If you work as a federal contractor abroad or are considering taking such a job, you likely know that you have workers’ compensation coverage under the Defense Base Act (DBA). But you may still be wondering, What does the Defense Base Act cover?
What Benefits are Provided By the DBA?
A logical starting place in figuring out the answer to, What does Defense Base Act insurance cover? is an exploration of what benefits the DBA includes. According to the Department of Labor (DOL), the benefits provided by Defense Base Act insurance coverage fall into four different categories:
- Medical treatment,
- Disability compensation,
- Death benefits, and
- Vocational rehabilitation.
A more in-depth explanation of each of these categories is necessary to understand what benefits the DBA provides.
DBA insurance coverage includes compensation for any medical costs associated with treatment for an injury you sustain at work. Depending on the injury and the circumstances surrounding it, medical costs can include:
- Emergency room,
- Limb replacement,
- Mental health treatment,
- Physical therapy,
- Other medical specialists, and
- Follow-up costs for any of the above.
Essential to any covered medical costs is that they are reasonably medically necessary to recover from the injury.
It is important to know that you have the initial choice on which (Department of Labor approved) physician to see for treatment. It is important to choose your physician carefully, as they will be the ones to recommend you to other medical specialists for treatment. Furthermore, your physician is key in determining what is reasonably medically necessary to treat your injury. Most importantly, you typically have to stick with the initial physician of your choice through the duration of your treatment. It is possible to change physicians, but it is not easy.
There are only two ways to change physicians. The first way to do so is by agreement between you and your employer. This may not be a problem at all, but that is not always the case. For example, if your employer thinks you are trying to receive extraneous treatment, they may not readily agree to a physician change. By proxy, your employer’s insurance carrier may not always be willing to agree to a physician change either. The other option for changing physicians is to petition the Secretary of Labor for an order to do so. Either of the options can take months, and neither is guaranteed to work.
If you need help changing physicians, contact an experienced DBA lawyer to help guide you through the process as soon as possible. To avoid changing physicians, we recommend that you consult with an experienced DBA attorney before choosing your physician. An experienced DBA attorney can help you decide which physician will be the best fit for your specific injuries and personal circumstances.
If you are disabled due to your work-related injury or become disabled as a result of your work, you are eligible for disability compensation. Your disability compensation is generally two-thirds of your average wages. Disability benefits may be temporary or permanent and include disabilities that are either total or partial. Disability is subject to annual cost-of-living increases. Finally, DBA insurance may pay a lump sum for permanent disability to individuals who are legal aliens residing in the U.S. and non-U.S. citizens living outside of the U.S. The lump sum, however, is only 50% of the value of future compensation.
If you die as a result of your work-related injury, your spouse or family is entitled to compensation. If you do not have a spouse or children, DBA insurance will cover burial expenses of up to $3,000. If you do have a spouse, your spouse is entitled to 50% of your average wages in addition to burial expenses. That rate will increase to two-thirds of your average wages if you have a child under the age of 18. Your spouse is also eligible for the increased benefits if your child is between 18 and 23 and enrolled in school full-time. Like disability compensation, death benefits are subject to annual cost-of-living increases, and a lump sum payment is possible.
Vocational rehabilitation is available under DBA insurance to help disabled workers return to work. You will be eligible for vocational rehabilitation only if you are unable to return to employment without assistance. Typically such vocational training is to help you return to work in a different occupation or a different capacity in a similar field. These benefits are available only if there are appropriate opportunities for returning to work within your geographic area.
Is Fault a Requirement in a DBA Claim?
DBA workers’ compensation coverage intends to work just like other workers’ compensation in the United States. In line with this, workers’ compensation coverage under the DBA is a form of no-fault insurance coverage. Someone covered by a no-fault insurance policy does not have to prove anyone else’s fault for insurance coverage to kick in. Furthermore, an injured person’s own fault or negligence, with limited exceptions, is not called into question in a DBA claim.
Just like with workers’ compensation rules, there are exceptions to the no-fault rule under the DBA. If you hurt yourself while engaging in reckless horseplay at work (like wrestling in an electrical plant), your employer does not have to compensate you for damages. In addition, if you intentionally hurt yourself at work, your employer does not have to compensate you for your injuries under the DBA workers’ compensation protections. The same applies if you are drunk or otherwise intoxicated at work when you sustain an injury. These three categories exemplify the majority of exceptions to the DBA’s no-fault rules. Other limited exceptions may also exist. If you are unsure whether your injury or disability circumstances fall under an exception to the no-fault rule, consult with a DBA attorney.
Who Is Covered by the DBA?
Generally, DBA insurance covers anyone employed outside the continental United States by a federal agency. This includes anyone working as or for a contractor or subcontractor hired by a federal agency. Foreign nationals, U.S. citizens, and U.S. legal residents are all covered by the DBA. The number of different jobs that are covered by the DBA is practically infinite. On a military base, for example, the types of jobs covered could include:
- Heavy machinery operators,
- Manufacturing workers,
- Commercial divers,
- Kitchen workers,
- Security contractors,
- Cultural advisors, and
- Social scientists.
Since a military base abroad can operate effectively as a self-sufficient city, the list is endless. For practically any job you can think of, there is likely someone covered by the DBA.
Are There Any Exceptions to Who Is Covered by the DBA?
Yes, there are exceptions to who is covered by the DBA. The exceptions, however, are limited. Further, anyone not covered by the DBA will likely have substantially equal workers’ compensation protections.
Any federal agency or department head can apply to the DOL for a “DBA waiver” concerning a specific contract, work location, or class of workers. If an employer wants to waive DBA rules, the critical requirement for acquiring a DBA waiver is that the employees subject to the waiver must otherwise have coverage through a compulsory workers’ compensation system. In addition, that compulsory system must meet DBA standards.
DBA waivers cannot apply to workers who are:
- Citizens of the United States;
- Legal residents of the United States; or
- Employees hired in the United States.
The OWCP publishes a list of countries that have active DBA waivers; you can find it here. If you are unsure whether a DBA waiver covers you, it is best to ask your employer directly.
What If My Employer Does Not Have DBA Insurance?
It’s common to wonder what happens if you suffer an injury at work and then find out that your employer does not have the mandated DBA insurance. It is a scary situation to find yourself in that can compound the stress of any injury.
If this happens to you, don’t panic. While it may not be as simple a process as a basic DBA claim, you will still be able to get compensation for your medical costs and lost wages. Instead of filing a DBA claim, you will have to file a personal injury lawsuit against your employer. You may also want to report your employer to the DOL or OWCP.
In addition to your personal injury suit, your employer can face steep penalties if they violate the DBA. If convicted, an employer who does not have the proper DBA coverage can be liable for a fine of up to $10,000, one year of incarceration, or both.
If you need to file a personal injury lawsuit against your employer after finding out they don’t have the required DBA insurance, contact an experienced DBA lawyer for help. A personal injury attorney may be helpful, but a lawyer experienced with the DBA’s ins and outs is a much better option. The fact that your employer violated the DBA will help your case in court, and an experienced DBA lawyer will be much better prepared to work this angle in your case.
Contact Us Today
If you need help with a DBA claim in any way, contact us at Grossman Attorneys at Law today either online or call us at 1-800-940-8048 for a free consultation. We are available 24 hours a day, seven days a week, all around the world. Whether you need help choosing a doctor or need help resolving a complex dispute over a claim, we can help. As the DBA is our firm’s sole focus, we know its ins and outs. We have likely helped solve similar problems in the past, so we are ready to set you up for success. Don’t wait—get help now!