|
 Printer-Friendly Version
The Law
The program was enacted by Congress in 1927, with the passage of the Longshore and Harbor Workers’ Compensation Act. Our Office is under the Office of Workers Compensation Programs which also administers the Black Lung Act and the Federal Employees' Compensation Act. The Office of Workers' Compensation Programs is responsible for administering the Longshore Act through 13 District Offices located throughout the United States. The Longshore Act also includes three other Acts for which the same laws apply:
Nonappropriated Fund Instrumentalities Act - Employees of facilities on military bases that provide support services to military personnel, such as Post Exchanges, bowling alleys, etc. The wages of these employees are not paid from Government funds — they are paid from the profits of the facility, i.e., Nonappropriated funds.
Outer Continental Shelf Lands Act - Covers Primarily Oil rig employees.
Defense Base Act - Contractors with the United States on overseas bases. Cases are initially reported to the New York, Boston, or Honolulu District Offices, depending on which side of the world the injury occurs, and then transferred to the District Office that is responsible for the State in which the claimant resides.
Despite the widely diverse employment activities covered by these Acts, the same compensation rates and rules apply to the administration of these Acts as they do to the Longshore Act
Jurisdiction
The District Office in Jacksonville is responsible for the 7 southeastern states from Alabama to the west to Tennessee and Kentucky to the north. As of April 1, 1996, all new injuries occurring in the state of Mississippi are filed in our District 7 Office in New Orleans. However, our office still handles all injury claims which occurred in the state of Mississippi prior to April 1, 1996. We adjudicate claims informally by letter, telephone, and in face to face meetings between the parties known as Informal Conferences.
Case Handling
When the First Report of Injury is received in the District Office from the employer, we jacket the report and give it a case file number. At the same time, a postcard is automatically sent to the insurance carrier or Servicing Agency with the hope that all future correspondence will contain our case file number. Last year, our office received over 138,000 pieces of mail — so it is important that the case file number is put on each piece of mail so that it can be easily matched with the case file and taken to the Claims Examiner for review and/or any indicated action. At the present, we have 2 mail room employees to do this work.
The new cases are taken to the Claims Examiner within 30 days of jacketing. There are 8 Claims Examiners authorized for the Jacksonville District Office. The Claims Examiners have a Contact Representative assisting them. These Reps are experienced in the handling of Longshore claims and will be able to help you in many instances without referral to the Claims Examiner. You are encouraged to speak with the Contact Rep when you initially contact our office and try to resolve any problems you may have. If they cannot help, then the call will be referred to the Claims Examiner for a return call.
The senior Claims Examiners are out of the office for some period of time each month holding Informal Conferences throughout the District, and are not always available. The District Office has a conference docket for all states in the district and the Claims Examiners travel to various cities, as assigned, to hold Informal Conferences in cases that have been listed on the docket. The cases listed on the conference docket are those in which the Claims Examiner has been unable to resolve a dispute by means of correspondence. The conference is an informal meeting between the claimant, his attorney, the insurance carrier, and its representative or attorney, and the Claims Examiner to try to amicably resolve the dispute. The conference cannot be recorded and testimony of witnesses is not taken.
At the end of the conference, the Claims Examiner will review the results and if agreement is not reached, the Claims Examiner will attempt to make a recommendation for the parties' consideration. Recommendations made by the District Office's Claims Examiners are not binding — they are recommendations which are made based upon our knowledge of the laws governing the Longshore Act and our knowledge of the decisions rendered by the Courts in Longshore cases.
However, if either party does not agree with the recommendation of this office, the claim will be referred to the Office of Administrative Law Judges for a formal hearing on receipt of Form LS-18, Pre Hearing Statement. The recommendation made by the Claims Examiner may not by law be referred to the Office of Administrative Law Judges. The Formal Hearing is recorded, witnesses' testimonies are taken, and evidence is received into the official record as exhibits. The decision issued by the Administrative Law Judge is binding.
If the carrier proceeds to a Formal Hearing and an Order is issued against the carrier, the award must be paid within 10 calendar days of the date the Order is filed, or a 20% penalty will be due. The only way a carrier can be relieved of this payment is to receive a Stay Order from the Benefits Review Board. The only way a Stay Order will be issued is if the Benefits Review Board finds that payment of the Order will cause the carrier irreparable harm, and this is seldom done.
Disfigurement Schedule Awards
The Act also provides for payment for serious disfigurement to the head, face or neck, or to some other portion of the body normally exposed which would likely handicap the claimant in obtaining or maintaining employment. The maximum money amount paid in a disfigurement case is $7,500.00. The DOL Claims Examiner will schedule an Informal Conference in disfigurement cases, or the parties may submit photographs in order for the Claims Examiner to make a recommendation for a reasonable money figure to compensate the claimant for his disfigurement.
| 
