Filing a Claim
The first  thing an injured
contractor should do is to file a
 
 LS 203
Employees Notice of Claim.  

Foreign Workers need to file
claims in the New York Office

All American Contractors
should file their claims in their
District Office

If they were injured in either
Iraq,
Kuwait or Afghanistan it should
be mailed to the New York
office
the Second District.

Office of Workers
Compensation Programs

Longshore and Harbor Workers
Compensation

Post Office Box 249

New York, New York 10014-0249

Fax (646) 264-3002




There are district offices
located in New York, Boston,
Baltimore, Norfolk,
Jacksonville, New Orleans,
Houston, San Francisco,
Long Beach, Seattle, and
Honolulu.
The Defense Base Act (DBA) adopts the provisions of the
Longshore and Harbor Workers' Compensation Act (LHWCA)
with but a few exceptions. The insurance requirements for the
DBA are identical to those found in the LHWCA.

Section 32(a) of the Longshore Act requires every employer
either to secure insurance for the payment of workers'
compensation benefits provided under the Act or to be
permissibly self-insured. The OWCP is responsible for the
authorization of insurance carriers and self-insurance of
employers. For a list of the over 700 insurance carriers and
self-insured employers currently authorized. Three major
insurance carriers are currently providing Defense Base Act
insurance coverage. They are ACE-USA, AIG, and CNA.

Section 4(a) of the Act requires every employer to be liable for,
and to secure the payment of, disability, medical, and death
benefits to its employees in the event of injury or death. If a
subcontractor fails to secure the payment of compensation,
the contractor will be liable for and be required to secure the
payment of such benefits.

Section 5(a) of the Act provides that "a contractor shall be
deemed the employer of a subcontractor's employees if the
subcontractor fails to secure the payment of compensation."

Section 5(a) also provides that if an employer fails to secure
payment of compensation as required by this Act, an injured
employee, or his survivors in case death results from the
injury, may elect to sue the employer for tort damages on
account of such injury or death. In such action the defendant
may not plead as a defense that the injury was caused by the
negligence of a fellow servant, or that the employee assumed
the risk of his employment, or that the injury was due to the
contributory negligence of the employee.

Section 38(a) provides that an employer who fails to secure the
payment of compensation when required shall be guilty of a
misdemeanor and, upon conviction thereof, shall be punished
by a fine of not more than $10,000 or by imprisonment for not
more than one year, or both. And if the employer is a
corporation, the president, secretary, and treasurer shall be
also severally liable for such fine and imprisonment.

Furthermore, if a corporation fails to secure the payment of
compensation, the president, secretary, and treasurer shall be
severally and personally liable, jointly with the corporation, for
any compensation or other benefits payable under the Act in
respect to any injury or death which may occur to any of its
employees.
Clues
That your DBA Attorney is
not working in your best
interest

Defense Base Act
Worker's Compensation
A guide for the employee


The Defense Base Act
Compensation Blog

Doctor's who work for
Insurance Companies
War Hazards Act

§ 61.100  The Office shall
reimburse any carrier that
pays benefits under the
Defense Base Act or other
applicable workers'
compensation law due to
the injury, disability or
death of any person
specified in §61.1(a), if the
injury or death for which
the benefits are paid arose
from a war-risk hazard.
The amount to be
reimbursed includes
disability and death
payments, funeral and
burial expenses, medical
expenses, and the
reasonable and necessary
claims expense incurred in
processing the request.

(b) The Office shall not
provide reimbursement in
any case in which an
additional premium for war-
risk hazard was charged,
or in which the carrier has
been reimbursed, paid, or
compensated for the loss
for which reimbursement
is requested.

(c) Reimbursement under
this section with respect to
benefits sh
all be limited to the
amounts which will discharge
the liability of the carrier under
the
applicable workers'
compensation law.



§ 61.104   Reimbursement
of claims expense.
(to Insurancecarrier)
top
(a) A carrier may claim
reimbursement for
reasonable and necessary
claims expense incurred in
connection with a case for
which reimbursement is
claimed under the Act.
Reimbursement may be
claimed for allocated and
unallocated claims
expense.

