Health Conditions Not Covered by DBA

The insurance benefits afforded under a Defense Base Act Insurance policy provide comprehensive protection for workers who are employed to perform work overseas under a U.S. Government contract. In order for a claim to be compensable under DBA, it must be occupational in nature, meaning that an injury sustained or resulting in death must be directly related to an employee’s job duties.

While DBA benefits are equivalent to those afforded by domestic Workers’ Compensation, there are some excluded ailments, or conditions, that contractors and employees should be mindful of.

Heart attack and stroke are two afflictions that are typically not compensable DBA claims. However, these conditions may be considered if it is determined that the heart attack or stroke is stress-related due to the strenuous nature of the employee’s occupation.

Appendicitis is another ailment that is typically not covered by DBA. However, if the condition occurs while an employee is confined to a remote location such as a military base where medical services are limited, coverage for the claim could be allowable under the Zone of Special Danger doctrine, which broadens DBA benefits.

Suicide is never covered under DBA. In order to facilitate necessary counseling services to those employees who may be in need of assistance, employers should provide their on-location management team with the training they need to help identify employees who may be experiencing depression or other personal difficulties.

These exclusions are just a few examples of some ailments that are not generally covered under a DBA Insurance policy—but it is not a comprehensive list. As such, employers should submit every claim to their DBA Insurance company, regardless of the situation. The insurance carrier will review the claim and determine whether or not it will be eligible for compensation under the policy (the employer should never attempt to make this determination on their own!). By reporting every claim at the time it is presented, the employer avoids the risk of incurring a fine for late reporting and also the potential for wrongfully denying benefits owed to an employee in the event the claim is deemed to be compensable.

As the DBA Insurance broker for Allied World Assurance, the LATITUDE DBA Insurance team has a deep understanding of the complexities of Defense Base Act coverage. Contractors seeking DBA coverage should contact LATITUDE DBA Insurance today―we’d be happy to assist in creating an insurance plan that protects both the business and its employees against all overseas exposures.

 

Zone of Special Danger & Reasonable Recreational Doctrines

Zone of Special DangerWhen deployed overseas to war-torn or unstable locales around the world, living conditions for employees can be quite dangerous. They must be precautious, whether on or off base, working or not. Because of the volatile and remote locations in which many overseas U.S. Government contractors work, the Department of Labor chose to include two addendums to the Defense Base Act in order to broaden eligibility under DBA Insurance benefits.

Zone of Special Danger

The Zone of Special Danger doctrine broadens DBA Insurance benefit eligibility by making more types of claims compensable when an employee is confined to a “zone of special danger” (i.e. on military bases in Iraq or Afghanistan). Because of the doctrine, injuries stemming from activities normally not considered as part of the workday are given consideration under DBA because of the contained living environment.

While the scope of benefits may be expanded by the Zone of Special Danger doctrine, it does not mean that employees are covered 24-hours a day, regardless of the activities they engage in. Claims arising from activity that is completely disconnected from an employee’s employment are not compensable, in most cases.

Reasonable Recreation

The Reasonable Recreation doctrine allows consideration of compensation for claims arising from recreational activities for employees stationed in very remote or confined locations. Coverage is based on the premise that employees who are confined to such areas (i.e. Naval Bases on Marshall Islands or Guantanamo Bay) will engage in the limited recreational activities available to them. Injuries that are sustained as a result of these recreational activities may be considered for compensation.

The following claim examples illustrate how these doctrines affect eligibility for DBA benefits:

Example of compensable claim: An employee stationed at Guantanamo Bay was bitten by shark in the waters while swimming as a recreational activity. DBA benefits were payable under the Reasonable Recreation doctrine.

Example of claim NOT covered: A claim was filed by an employee stating he suffered psychological harm from the use of chemical peels during his employment in Kuwait. The employee was awarded benefits under the Zone of Special Danger doctrine. However, the DBA Insurance carrier later appealed the decision through the Benefits Review Board, resulting in an overturning of the benefits award on the grounds that the chemical peel treatment was personal in nature and not related to the employee’s employment.

As the DBA Insurance broker for Allied World Assurance, the LATITUDE DBA Insurance team has a deep understanding of the nuances of Defense Base Act coverage. We’re here to assist contractors in creating an insurance plan that protects both their business and its employees against all overseas exposures. Contact LATITUDE DBA Insurance today!

 

DBA Insurance Application Checklist

Defense Base Act (DBA) Insurance is a form of Workers’ Compensation Insurance required by the U.S. Department of Labor that is designed to provide benefits to employees working overseas to complete the contracted work. Contractors who have secured a contract with the U.S. Government to complete work overseas on military bases or other public works projects need to secure DBA Insurance before employees are deployed to begin the work.

