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What to Do If My Defense Base Act Claim Is Denied?

What to Do If My Defense Base Act Claim Is Denied?

Private employees can typically file a Workers’ compensation claim with their employer’s insurance provider when they are injured on the job. But what if you are a civilian contractor employed by the United States Department of Defense who was injured while performing regular job duties overseas for the military installation?

Civilian employees who’ve sustained bodily injuries while working for the U.S. Armed Forces will have their on-the-job injury claims handled by a private insurance provider. Instead, your employer is supposed to notify its insurance carrier about your claim under the federal Defense of Base Act.

What Is the Defense of Base Act?

The Defense of Base Act (DBA) is a federally required insurance program provide workers’ compensation type coverage for all military contractors and subcontractors working overseas. Provisions of the Defense Base Act can be found in 42 U.S.C. §§1654-54. Accordingly, even if your employer is a private company and not the federal government, you are entitled to benefits under the DBA.

Civilian contractors working for the federal government may receive the following benefits under the DBA:

  • Medical benefits
  • Total disability compensation
  • Death benefits

Claim Filing Procedures for DBA Claims

To receive compensation based on your work injury, you must file a written claim on Form LS-203 (Employee’s Claim for Compensation) with the U.S. Department of Labor Office of Workers’ Compensation Programs (OWCP) within one year from the latter of the date of your injury or date you last received compensation payment.

To receive death benefits, you must submit written notice of the employee’s death to their employer using Form LS-201 (Notice of Employee’s Injury or Death) within 30 days of their death. Next, file a written claim for compensation on Form LS-262 (Claim for Death Benefits) with the OWCP within one year after the employee’s death.

If the OWCP requests medical reports and documentation, you should make a good faith effort to cooperate and comply with their requests.

It always helps to include as much documentation to support your claim, such as:

  • Earnings records
  • Wage statements
  • Medical records
  • Physician reports

The insurance carrier is responsible for paying compensation benefits 14 days from the day your disability first started. If the insurance company decides that benefits should be delayed or denied, it must file a Notice of Controversion with the OWCP within 14 days after compensation was due.

What to Do If Your Claim Was Denied

The U.S. Department of Labor recommends that you reach out to the district office servicing your claim for assistance if you do not agree with the OWCP’s decision to deny your claim. You should always support your claims with as much documentation as possible. Often, denials result from lack of documentation.

However, if the OWCP still denies your claim despite you providing sufficient documents and records, you can request that your claim be referred to the Office of Administrative Law Judges (OALJ) for a formal hearing. At this point, it is in your interest to retain the professional services of an attorney who can guide through the administrative law process and prepare you for your hearing.

If the OALJ does not find in your favor, you can appeal their decision to the Benefits Review Board. If the decision rendered by the Benefits Review Board continues to be erroneous, you can make a federal case out of your claim with the U.S. District Court. Rulings of the U.S. District Court can be appealed to the U.S. Court of Appeals.

If you’ve been injured on the job while working overseas as a military contractor or subcontractor, you should consult an experienced attorney from The Law Offices of George P. Escobedo & Associates, PLLC. Call our office at (210) 807-3178 or contact us online to arrange a free consultation about your case today.

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