(b) The term “allocated
claims expense” includes
payments made for
reasonable attorneys'
fees, court and litigation
costs, expenses of
witnesses and expert
testimony, examinations,
autopsies and other items
of expense that were
reasonably incurred in
determining liability under
the Defense Base Act or
other workers'
compensation law.
Allocated claims expense
must be itemized and
documented as described
in §61.101.

(c) The term “unallocated
claims expense” means
costs that are incurred in
processing a claim, but
cannot be specifically
itemized or documented. A
carrier may receive
reimbursement of
unallocated claims
expense in an amount of
to 15% of the sum of the
reimbursable payments
made under the Defense
Base Act or other workers'
compensation law. If this
method of computing
unallocated claims
expense would not result
in reimbursement of
reasonable and necessary
claims expense, the Office
may, in its discretion,
determine an amount that
fairly represents the
expenses incurred.

(d) The Office shall not
consider as a claims
expense any general
administrative costs,
general office
maintenance costs, rent,
insurance, taxes, or other
similar general expenses.
Nor shall expenses
incurred in establishing or
documenting entitlement
to reimbursement under
the Act be considered.

The issuance of an authorization for treatment by the employer
shall bind his insurance carrier to furnish and pay for such care
and services.

Sec. 702.203  Employer's report; how given.
The employer's report, an original and one copy, may be furnished
by delivering it to the appropriate office of the district director, or
by mailing it to said office.

Sec. 702.392  Appeals; what may be appealed.
An appeal raising a substantial question of law or fact may be
taken from a decision with respect to a claim under the Act. Such
appeals may be taken from compensation orders when they have
been filed as provided for in Sec. 702.349.

Sec. 702.403  Employee's right to choose physician; limitations.
The employee shall have the right to choose his/her attending
physician from among those authorized by the Director,(
any doctor
that is not on the NO Doctors List, you can choose and Department of
Labor states there are none in Spring of 08 see below
) OWCP, to
furnish such care and treatment, except those physicians
included on the Secretary's list of debarred physicians. In
determining the choice of a physician, consideration must be
given to availability, the employee's condition and the method and
means of transportation. Generally 25 miles from the place of
injury, or the employee's home is a reasonable distance to travel,
but other pertinent factors must also be taken into consideration.

IE....NO specialist  for Injury within a reasonable
range, then  you go to next city closest to the
INJURED!, NOT Flying to Texas for a  MMPI-2 test/
Fake Bad Scale) to see the insurance company hired
doctor, That IS NOT Reasonable nor justified for
reimbursement.  Second opinions come from the
Court not Insurer....
(see Sec. 702.135 for mileage fees paid...)

Sec. 702.404  Physician defined.
The term physician includes doctors of medicine (MD), surgeons,
podiatrists, dentists, clinical psychologists, optometrists,
chiropractors, and osteopathic practitioners within the scope of
their practice as defined by State law. The term includes
chiropractors only to the extent that their reimbursable services
are limited to treatment
consisting of manual manipulation of the spine to correct a
subluxation shown by X-ray or clinical findings. Physicians defined
in this part may interpret their own X-rays. All physicians in these
categories are authorized by the Director to render medical care
under the Act.  Naturopaths, faith healers, and other practitioners
of the healing arts which are not listed herein are not included
within the term "physician'' as used in this part.

Sec. 702.135  Payment of claimant's witness fees and mileage in
disputed claims.
In cases where an attorney's fee is awarded against an employer
or carrier there may be further assessed against such employer
or carrier as costs, fees and mileage for necessary witnesses
attending the hearing at the instance of claimant. Both the
necessity for the witness and the reasonableness of the fees of
expert witnesses must be approved by the hearing officer, the
Board, or the court, as the case may be. The amounts awarded
against an employer or carrier as attorney's fees, costs, fees and
mileage for witnesses shall not in any respect affect or diminish
the compensation payable under this Act (see Act, section 28 (d)).  
     
