When a worker is injured in the maritime industry one of the first questions asked is whether the maritime worker should file a claim for Jones Act workers’ compensation or one for Jones Act claim benefits. While state workers’ compensation insurance programs and the Jones Act both provide injured workers with important benefits and compensation, the two should not be confused.
Worker’s compensation programs are state-regulated programs and the benefits provided to injured workers are established by the laws of the individual state. The Jones Act is a federal statute that provides certain rights and protections to seamen who are injured in the scope and course of their employment. It is important to understand that injured maritime workers do not have the ability to choose whether they want to pursue a workers’ compensation claim or a Jones Act claim – the law will dictate whether your claim should be filed under a state workers’ compensation system, the Jones Act or other federal and state laws that provide compensation and benefits to injured maritime workers. These worker’s compensation laws can be hard to navigate and it is always best to consult with a lawyer who has extensive experience handling maritime accidents, Jones Act insurance compensation, and Jones Act claims.
Benefits Under A State Workers’ Compensation System
In the vast majority of cases, individuals working in the maritime industry will not be eligible to collect state workers’ compensation benefits when they are injured on the job. Rather, injured seamen and maritime workers will typically need to file a Jones Act claim, or various other acts that protect maritime employees such as the Longshore Harbor & Workers Compensation Act (LHWCA). If, however, your lawyer determines that your accident or injuries are covered by a state worker’s compensation program, you will generally be eligible to collect certain benefits such as:
- Compensation for medical bills
- Replacement income (weekly compensation payments)
- Compensation for permanent injuries
- Vocational rehabilitation/job retraining
- Survivor benefits when a worker is killed
Benefits Received After a Jones Act Workers Compensation Claim
If you are a maritime worker who is classified as “seamen” pursuant to the Jones Act you will be afforded certain legal rights and protections under the Act. These rights and protections include:
- Maintenance & Cure Payments – When a Jones Act seaman is injured on a ship or vessel, the maritime employer is required to pay the seaman maintenance and cure benefits. Maintenance benefits cover your cost of living on the land while cure benefits are meant to compensate you for the reasonable medical care you need to treat and recover from your injuries.
- Unearned Wages – Jones Act seamen have the legal right to collect unearned wages from their employers when they are injured. Employers must pay these wages from the time of the accident up until the completion of the voyage.
- Right to File a Jones Act Negligence Lawsuit – When a seaman’s injuries are caused by employer negligence or the negligent actions of a co-worker, the seaman has the right to file a negligence lawsuit against his or her employer. In a Jones Act negligence lawsuit the maritime employee is generally able to seek damages similar to those in a traditional personal injury lawsuit, which may include past and future medical care, lost wages, loss of earning capacity, pain and suffering, mental anguish, disability and disfigurement and the loss of enjoyment of life.
Does My Employer Need to Have Jones Act Insurance to Cover My Worker’s Comp Benefits?
If you are injured in a maritime accident, your own insurance company is not required to pay for your injuries. Instead, your employer should have a Jones Act insurance policy that covers workplace accident claims under the Jones Act. Typically, your employers’ insurance will cover your Maintenance and Cure benefits, as well as “transportation and wages” if you must remain at sea while you are injured. In order to recover compensation for negligence, however, you will need to file a lawsuit.
What Injured Seamen Need to Know about Jones Act Insurance
Many companies purchase Jones Act insurance to cover their employees’ job-related injury claims. If your employer has insurance, you may end up dealing with the insurance company instead of your employer. This can make the process more difficult, but an experienced Jones Act lawyer can still help you seek the full compensation you deserve.
If your employer has Jones Act insurance, this does not impact your legal rights in any way. You are still entitled to receive maintenance and cure benefits until you fully recover or reach maximum medical improvement (MMI), and you are still entitled to file a lawsuit based on unseaworthiness or Jones Act negligence.
