If you are a contractor who has been injured on the job while working overseas in Iraq, Afghanistan or on any military base across the world, your case is covered by the Defense Base Act which is an extension of the Longshore and Harbor Workers’ Compensation Act. At the Law Offices of Gillis, Mermell & Pacheco, P.A., we have a combination of over 43 years of experience in representing injured workers covered by the Defense Base Act and the Longshore and Harbor Workers’ Compensation Act. Let us put our years of experience and our reputation to work for you today! Contact us today at firstname.lastname@example.org, or go on our website at www.dbalawyers.com and fill out our form on the contact us page, or call us at 305 595 3350.
Here are some very interesting facts and case summaries regarding medical benefits in a DBA or Longshore case coming directly from the Longshore Deskbook from the Benefits Review Board. The Longshore Desk Book is a searchable website which is a public record. According to the Longshore Deskbook:
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 the process of recovery may require.
33 U.S.C. §907(a).
The applicable regulations expand on this provision, specifying that compensable care
shall include medical, surgical, and other attendance or treatment, nursing and hospital services, laboratory, X-ray and other technical services, medicines, crutches, or other apparatus and prosthetic devices, and any other medical service or supply, including the reasonable and necessary cost of travel incident thereto, which is recognized as appropriate by the medical profession for the care and treatment of the injury of disease.
20 C.F.R. §702.401(a). Section 702.402 provides that it is employer’s duty to furnish appropriate care as defined in Section 702.401(a). Section 702.403 provides that the employee shall have the right to choose his attending physician, see Section 7(b), infra, and that in determining the choice of physician, availability, the employee’s condition and the method and means of transportation must be considered. It provides that a reasonable travel distance generally is 25 miles from the place of injury or employee’s home, but other factors must be considered.
In order for a medical expense to be assessed against the employer, the expense must be both reasonable and necessary for treatment of a work injury. Pernell v. Capitol Hill Masonry, 11 BRBS 532, 539 (1979).
The employee must establish that the medical expenses are for treatment of the compensable injury. Pardee v. Army & Air Force Exchange Service, 13 BRBS 1130 (1981) (Miller, J., dissenting); Suppa v. Lehigh Valley R.R. Co., 13 BRBS 374 (1981). Whether a specific condition for which claimant has been treated is work-related is a causation issue under Section 2(2), and the Section 20(a) presumption applies to this issue. However, the presumption does not aid claimant in establishing entitlement under Section 7. See Schoen v. U.S. Chamber of Commerce, 30 BRBS 112 (1996); Shahady v. Atlas Tile & Marble Co., 13 BRBS 1007 (1981) (Miller, dissenting), rev’d on other grounds, 682 F.2d 968 (D.C. Cir. 1982), cert. denied, 459 U.S. 1146 (1983) (Section 20(a) does not apply to Section 7). Claimant must establish that treatment is reasonable and necessary for his work-related condition and that he has met the other requirements for employer to pay medical benefits. In this regard, the Fourth Circuit held that the presumption does not relieve the claimant of his burden of proving the elements of his claim for medical benefits and reversed the Board’s decision requiring that employer prove with substantial evidence that claimant’s private physician did not file a report pursuant to Section 7(d). Maryland Shipbuilding & Drydock Co. v. Jenkins, 594 F.2d 404, 10 BRBS 1 (4th Cir. 1979), rev’g 6 BRBS 550 (1977).
If you have a question about medical benefits in your DBA or Longshore case, Contact Us today at email@example.com, or go on our website at www.dbalawyers.com and fill out our form on the contact us page, or call us at 305 595 3350.