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BENEFITS UNDER THE DEFENSE BASE ACTThe first thing to be done after an injury or illness is to notify your employer, as soon as practicable, BUT NO LATER THAN 30 DAYS. Regardless of fault, even your own, you should be entitled to various benefits. I. MEDICAL TREATMENTAn injured employee has the initial right to obtain medical treatment from a physician of his or her choice. The term "physician" is defined to include a medical doctor, surgeon, psychologist, optometrist, podiatrist and dentist. A chiropractor is also included but his or her treatment is limited to spinal manipulation to treat subluxation. Although the employee has the initial free choice of physician, such person must obtain authorization from the employer or its insurance company if the employee wishes to change physicians. Your employer does have the right to have you examined by a doctor of its choosing to verify the need for treatment and continuance of payments of benefits. Failure to comply with such an exam could result in the stoppage of your benefits. The employee is entitled to all medical treatment, medical supplies, and other medical services related to the work injury as well as reimbursement for travel costs and mileage incurred in obtaining such treatment. II. LOSS OF EARNINGS OR DISABILITY OR DEATH BENEFITSDISABILITY BENEFITS Disability is defined as the inability to earn the same amount of wages as was being earned at the time of the injury. There is no compensation disability benefits paid the first three days unless the disability lasts longer than fourteen days. AMOUNT OF COMPENSATION PAYMENT In order to determine the amount of weekly compensation to which the employee is entitled, for most cases, the average weekly wage must be determined by calculating the employee's total gross earnings for the fifty two week period prior to the accident, including overtime, and dividing by fifty-two. The rate of compensation payments is two-thirds of the average weekly wage, subject to a maximum amount which adjusted upwards every October 1. TEMPORARY AND PERMANENT DISABILITY For Temporary Total Disability, the employee is paid two-thirds of the average weekly wage, subject to a maximum amount, while the employee is unable to return to work and is under medical care. If the employee is unable to return to any gainful employment due to his or her injury or occupational disease, and maximum benefit of medical treatment has been reached, permanent total disability benefits would be paid as set forth above, with a cost-of-living raise every October 1. PARTIAL DISABILITY - SCHEDULE If the employee is able to return to work, but has sustained a permanent injury to certain body parts such as hands, feet, legs, toes, fingers, eyes, and ears, compensation is payable for a number of weeks depending upon the percentage of loss to that body part. For instance, 10% schedule loss of use of a foot equals 20.5 weeks of compensation at the applicable compensation rate. Compensation for scheduled total loss of use of different body parts is as follows:
Partial Disability - Non Scheduled If the employee injuries certain other body parts such as head, neck, shoulders, and back and is unable to earn wages as much as the established average weekly wage at the time of injury, the employee would be entitled to non-scheduled permanent partial disability consisting of two-thirds of the difference between the average weekly wage and the lesser post-injury earnings. DEATH BENEFITS If a person dies as a result of an injury or occupational disease, death benefits are paid to the widow or widower and other eligible survivors as well as funeral expenses to a maximum of $3,000.00. The widow or widower would receive 50% of the deceased employee's average weekly wage for life. If, however, if the person remarried, that person would be paid a lump sum of two years of benefits. In addition, if there are surviving children, additional benefits would be paid for each minor child at the rate of 16 2/3% of the average weekly wage, subject to a maximum limit. WHAT TO DO IF YOU DO NOT RECEIVE YOUR BENEFITS OR YOU ARE UNSURE ABOUT YOUR BENEFITSIn the event you do not receive your proper benefits in a timely manner, or you receive a notice contesting the benefits, you should immediately contact an attorney because of the time limits protecting your rights to dispute the actions of your employer. Claims must be filed in the appropriate district office of the United States Department of Labor. The New York District covers all claims arising in Iraq, Afghanistan as well as all of Central and South American, Europe and Africa. Because the rate of compensation is the basis of both the temporary and permanent award, it is extremely important to establish the maximum Average Weekly Wage that you are entitled to, in light of past instances when the employer and or their insurance carrier did not include all the compensation and prior earning records so as to minimize your Average Weekly Wage. Additionally, and because awards for permanent partial disability are often based on the impairment rating assigned by the examining physician, such as a 20% permanent partial disability to the arm, it is important that your disability is properly assessed by a physician who is experienced and competent in establishing disability ratings. Psychological
and occupational illness such as carpal tunnel, hearing Remember, that even if you believe you are receiving your proper benefits, you should always contact an attorney before signing any documents or agreeing to any settlements or having any examination arranged by your employer. Most attorneys will not charge a consultation fee in these matters in an effort to help you. If the possibility exists, no matter how remote, that persons other than your employer might have caused your injury, you may have a claim separate from your compensation claim. Your employer or its compensation carrier has no obligation to advise you of this so consulting an attorney can be important for your future. If you do have such a claim, the law requires that a lien for compensation benefits paid against any recovery in the other claim. Jorden N. Pedersen, Jr., represents claimants in
Defense Base Act claims against persons other than your employer . There
is no charge for a consultation and there is no fee if there is no recovery in
Defense Base matters, Workers Compensation or Personal Injury. Your inquiries
will be promptly answered. Click
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