dba claims process

With any subject, getting a sense of how all the pieces work together can be invaluable in understanding that subject. Chemistry can be a bit easier if you look at how the table of elements relates to the overall picture. Your experience at the DMV might be less frustrating if you are aware of all the steps that DMV officials need to make sure your driver’s license is accurate.

Know-How All the Pieces Work Together

To give a very literal example of understanding the big picture, consider the often crazy-making activity of putting together a cabinet or other piece of furniture yourself. That classic scenario of trying to build a piece of IKEA furniture or something that comes in a box from Target has been fodder for many a funny sitcom or movie scene.

Yet, if you really want that furniture to look and function as good as it can and keep your sanity in the process, then try this trick – leaf through the instruction guide all the way to the end.  Look at the totality of steps you need to take at the beginning.  That brief process will then prepare you for the task at hand.  If you don’t do this, then it will feel like each step is just another impossible task in a never-ending series of tasks using only an annoying Allen wrench.

Of course, the same is true for understanding the workers’ compensation process under the Defense Base Act. If you are a civilian working for the U.S. military overseas, then your workers’ compensation plan is administered by the Department of Labor under the Defense Base Act (DBA). What is key to the DBA claims process is an understanding of all of the players in the process, and how they fit together. Just like the IKEA furniture, if you know all the pieces of the puzzle ahead of time, you will be better able to effectively navigate the DBA claims process.

That said, it is always a good idea to have an experienced DBA attorney in your corner.  Having practiced law in the world of the Defense Base Act for decades, the ideal Florida attorneys to help you with the DBA claims process are the experts at Rudolph, Israel, Tucker, and Ellis, P.A. So, if you are reading this because you are looking to make a DBA claim yourself, then we welcome you to call us today at 904-500-7483. RITE law knows how to maximize your compensation under the DBA.

The DBA Players

The first step in understanding the full DBA claims process picture is to know all of the players.  Those players are as follows:

  • Your employer,
  • The DBA insurance carrier,
  • You, as the employee, and

We will discuss each player’s responsibility in some detail.

Your Employer’s Responsibilities

Compliance with the government workers’ compensation program that is the Defense Base Act starts with your employer. Your employer’s responsibilities begin long before any injury occurs.

As an initial matter, your employer must secure Defense Base Act workers’ compensation insurance before any employees are deployed overseas. Once the DBA insurance is secured, then your employer must post a notice to all employees regarding the DBA coverage.  That is typically done by posting the Department of Labor form, called an LS-241 form. Your employer must also inform you, and all employees, about DBA benefits and how to report a work-related injury.

In the event that you are involved in a work-related injury, your employer must file a report of the injury within ten days of receiving notice from you about the injury. The employer must also notify the insurance carrier of your injury.

Further, your employer has the responsibility to authorize medical care when requested, or upon learning of the injury.  Your employer must also provide medical, earnings, employment, and other records to the Department of Labor’s Office of Workers’ Compensation Programs (OWCP) when requested.

Finally, your employer must also assist you in filing a DBA claim for benefits.

The Insurance Carrier’s Responsibilities

The insurance company chosen by your employer for DBA coverage must file a form with the relevant Department of Labor District Office, informing the Department of its role as DBA insurer. It also has the responsibility of educating your employer about its rights and responsibilities under the DBA.

In the event of a work-related injury, the insurance carrier essentially stands in the shoes of your employer. Thus, upon getting notice of you being in a work-related injury, the insurance carrier must investigate the compensability of the claim, and determine if your DBA claim for medical care and compensation is payable.

The insurance carrier must also make sure that the necessary medical care has been authorized, and that the medical providers understand how to handle billing. The insurance carrier has 14 days from the first day of disability to pay compensation to you.

If the insurance carriers find that your benefits should be delayed or denied, then it must file a Notice of Controversion with the OWCP within 14 days of when compensation is due.

Finally, the insurance carrier has the job of keeping the OWCP apprised of your compensation status and any necessary medical reports.

Your Responsibilities as the Employee

If you are injured in the course of your work, then you also have a number of responsibilities.  First, you must report a work-related injury to your employer as soon as possible. You should also request authorization for medical care when necessary. Under the DBA, you have a choice of your treating physician, but your treatment must be authorized in advance.

As the injured employee, you also must cooperate with your employer and the insurance carrier in their investigation of your DBA claim, which includes providing any documents or medical reports. You also will need to attend a medical examination arranged by your employer, the insurance carrier, or the OWCP when requested.

You also must complete a report of your earnings (form LS-200) and a written Claim for Compensation within a year of your injury.

Let Experienced Jacksonville Attorneys Assist You in the DBA Claims Process

As you can see, you as the employee are an important party with responsibilities, just like your employer and the relevant insurance carrier. To make sure that you fulfill all of your responsibilities and protect your DBA claim, call the experts at RITE law. We are ready to help you handle the DBA claims process. Call today at 904-500-7483.