What happens if there is a dispute with the longshore district?
If a dispute arises concerning the necessity of treatment, the frequency of treatment, the type of treatment provided, or the amount of fees billed, the Longshore District Director (or his/her designee, the Claims Examiner) will attempt to resolve the dispute informally.
What do I do if my Longshore claim is denied?
If you disagree with the reasons for the denial, you may also contact the Longshore Claims Examiner handling your claim to seek assistance and guidance. Provide your rationale and any supporting documentation, such as earnings records, wage statements and medical reports from your doctor, for review.
What is Section 8 (I) of the Labor Act?
Section 8(i) provides the requirements for the settlement of claims under the Act. This provision was substantially amended by the 1984 Amendments, following which the Department of Labor promulgated new regulati ons, effective January 31, 1986.
Can a Longshore district director order a change of treating physician?
If the employer or insurance company objects to the referral or to your request for a change of physician, the Longshore District Director may order a change of treating physician if good cause exists for the change. The employer or insurance company may also request that your treating physician be changed for good cause.
What happens if a Section 8(i) settlement is disapproved?
What is Section 8(i)?
What to do if a settlement is disapproved?
What is Section 14(f) in a settlement?
Which court case referred to the authority of the deputy commissioner to approve settlements?
Can a settlement agreement be conditioned?
Does a compromise and release form constitute an application for Section 8(i) settlement?
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Section 8(i) Settlements Are Final and Cannot Be Modified
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Settlements and Section 8 - Legal Answers - Avvo
Most settlement income is not counted in the Section 8 income calculations. So long as it is for a personal loss (injury or the like) or a property loss, it should not be included, unless it is disability or unemployment money.
Department of Labor OWCP Defense Base Act Workshop - DOL
Settlements and Commutations 1. Concluding a Claim by Settlement – the Basics 2. Settlements Involving Foreign National 3. Commutations – the Basics
Creditors ex rel. Bankr. Estates of Jevic Holding Corp. v ... - Casemine
Get free access to the complete judgment in Creditors ex rel. Bankr. Estates of Jevic Holding Corp. v. Cit Group/Business Credit Inc. (In re Jevic Holding Corp.) on CaseMine.
BENEFITS UNDER THE DEFENSE BASE ACT - DOL
Oct 08 OWCP/DLHWC 5 Compensation is Determined by Average Weekly Wage (AWW) • Temporary Total (TTD): 2/3 of the AWW • Temporary Partial (TPD): 2/3 of employee’s loss of wages • Permanent Total (PTD): 2/3 of the AWW • Permanent Partial (PPD): • 2/3 of loss of earning capacity (2/3 unscheduled PPD) or, • TTD for a defined number of weeks for a % of permanent
What happens if a Section 8(i) settlement is disapproved?
Where a Section 8(i) settlement application is disapproved by the deputy commissioner, any party to the settlement may request a hearing before an administrative law judge or submit an amended application to the deputy commissioner. 20 C.F.R. §702.243(c). Accordingly, this case was properly forwarded to the administrative law judge once the settlement was disapproved by the deputy commissioner. However, the administrative law judge erred in finding the settlement should have been deemed approved as the application did not comply with the regulations.. Although a claims adjuster for employer did sign the portion of the settlement application regarding the settlement of the disability claim, his failure to sign the portion of the settlement application which dealt with settlement of the medical benefits renders the entire settlement application incomplete; under 20 C.F.R. §702.243(e), if either portion of a combined compensation and medical benefit settlement is disapproved, the entire application is disapproved unless the parties indicate on the face of the application that they agree to settle each portion independently. McPherson v. Nat’l Steel & Shipbuilding Co., 24 BRBS 224 (1991), aff’d on recon. en banc, 26 BRBS 71 (1992).
What is Section 8(i)?
Section 8(i) provides the requirements for the settlement of claims under the Act. This provision was substantially amended by the 1984 Amendments, following which the Department of Labor promulgated new regulations, effective January 31, 1986. 20 C.F.R.
What to do if a settlement is disapproved?
