In the midst of this terrible coronavirus crisis, we are learning about some true heroes. These heroes do not get the media spotlight on a daily basis, these heroes are not those who are able to shelter at home during the crisis. These heroes are the men and women who are working each day at our health care centers, at our grocery stores, at food delivery restaurants, and at the harbors handling important life-saving cargo every day.
For those true heroes we want to make sure that they are protected in case they confront their own illness due to the COVID-19 pandemic. At our firm, in fact, we have gotten many, many calls about workers’ compensation coverage in connection with the COVID-19 outbreak.
While it is far too soon to tell whether a person can successfully claim workers’ compensation coverage for a COVID-19 infection, it is reasonable to think that workers’ compensation insurance should be a source of funds for medical costs if someone can show that they contracted the coronavirus during the course of their employment.
This article will delve into the process for longshoremen and harbor workers by which they would make a claim under the Longshore and Harbor Workers’ Compensation Act. If you have additional questions pertaining to your own personal circumstances, then we invite you to contact the Longshore and Harbor Workers Act attorneys in Jacksonville, FL – RITE Law. Our number is (904) 500-RITE or you can fill out our contact form online. We provide a free case evaluation, so call today.
What is the Process for Making a Claim Under the Longshore Act?
Making a claim, and possibly having to resolve a dispute, under the Longshore and Harbor Workers’ Compensation Act (Longshore Act) is a process to be sure, but it is worthwhile as you most likely will benefit a great deal from the process.
If you are injured or acquire a disease on the job, then you should make a claim for compensation and seek medical treatment. Part of your claim will be to alert the Department of Labor’s Division of Longshore and Harbor Workers’ Compensation (DLHWC) of your injury or illness.
The DLHWC, which will administer your claim, will make initial recommendations with regard to your eligibility for medical and other benefits. The DLHWC will also get information from your employer and insurance carrier before making its recommendation.
It is typical that both parties will engage in an informal conference before the DLHWC makes a recommendation. Ultimately, the DLHWC will make a recommendation in the form of a formal memorandum to all relevant parties.
What Happens If the Longshore Act Insurance Company Wishes to Dispute the Claim?
If you or your employer/insurer disagrees with the DLHWC’s recommendation – which may very well occur given that claims for illness related to COVID-19 is likely to be seen as new territory – then you or your employer will file what is called a Form LS-207, which allows the party to explain the disagreement.
At that point, either your or your employer may choose to refer the case to the Office of Administrative Law Judges. That is the point at which a formal “adjudication” of your claim has begun.
Claim Before an ALJ
The adjudication before an Administrative Law Judge (ALJ) will look similar to a typical civil lawsuit. Each party will ask the other for records and documents, and will serve interrogatories (or questions) on the other side. The parties will also likely have depositions so key people can answer questions under oath. It is common to have the injured worker, physicians, defense experts, insurance adjusters, and even someone from your employer come to a deposition.
Once all the information is gathered through that discovery process, the case will be heard before the ALJ. The court rules are not strictly followed; yet, the proceeding before the ALJ will be similar to a small case before a judge, so it is importa in front of the ALJ. That is because you will have a burden of proof to show that you are entitled to workers’ compensation benefits.
Typically, after the hearing, there is a substantial waiting period before you get a decision. Sometimes, the wait can be as long as a year, but hopefully you can get an opinion from the ALJ within a matter of months.
When you receive the ALJ’s decision, you or your employer/insurer can choose to follow the ALJ’s decision, or appeal to a higher court.
Can a Claim be Settled?
Given that the path through adjudication before an ALJ can be an lengthy one, an alternative would be to settle your claim. In fact, most cases do settle at some point during the adjudication process.
The benefit of a settlement, rather than going all the way to an ALJ trial and decision, is that you have more control over the outcome. It makes a very unpredictable ALJ adjudication process predictable and final. What is key when it comes to settlement, however, is knowing when to settle and how to negotiate terms. You do not want to short-change yourself by settling too early or taking less than what you believe you deserve. Your goal should be to get the best deal you can, while getting the finality you need.
DLHWC Reviews Any Settlement
Thankfully, the DLHWC provides one helpful safety measure in the settlement process. For any settlement of a Longshore Act claim, the DLHWC reviews the terms to make sure that they are “reasonable.” That said, the standard for reasonableness is not terribly high for the DLHWC, but it is a way in which the DLHWC can make sure that you have not settled for benefits that are woefully inadequate to the injury you suffered.
Get Help For Your Claim From Longshore and Harbor Workers Act Attorneys in Jacksonville
Our RITE Law attorneys focus on a Longshore Act practice. That experience can be invaluable if you make a Longshore Act claim, particularly in a new area such as COVID-19 illness. At RITE Law, we started the firm for one reason – to help those in Florida and elsewhere have the resources of a firm that was “big enough to fight but small enough to care.” At Rudolph, Israel, Tucker & Ellis (RITE law), we have the resources and experience to go to trial when it is necessary, and we have the wisdom to advise you appropriately.
Without help from the RITE Law Longshore and Harbor Workers Act Attorneys in Jacksonville, making Longshore Act claims can be very difficult. When you turn to our firm, we spring into action, making sure that every detail of your claim is addressed. Call us for help. Our number is (904) 500-RITE or you can fill out our contact form online. We provide a free case evaluation, so feel free to call us today.