A painful injury far from home, lost earnings, laborious paperwork, uncertainty: Defense Base Act claims are already stressful enough.
So a rejected claim can feel like adding insult to injury. Insurance companies count on claimants feeling too overwhelmed and disheartened by the denial of a claim to pursue it any further.
That’s why you need a Defense Base Act attorney. A good DBA attorney knows how to navigate an illegitimate denial and help claimants get the benefits they deserve, whether they’ve suffered a physical injury or a psychological one such as PTSD.
If your claim was denied, your DBA attorney’s job isn’t over. Here’s what they need to do to fight for your rights:
Your Defense Base Act Attorney Needs to Provide Complete Evidence
Insurance companies try to find any reason they can to deny your claim–so don’t let your paperwork give them one. Your lawyer should help you double-check that all your supporting evidence is in your claim.
Maybe insurance claimed your injury wasn’t a workplace one. Additional documentation can prove that your injury still fell under the “zone of special danger” doctrine. This rule provides coverage for activities that are necessary to perform your job even if the injury wasn’t directly related to your job duties.
If you were injured driving to the grocery store because your base doesn’t provide all your meals, for example, then you likely qualify for zone of special danger coverage.
Your DBA Attorney Needs to Look at Settlement Options—And Reject Unfair Ones
Defending a claim denial in court can get messy and expensive—so insurance providers don’t like doing it if they don’t have to. That’s why if your claim has reached an impasse, your lawyer should be reaching out to insurance to ask about a settlement.
Sometimes the threat of a court case is enough to push insurance to offer a fair amount as a settlement. If they try to underpay you, however, it’s time to move forward with a legal case. Settlement negotiations may be on the table again later as the case progresses—but never accept less than you deserve.
Preparing For Court and Filing Appeals
If you and your attorney have provided all necessary documentation and had a fair settlement offer rejected, then it’s time to take the claim to the legal system.
First, your lawyer needs to schedule an informal conference with a local branch of the Office of Workers’ Compensation Programs (OWCP), a division of the Department of Labor (DOL). The OWCP looks at evidence from both sides and makes a recommendation about whether the claim should or shouldn’t be denied.
The recommendation isn’t legally binding, but it is a legally required step before taking the case further. If either side disagrees with the OWCP, they can send the case to the DOL’s Office of Administrative Law Judges (OALJ). A trial before an OALJ Administrative Judge usually takes a few days.
If either side disagrees with that trial’s decision, they can continue to appeal it. And as long as courts agree that merit for an appeal is present, the case can continue to move upwards.
Your attorney should appeal to the DOL’s Benefits Review Board (BLB). From there, they can go to the US Court of Appeals.
Throughout this process, your attorney needs to continue paying close attention to legal deadlines to ensure your appeal rights are protected. In some scenarios, it may be appropriate to ask a judicial body to reconsider its decision before appealing it up the chain.
Don’t Let Insurance Companies Overwhelm You
When you’re recovering from a physical injury or PTSD and worried about the future, the last thing you need is to navigate a DBA denial alone.
Your Defense Base Act attorney can help you through this difficult time. Contact us at Barnes Law Firm to learn more about filing a new DBA claim or responding to a denial. We can help you get the benefits you deserve.