If the proposed settlement is disapproved by the district director, the parties may either request a hearing before an administrative law judge or submit an amended settlement application. 20 C.F.R. §702.243(c). If the administrative law judge disapproves a settlement following a hearing, the parties have the option to submit a new application, file an appeal to the Board, or proceed with a hearing on the merits of the claim. Id. If the settlement is initially disapproved by the administrative law judge, the parties may either submit a new application or proceed with a hearing on the merits. Id. The district director or administrative law judge must explain the reasons for rejecting a settlement agreement with sufficient particularity so as to allow a proper review of his determination. Sablowski v. Gen. Dynamics Corp., 10 BRBS 1033 (1979); see 20 C.F.R. §702.243(c).
What is Section 14(f) in a settlement?
In a case where employer paid the 20 percent penalty under Section 14(f), giving the Board jurisdiction over the appeal, the Board held that the parties may negotiate claimant’s entitlement to or waiver of a Section 14(f) assessment in a Section 8(i) settlement, as the assessment is additional compensation and claimants may waive their rights to compensation through a Section 8(i) settlement. In this case, claimant and employer entered into a Section 8(i) settlement which provided for claimant’s waiver of the Section 14(f) assessment in the event he did not provide a “valid street address for purposes of delivery of the settlement proceeds.” Claimant supplied his correct street address but the USPS refused delivery because claimant did not have a mailbox at that address. Consequently, delivery of the proceeds was late. Because the district director did not address employer’s argument that claimant violated the settlement clause, the Board vacated the Section 14(f) assessment and remanded the case to the OALJ for fact-finding on this issue. D.G. [Graham] v. Cascade Gen., Inc., 42 BRBS 77 (2008).
Which court case referred to the authority of the deputy commissioner to approve settlements?
In Clefstad v. Perini North River Associates, 9 BRBS 217 (1978), the Board held that both deputy commissioners and administrative law judges had the authority to approve proposed settlements under the Section 8(i)(A) of the 1972 Act. The Fifth Circuit, however, held that administrative law judges were not authorized to approve such settlements, but could only recommend approval or disapproval and then remand the case to the deputy commissioner for ultimate approval. Ingalls Shipbuilding Div. Litton Sys., Inc. v. White, 681 F.2d 275, 14 BRBS 988 (5th Cir. 1982). The Board followed White only in cases arising in the Fifth Circuit. In Blake v. Hurlburt Field Billeting Fund, 17 BRBS 14 (1985), which arose in the Eleventh Circuit, the Board reaffirmed its holding that both deputy commissioners and administrative law judges may approve settlements and expressly refused to adopt the Fifth Circuit’s view in White. The Board noted that its determination was consistent with the 1984 Amendments.
Can a settlement agreement be conditioned?
settlement agreement may be conditioned and restricted, as long as it is in accordance with law. For example, the Board has held that a settlement agreement providing benefits for Section 8(c)(13) permanent partial disability could be made contingent on the end of total disability. Sablowski v. Gen. Dynamics Corp., 10 BRBS 1033 (1979).
Does a compromise and release form constitute an application for Section 8(i) settlement?
The filing of a compromise and release on a state form with the district director does not constitute an application for a Section 8(i) settlement where: 1) it does not satisfy the requirements of the regulations; 2) it is not submitted in accordance with Section 8(i); and
What is Section 8 settlement?
Section 8 (i) settlements may be in the form of a lump sum settlement or a structured settlement, i.e., one that provides for continuing periodic payments. [n13] In the broader workers’ compensation context, structured settlements are often funded by an annuity purchased from a life insurance company and held for the claimant’s benefit by employer/carrier. [n14] Alternatively, employer/carrier may wish to assign its periodic payment obligation under a structured settlement to a third party. [n15] If a “qualified assignment” is made in accordance with Section 130 of the Internal Revenue Code (IRC), all payments made to claimant are tax-exempt. [n16] The qualified assignment is achieved by the employer/carrier assigning its future payment obligation to a third party, typically an affiliate of a life insurance company, which, in turn, insures its risk by purchasing an annuity from its parent. It thus allows employer/carrier to eliminate a liability from its books. [n17] Qualification of the assignment is also important to assignment companies because without it the amount they receive to induce them to accept periodic payment obligations would be considered income for federal income tax purposes. [n18]
What is Section 8 (i)?
