Why are Maintenance and Cure Benefits Denied?

Maintenance and Cure Mar 15, 2022

The Jones Act entitles many offshore workers to maintenance and cure benefits when they get injured on the job. With only a couple of exceptions, companies are supposed to pay these benefits regardless of whether they are responsible for their employees’ injuries. Yet, maintenance and cure denials are common. Why is this the case? And, if your employer has denied your maintenance and cure claim, what are your options?

7 Reasons for Maintenance and Cure Denials Under the Jones Act

Here are seven common reasons for maintenance and cure benefit denials:

1. Lack of “Seaman” Status

To be eligible for maintenance and cure benefits, you must qualify as a “seaman” under the Jones Act. While many offshore and maritime workers qualify as seamen, some do not. If you are not a seaman, then you aren’t entitled to maintenance and cure, but you may have other legal rights.  

2. Work Not In Service of the Vessel’s Mission

Maintenance and cure benefits are only available to seamen who get injured while working in service of their vessel’s mission. While this is to be interpreted broadly, companies will often deny benefits when seamen fail to prove how and when they got injured.

3. Injury Not Work-Related

Companies will also deny maintenance and cure benefits when injured seamen fail to prove that their injuries are work-related. The Jones Act does not cover all injuries that prevent seamen from working, but instead only those that seamen suffer on the job.

Another common excuse companies use when denying maintenance and cure is the McCorpen defense. This defense allows companies to deny benefits to seamen who have pre-existing medical conditions but only in very limited circumstances.

4. Willful Misconduct or Intoxication

The Jones Act does not entitle seamen to maintenance and cure benefits when they intentionally injure themselves. It also does not provide benefits to seamen who get hurt because they are intoxicated on the job.

5. Lack of Proof

Simply being eligible for maintenance and cure is not enough. To receive maintenance and cure benefits, injured seamen must prove that they qualify. If your employer is questioning your seaman status or the cause of your injury, you may need to submit the additional proof in order to collect the benefits you deserve.

6. Rejecting or Abandoning Medical Care

Case law under the Jones Act entitles employers to deny benefits to seamen who reject or abandon medical care for their on-the-job injuries.

7. Bad-Faith Maintenance and Cure Denials

Finally, while there are several legitimate reasons why companies can deny maintenance and cure benefits, many companies deny benefits in bad faith. As a result, seamen should never assume that a denial is justified.

Talk to a Lawyer About Your Maintenance and Cure Claim

If you have been denied maintenance and cure benefits, you should speak with a lawyer about your claim promptly. Depending on the reason for the denial, a lawyer may still be able to help you collect benefits. For a free, no-obligation consultation, call 800-468-4878 or tell us how we can reach you online now. 

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