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!