The Defense Base Act

How Are Claims Made Under the Defense Base Act?

The Defense Base Act provides disability, medical, and death benefits to employees who are injured or killed in the course of employment, whether or not the injury or death occurs during work hours.

INJURY BENEFITS

Medical Care

The DBA covers:
• All medical, surgical, and hospital treatments
• Required medical supplies and services
• The cost of travel and mileage for treatment

The employee can choose his or her own physician. This includes:
• Doctors of medicine (MD)
• Surgeons
•Podiatrists
• Dentists
• Clinical psychologists
• Optometrists
• Osteopathic practitioners
• Chiropractors (but only to correct dislocation of the spine)

An employee may not choose a physician who is currently not authorized by the Department of Labor. The list of physicians not authorized is available from the local Office of Workers' Compensation Programs.

Disability Compensation

Disability means that the employee is unable to earn the same wages earned at the time of injury. Compensation is available for:

• Permanent Total and Temporary Total Disability - Compensation is two-thirds of the employee's average weekly wage, subject to a maximum amount, which is currently $1,030.78 per week.
• Permanent Partial Disability - The permanent loss or loss of use of certain parts or functions of the body, such as the loss of the arm, hand, fingers, leg, foot, toes, hearing or vision. The Act specifies the length of compensation, which varies according to the type of disability. For example, total loss of use of a foot entitles the employee to 205 weeks of compensation.
• Temporary Partial and Non-Scheduled Permanent Partial Disability - Compensation is two-thirds of the employee's weekly wage loss or loss of wage-earning capacity.
• Permanent Partial Disability for Retirees - If a worker develops a latent occupational disease after retirement, compensation is two-thirds of the National Average Weekly Wage (NAWW) multiplied by the percentage of impairment resulting from the disease.

Rehabilitation

Vocational rehabilitation may include evaluation, testing, counseling, selective placement, and retraining, if the employee is injured and cannot return to the former job. Rehabilitation services may include the cost of tuition, books and supplies. A maintenance allowance of up to $25.00 per week is also provided during retraining. The cost of vocational rehabilitation services is paid by the U. S. Department of Labor.

DEATH BENEFITS

Death benefits are paid to the surviving spouse or other eligible survivors if the injury causes the employee's death. A maximum of $3,000 will be paid to cover funeral expenses.

The widow or widower receives 50% of the average weekly wage of the deceased employee for life or until remarriage. Upon remarriage, a widow or widower receives a lump sum payment of compensation covering two years. An additional 16 2/3% of the employee's average weekly wage is paid if there are one or more dependent children.

If children are the sole survivors, 50% of the employee's average weekly wage is paid on behalf of the first child. If there is more than one child, a maximum of 66 2/3% applies, shared equally.

Other eligible survivors - parents, brothers, sisters, grandparents and grandchildren who were dependent on the employee.

Benefit payments to children, brothers, sisters, and grandchildren end when the beneficiaries reach 18, but may be extended to age 23 if the beneficiary is a student. Payments may continue indefinitely if a child remains incapable of self-support due to mental or physical disabilities.

BENEFITS FOR NON-U.S. CITIZENS

Foreign nationals receive the same DBA benefits as U.S. citizens with two exceptions:

1. Death benefits are only available to the worker's surviving spouse and children or, if there is no spouse or children, the worker's surviving father or mother, provided that the worker supported the father or mother for at least one year before the worker's death.
2. Permanent disability benefits or survivors benefits may be changed from installment payments to a single lump-sum payment equal to one-half of the present value of the future compensation. This decision is made by the Secretary of Labor and can be requested by the insurance carrier responsible for paying benefits.

IF YOU ARE INJURED

1. Notify your supervisor immediately. If you need medical treatment, ask your employer for a Form LS-1, which authorizes treatment by a doctor of your choice.
2. Obtain medical treatment as soon as possible.
3. Use Form LS-201 to give written notice of your injury to your employer. This must be done within 30 days. Notice of death must also be given within 30 days. Additional time is provided for certain hearing loss and occupational disease claims. The employer should notify its insurance carrier, or if it is self-insured the claims administrator, as soon as it has knowledge of an injury. The employer must file Form LS-202 with the OWCP district office having jurisdiction within 10 days of the injury, if it causes loss of one or more work shifts.
4. File a written claim for compensation within one year after the date of injury or last payment of compensation, whichever is later. A claim for survivor benefits must be filed within one year after the date of death. The time for filing claims in certain occupational disease cases has been extended to two years.

If You Need Further Assistance

The Office of Workers' Compensation Programs (OWCP) will help claimants prepare claims, explain benefits and proceedings under the Act, and advise about medical and vocational rehabilitation services.

The OWCP district office monitors compensation payments and medical care to ensure compliance with the DBA. In case of claims disputes, OWCP claims examiners conduct informal conferences to help the parties resolve their disputes through mutual agreement or compromise without formal litigation. The district director has authority to approve settlements and issue compensation awards in undisputed claims.

If the parties are unable to resolve their disputes informally, they may request a formal hearing through the Office of Administrative Law Judges. Decisions of the administrative law judge may be appealed to the Benefits Review Board, and thereafter to the U.S. District Court or to the U.S. Court of Appeals.

Source: U.S. Department of Labor, Office of Workers' Compensation Programs

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