Subpart D_Medical Care and Supervision-Revised April 08

Sec. 702.408  Evaluation of medical questions; impartial specialists.
In any case in which medical questions arise with respect to the
appropriate diagnosis, extent, effect of, appropriate treatment,
and the duration [[Page 907]]  of any such care or treatment, for
an injury covered by the Act, the Director, OWCP, through the
district directors having jurisdiction, shall have the power to
evaluate such questions by appointing one or more especially
qualified physicians to examine the employee, or in the case of
death to make such inquiry as may be appropriate to the facts and
circumstances of the case. The physician or physicians, including
appropriate consultants, should report their findings with respect
to the questions raised as expeditiously as possible. Upon receipt
of such report, action appropriate therewith shall be taken.
***   Subpart B_Claims Procedures

Sec. 702.204  Employer's report;
penalty for failure to furnish and or
falsifying.
Any employer, insurance carrier, or self-insured employer who
knowingly and willfully fails or refuses to send any report required
by Sec. 702.201, or who knowingly or willfully makes a false
statement or misrepresentation in any report, shall be subject to a
civil penalty not to exceed $10,000.00 for each such failure,
refusal, false statement, or misrepresentation. Provided,
however, that for any violations occurring on or after November
17, 1997 the maximum civil penalty may not exceed $11,000.00. The
district director has the authority and responsibility for assessing
a civil penalty under this section.

Sec. 702.603  Determining the payrate for compensating
occupational disease claims which become manifest after
retirement.
(a) If the time of injury occurs within the first year after the
employee has retired, the payrate for compensation purposes
shall be one fifty-second part [[Page 917]]
of the employee's average annual earnings during the fifty-two
week period preceding retirement.
(b) If the time of injury occurs more than one year after the
employee has retired the payrate for compensation purposes
shall be the national average weekly wage, determined according
to section 6(b)(3) of the Act, 33 U.S.C. 906(b)(3), at the time of
injury.
***********************************************
If you have "MULTIPLE INJURIES" you are not expected to
become your own doctor and diagnose your injuries.  
Facts...

The Likely hood of a contractors coming home with ONLY 1
injury is pretty rare, and in many cases, require several
different doctors.

If your first doctor doesn't specialize in that injury, then you
have a right to choose another FIRST CHOICE DOCTOR FOR
the other INJURIES (specialist's), not the insurance company.
Unless you just want to change doctors, then you must get
approval.  Other words, you get a First choice doctor per
injury.  NOT JUST THE ONE INJURY

Attorney's who represent  the injured (Claimants) under the
DBA must FIGHT for
all your compensation needs.  These
attorney's are not doctors  and can not choose what they think
you should or will get.  They are required by law to Represent
your rights to ALL Compensation that you are entitled to under
the DBA...(PTSD & Diseases INCLUDED!)
See Iraq Infections at:
www.IraqInfections.com for more
information on this.

If you find a DBA attorney who refuses to take your CASE or will
tell you that only one injury is worth fighting for, then let us
know!  
EXAMPLE: Your injured in Iraq, your sent home and you go to
your family physician, he tells you that you need to see a Brain
Injury Doctor and an  Orthopedic surgeon.  The insurance has
to pay for that doctor, on top YOU get to choose your first
choice neurologist  AND your Orthopedic surgeon!  Again NOT
THE INSURANCE Company, you don't have to go to who they tell
you to unless you just want to...

IT's YOUR RIGHT TO CHOOSE YOUR DOCTORS UNDER THE DBA!
Legal requirements for Employers
Civilian Contractors in Iraq and Afghanistan
DBA Defense Base Act Resources
DBA insurance premiums are cost
reimbursable to the Contract Company

DBA insurance premiums are based
on a percentage of your full pay,
taxable pay to include all incentives
and up pays.

The US Government reimburses the
DBA insurance company for all claims
and expenses that qualify for War
Hazard Recovery under the War
Hazards Act.

FECA BULLETIN NO. 12-01

XI. Miscellaneous

1. DFEC requires, before acceptance
of any WHCA reimbursement claim,
that the employer/carrier has
made only reasonable and prudent
efforts in presenting all meritorious
defenses against a DBA claim
without regard to whether the case is
eligible for WHCA reimbursement. An
employer/carrier’s inadequate
or overly zealous representation in
defending against a DBA claim may be
grounds for denying all or some
portion of a request for WHCA
reimbursement.

CECILY A. RAYBURN
Director, Division of Planning, Policy
and Standards
As a DBA Claimant you'll be pleased to
learn that


THERE IS NO PAIN AND SUFFERING
UNDER THE DEFENSE BASE ACT
The Defense Base Act
The Government Mandated
Taxpayer Supported

LICENSE TO KILL