To apply for DBA Insurance, contractors need to provide information about their business and the contracted work to an insurance agent who is well-versed in placing DBA Insurance. It’s important to be thorough in the information provided, giving as much detail as possible about the work to be done. This will help the insurance company underwriters provide the most competitive rate possible.

What information needs to be submitted to obtain a DBA Insurance quote?

A completed DBA Insurance application—While all contracts will be included under the same DBA Insurance policy, contractors will need to complete a separate DBA Insurance application for each contract secured with the U.S. Government. The application is provided by the insurance agent, and includes questions regarding:

  • Number of employees to be deployed and their class of work
  • Total payroll for all employees
  • Employee concentration (i.e. number of employees per flight, per land conveyance, per work location, etc.)
    • Underwriters don’t want to see more than 5 employees per flight due to the potential for a catastrophic loss
    • Good risk management for the contractor—could they afford to lose more than 5 employees at any one time should the plane crash?

 

Statement of Work (SOWs)—Required for each work contract, a Statement of Work is a comprehensive description of the project and the work to be completed. If the SOW is “classified,” be sure to state that on the application and provide a detailed statement of services in lieu of the SOW.

The Statement of Work is issued by the USG agency awarding the contract and will include any special distinctions or requirements of the contract. For example, a contract may require that employees carry a weapon for their personal protection due to the volatile environment in which they will be working. In a case like this, details of the requirement will need to be provided, including which employees will be armed and what training they’ve had on proper handling of the devices.

DBA Claim Loss Runs—The insurance underwriter will ask to review DBA claims history for the previous five years. The contractor will need to request loss runs (also called loss history) from the insurance carrier with whom coverage was placed in the past. If this is the contractors first time purchasing DBA Insurance, that fact should be indicated on the application.

The contractor’s insurance agent will assist in preparing these documents and, once complete, will submit the documents to carriers in the DBA Insurance market. The underwriters will review the submission and, in some cases, may ask for clarification or additional information in order to assess the risk and prepare a coverage proposal and quote.

As the DBA Insurance broker for Allied World Assurance, The LATITUDE DBA Insurance Program is a great option for DBA Insurance. Our team has a deep understanding of the complexities and unique business needs associated with government contracts, the Defense Base Act and DBA Insurance. Contact LATITUDE DBA Insurance today―we’re here to assist in the DBA Insurance application process and the creation of an insurance plan designed to protect a contractor’s business and its employees against all overseas exposures.

 

Required DBA Claim Filing Documentation

If an accident occurs and an employee is injured during the course of their work overseas, employers should be prepared to respond quickly by setting a DBA claim in motion. Below is a list of the required DBA claim filing documentation that the employer must complete to successfully file a DBA claim.

Information to Submit to the DBA

  • -The official DBA claim form—titled the Employer’s First Report of Injury or Occupational Illness (Form LS-202)—is available on the U.S. Department of Labor website. The LS-202 must be completed and submitted to the U.S. Department of Labor within 10 days of notice of the incident to the injured employee’s supervisor and/or the employer’s human resources department. Options for completing the form are listed at the bottom of the DOL web page.(Note: if the claim form is filed after 10 days, the employer could be assessed a fine of up to $11,000 by the Department of Labor. The fee applies to each late filing.)

 

Information to Submit to the DBA Insurance Carrier

In addition to completing and submitting the LS-202 form to the DOL, there are a number of items that must be provided to the DBA Insurance carrier. The information provided in the documentation will enable the carrier to determine if the claim is compensable under DBA benefits and includes:

  • Completed copy of the LS-202 claim form
  • Employee statement(s) of injury
  • Wage statement showing 52 weeks of the employee’s wages
  • Employee’s employment contract
  • DBA work contract number
  • Incident reports completed by the Project Manager or employee’s supervisor
  • Witness statement(s), if applicable
  • Reason for late reporting if the claim is filed beyond the 10 day required filing date
  • Medical records to support that the employee’s condition stemmed from the contracted work
  • Confirmation of any work time missed beyond the three day waiting period
  • Disability certificate that indicates the date of the first full day of missed work, as excused by the reporting physician
  • Medical and work status report (aka work release), as completed by the reporting physician
  • Employee’s current contact information and location
  • Additional required documentation if the claim is for death benefits, including:
    • Death certificate
    • Autopsy report
    • Birth certificate
    • Marriage certificate (if applicable)
    • Birth certificate(s) of dependent children (if applicable)

 

While proper job and safety training goes a long way in helping to keep employees safe, accidents can still happen. Knowing what’s required when filing a DBA claim will help facilitate a streamlined claim filing process and get benefits to the injured party in a timely manner.

As the DBA Insurance broker for Allied World Assurance, the LATITUDE DBA Insurance team has a deep understanding of the complexities of Defense Base Act coverage, including claims management, and can assist contractors in creating an insurance plan that protects their business and its employees against overseas exposures. Contact LATITUDE DBA Insurance today!