workforce, if that is a possibility.
Set up a free, no obligation legal consultation today to discuss your claim and find out how we can assist you. We work on a contingency fee basis, which means we do not get paid unless you do.
Click here to contact our Longshore and Harbor Workers' Compensation Act lawyers right now.