Section 8 (i) provides for the approval of settlements unless inadequate or procured by duress. 33 U.S.C.S. § 908 (i) (1); [n3] 20 C.F.R. § 702.243 (f), (g). The recent Board decision in Richardson v. Huntington Ingalls, Inc., 48 BRBS __ (May 26, 2014), affirming the ALJ’s approval of a settlement application over the objections of the Director for the Office of Workers’ Compensation Programs (OWCP), highlights the challenges attendant to the determination of “adequacy” and illuminates the standard to be applied in reviewing settlement applications.
Why did the ALJ reject the settlement?
The OWCP Director urged the ALJ to reject the settlement because the parties had failed to establish its adequacy.
What is the settlement agreement in McShane?
In McShane, the ALJ stated that: “ [t]he Settlement Agreement provides for the funding of an annuity which would relieve Respondents of any liability for payments to be paid by the annuity insurer. I advised the parties that that provision is unacceptable and that Respondents cannot be relieved of the liability for paying the annuity amounts in the event, though unlikely, that the annuity insurer fails to make the payment.” A revised settlement, which addressed the ALJ’s concerns, was ultimately approved in this case.
Which case cited the contract principles of Section 8 (i)?
11. The Director observed that the Board and the courts have recognized that contract principles apply to section 8 (i) settlement agreements in the absence of superseding provisions in the Act, citing Oceanic Butler, Inc. v. Nordahl, 842 F.2d 773, 780-781, 21 BRBS 33 (CRT) (5th Cir. 1988) (recognizing that where Act is silent on an employer's right to withdraw from an 8 (i) agreement, employer could have reserved right by means of a contractual provision).
Does the District Director have authority to require the parties to a section 8 settlement to obtain Medicare pre-approval?
6. The OWCP Procedure Manual states that: “ [t]he [District Director] has no authority to require the parties to a section 8 (i) settlement to obtain Medicare pre-approval, nor to deny the settlement as inadequate absent such pre-approval.” Available at: http://www.dol.gov/owcp/dlhwc/lsproman/proman.htm#03-0501-12. The Board adopted this position in Bomback v. Marine Terminals Corp., 44 BRBS 95 (2010) (stating that “even if Medicare is applicable, there is no requirement that the adjudicatory officer require the parties to obtain Medicare pre-approval nor can she deny the settlement as inadequate for failure to obtain such approval,” citing the OWCP Procedure Manual).
When was the ALJ's 11/21/13 order of remand issued?
The ALJ’s 11/21/13 order of remand stated that “ [t]he parties have submitted an application to approve a settlement to the District Director and he issued a compensation order on July 13, 2013 that settles the claim for medical benefits before this matter was administratively remanded to OWCP. I concur with his order.”
How long does it take to file a claim with the OWCP?
In addition to the Notice of Injury given to your employer, you should file a written claim with the OWCP within one (1) year after the date of injury; or, if the employer has been voluntarily paying compensation benefits, you should file a written claim within a year of the last payment of compensation.
Who pays for LHWCA?
These benefits are typically paid by the self-insured employer or by a private insurance company on the employer's behalf.
What is the OCSLA?
Outer Continental Shelf Lands Act (OCSLA) - The OCSLA covers employees working on the Outer Continental Shelf of the United States in the exploration and development of natural resources, for example, off-shore oil drilling rigs. To learn more about the OCSLA, please see the OCSLA section of our website.
How long do you have to give notice of injury?
You must give a written notice of injury to the employer within 30 days of the occurrence of the injury or within 30 days of when you become aware that you have an injury or disability related to the employment. You should use Form LS-201, Notice of Employee's Injury or Death, for this purpose.
Who is excluded from LHWCA?
The LHWCA also excludes the following individuals if they are covered by a state workers' compensation law: Individuals employed exclusively to perform office clerical, secretarial, security, or data processing work; Individuals employed by a club, camp, recreational operation, restaurant, museum, or retail outlet;
Does the LHWCA extend to other types of employment?
Congress extended the LHWCA to include other types of employment. Employees covered by these extensions are entitled to the same benefits, and their claims are handled in the same way as Longshore Act claims. The following are the extensions of the LHWCA:
What happens if a Section 8(i) settlement is disapproved?
