If you have been injured on the job, or you have become ill because of your job, and you qualify under the status and situ tests of the Longshore and Harbor Workers’ Compensation Act (LHWCA), and have been denied compensation by your employer’s workers’ compensation insurer, you can file a claim to try to win benefits.
The claims process requires that you follow certain guidelines and meet deadlines, which come with some exceptions. It can be confusing to get through the process without making mistakes. If you are unsure how to proceed, turn to the advice of an experienced lawyer who has helped with these claims for previous clients. With the guidance of someone knowledgeable in maritime law, you have a better chance of having a smooth claims process.
LHWCA Reporting Deadlines
One of the most important things you will do in the process of getting workers’ compensation is reporting your injury or illness in a timely and accurate way. Any time that you have an accident at work or think that work has made you sick, regardless of the particular situation, you should report it immediately and get your superior to complete and submit the appropriate forms. For the LHWCA the requirement is that you file that report within 30 days of the incident. The report must be filed with your employer and with the Office of Workers’ Compensation Programs, the federal department that administers LHWCA claims.
LHWCA Reporting Deadline Exceptions
There are some reasonable exceptions to this deadline, however. For instance, it is possible that an incident at work could cause you to have a physical or medical problem later. A back injury might seem mild at first, for example, but become severe and debilitating later, especially if aggravated by working conditions. If you can make that connection to an accident or exposure on the job, but you don’t realize it until more than 30 days after the accident, the 30 day deadline is waived.
Another possible situation in which you may be exempted from the 30 day reporting deadline for the LHWCA claims process is in the event that you contract an illness or disease. It is not uncommon for an illness to appear or to be diagnosed long after the exposure at work that caused it. For example, people exposed to asbestos may develop mesothelioma, but not until years later. Not everyone who thinks they should be exempt from the deadline will be, so it is important that you always file a report as soon as possible.
LHWCA Statute of Limitations
There is also a statute of limitations on filing LHWCA claims. The law gives you one year from an injury or death to file a claim for compensation. If an employer has already been paying compensation, but stops and you want to file a claim, you have one year from the last payment to do so. For illnesses, the statute of limitations extends to two years beyond the discovery of the illness or the time at which you should have been aware of the illness and its connection to the workplace if you have sought appropriate medical care.
The Informal Conference
A claim for LHWCA benefits is something you file in the event that your employer’s insurance company refuses to pay you after an accident or illness. If you feel they are wrong in denying you compensation, then an LHWCA claim will help you fight for your right to be compensated. In filling out the appropriate form and filing a claim you are requesting an informal conference.
The purpose of the informal conference is not to come to a decision about your claim or to grant you compensation; it is simply for an examiner to look at your medical records and accident reports to determine whether it can be proven that you were injured when and how you claimed and that it caused you to be disabled in some way. This examiner can then recommend that you start to receive benefits.
If you get a recommendation from the informal conference you can then use that to request a hearing. Another form has to be filled out and sent to the Office of Workers’ Compensation Programs so that you can be assigned a Judge for a formal hearing. Before the hearing begins, both sides have time to conduct an investigation, request documents, and ask questions or take depositions. This discovery period allows you and your lawyer to develop your case. The pre-hearing investigation can take up to six months, so be prepared to wait for a final decision.
At the actual hearing, if your claim has not been settled, a federal Administrative Law Judge will hear your case and determine if you did in fact get injured or sick while at work. The Judge will also decide on other factors important to your claim like the extent of your resulting disability, whether or not you had a prior injury that contributed to the work injury, and finally if and how much your employer’s insurer should pay you in benefits.
In rare cases it is possible to get an expedited hearing. These emergency hearings are usually given to someone in serious financial need or who has had all medical benefits denied and cannot afford to pay for proper care. Simple financial hardship is not enough to be granted an emergency hearing. There have to be severe consequences for this to be given.
The claims process for the LHWCA can be confusing, especially if you are not an expert in the law. If you have been denied benefits, a knowledgeable lawyer experienced in filing claims and going through LHWCA hearings can help you get through the process with the best chances of winning your compensation. If you have been injured on the job or your workplace has made you sick, you have the right to compensation.