Where a Section 8(i) settlement application is disapproved by the deputy commissioner, any party to the settlement may request a hearing before an administrative law judge or submit an amended application to the deputy commissioner. 20 C.F.R. §702.243(c). Accordingly, this case was properly forwarded to the administrative law judge once the settlement was disapproved by the deputy commissioner. However, the administrative law judge erred in finding the settlement should have been deemed approved as the application did not comply with the regulations.. Although a claims adjuster for employer did sign the portion of the settlement application regarding the settlement of the disability claim, his failure to sign the portion of the settlement application which dealt with settlement of the medical benefits renders the entire settlement application incomplete; under 20 C.F.R. §702.243(e), if either portion of a combined compensation and medical benefit settlement is disapproved, the entire application is disapproved unless the parties indicate on the face of the application that they agree to settle each portion independently. McPherson v. Nat’l Steel & Shipbuilding Co., 24 BRBS 224 (1991), aff’d on recon. en banc, 26 BRBS 71 (1992).
What is Section 8(i)?
Section 8(i) provides the requirements for the settlement of claims under the Act. This provision was substantially amended by the 1984 Amendments, following which the Department of Labor promulgated new regulations, effective January 31, 1986. 20 C.F.R.
What to do if a settlement is disapproved?
If the proposed settlement is disapproved by the district director, the parties may either request a hearing before an administrative law judge or submit an amended settlement application. 20 C.F.R. §702.243(c). If the administrative law judge disapproves a settlement following a hearing, the parties have the option to submit a new application, file an appeal to the Board, or proceed with a hearing on the merits of the claim. Id. If the settlement is initially disapproved by the administrative law judge, the parties may either submit a new application or proceed with a hearing on the merits. Id. The district director or administrative law judge must explain the reasons for rejecting a settlement agreement with sufficient particularity so as to allow a proper review of his determination. Sablowski v. Gen. Dynamics Corp., 10 BRBS 1033 (1979); see 20 C.F.R. §702.243(c).
What is Section 14(f) in a settlement?
In a case where employer paid the 20 percent penalty under Section 14(f), giving the Board jurisdiction over the appeal, the Board held that the parties may negotiate claimant’s entitlement to or waiver of a Section 14(f) assessment in a Section 8(i) settlement, as the assessment is additional compensation and claimants may waive their rights to compensation through a Section 8(i) settlement. In this case, claimant and employer entered into a Section 8(i) settlement which provided for claimant’s waiver of the Section 14(f) assessment in the event he did not provide a “valid street address for purposes of delivery of the settlement proceeds.” Claimant supplied his correct street address but the USPS refused delivery because claimant did not have a mailbox at that address. Consequently, delivery of the proceeds was late. Because the district director did not address employer’s argument that claimant violated the settlement clause, the Board vacated the Section 14(f) assessment and remanded the case to the OALJ for fact-finding on this issue. D.G. [Graham] v. Cascade Gen., Inc., 42 BRBS 77 (2008).
Which court case referred to the authority of the deputy commissioner to approve settlements?
In Clefstad v. Perini North River Associates, 9 BRBS 217 (1978), the Board held that both deputy commissioners and administrative law judges had the authority to approve proposed settlements under the Section 8(i)(A) of the 1972 Act. The Fifth Circuit, however, held that administrative law judges were not authorized to approve such settlements, but could only recommend approval or disapproval and then remand the case to the deputy commissioner for ultimate approval. Ingalls Shipbuilding Div. Litton Sys., Inc. v. White, 681 F.2d 275, 14 BRBS 988 (5th Cir. 1982). The Board followed White only in cases arising in the Fifth Circuit. In Blake v. Hurlburt Field Billeting Fund, 17 BRBS 14 (1985), which arose in the Eleventh Circuit, the Board reaffirmed its holding that both deputy commissioners and administrative law judges may approve settlements and expressly refused to adopt the Fifth Circuit’s view in White. The Board noted that its determination was consistent with the 1984 Amendments.
Can a settlement agreement be conditioned?
settlement agreement may be conditioned and restricted, as long as it is in accordance with law. For example, the Board has held that a settlement agreement providing benefits for Section 8(c)(13) permanent partial disability could be made contingent on the end of total disability. Sablowski v. Gen. Dynamics Corp., 10 BRBS 1033 (1979).
Does a compromise and release form constitute an application for Section 8(i) settlement?
The filing of a compromise and release on a state form with the district director does not constitute an application for a Section 8(i) settlement where: 1) it does not satisfy the requirements of the regulations; 2) it is not submitted in accordance with Section 8(i); and