Jones Act vs. Workers’ Compensation
Lots of offshore workers have questions about the differences between the Jones Act and workers’ compensation benefits. This is understandable—it is a confusing topic, and most employers don’t tell their workers what they need to know. But, if you’ve been injured on the job, you need to know how to protect your rights, and this starts with understanding which type of claim you need to file.
The Jones Act Applies If . . .
The Jones Act applies if you are a “seaman” and you have been injured while working on board a vessel “in navigation.” If you work on board a vessel offshore (not on a fixed rig or platform), then you are most likely covered under the Jones Act. The Jones Act also covers individuals who work on vessels navigating inshore waters, but it generally does not apply to land-based workers whose jobs require them to board a vessel from time to time.
Your State’s Workers Compensation Law Applies If . . .
Your state’s workers compensation law applies if you’ve been injured on the job and you are a land-based employee. Office workers, individuals who work in marina stores and restaurants, shipbuilders, and repairers who work on smaller recreational vessels, and other land-based workers will generally qualify. In most states, workers’ compensation covers all types of land-based workers with only a very limited number of specific exceptions.
What if you don’t fall into any of the categories listed above? If you work in the maritime industry and you don’t qualify as a seaman under the Jones Act and also don’t qualify as a land-based worker under your state’s workers compensation law, then you may qualify for benefits under the Longshore and Harbor Workers Compensation Act (LHWCA) or the Outer Continental Shelf Lands Act (OCSLA). These are federal workers’ compensation laws that provide benefits similar to those under state workers’ compensation systems—though there are some important differences as well.
Key Differences Between a Jones Act Claim and Workers’ Compensation Claims
There are several differences between the Jones Act and state workers’ compensation laws. Some of the key differences include:
- “No-Fault” Compensation – Maintenance and cure benefits under the Jones Act are intended to cover injured seamen’s medical bills and their basic daily living expenses. In contrast, workers’ compensation benefits typically cover injured employees’ medical bills and up to two-thirds of their weekly wage or salary.
- Fault-Based Claims – The Jones Act allows injured seamen to seek fault-based compensation from their employers (in addition to seeking “no-fault” maintenance and cure benefits). Workers’ compensation is exclusively a “no-fault” system, and employees who qualify for workers comp are unable to sue their employers in most cases.
- Fault–Based Compensation – Since the Jones Act allows injured seamen to file fault-based claims in many cases, this means that many injured seamen will have significantly more compensation available to them. In claims for Jones Act negligence and unseaworthiness, injured seamen can seek compensation for 100 percent of their lost earnings, their pain and suffering, and all other types of financial and non-financial losses.
- Location of Injury – Generally speaking, the Jones Act applies to accidents on the water, while workers’ compensation applies to accidents that happen on land. As discussed above, there are some cases in which the LHWCA or the OCSLA may apply instead.
- Deadline to File – In most cases, injured seamen have up to three years to file a claim under the Jones Act. In contrast, many state workers’ compensation laws have reporting deadlines that are much shorter, and some state laws require employees to report their injuries “as soon as possible”.
- Timeline to Receive Compensation – Workers should be able to start receiving “no-fault” benefits under the Jones Act and state workers compensation laws relatively quickly (although this isn’t always the case). However, it can take much longer to receive fault-based compensation under the Jones Act.
- Appeals Process – If your employer (or its insurance company) refuses to pay Jones Act benefits, you may need to file a lawsuit in either federal or state court. While employees will need to take their workers’ compensation claims to court in some cases, there is typically an administrative appeals process that comes first.
Can I File a Jones Act Claim and a Claim for Workers’ Compensation Benefits?
It is not possible to file a Jones Act claim and a claim for workers’ compensation benefits. You can qualify for one or the other, but not both. As a result, you need to make sure you know which type of claim you are eligible to file. To make sure you get it right, you should discuss your situation with a maritime injury attorney promptly.
Jones Act Insurance: How Do You File a Claim?
Many companies buy insurance to cover their liability under the Jones Act. If your company has Jones Act insurance, you will still need to deal with your company initially, though you may also eventually end up dealing with its insurer.
In order to seek benefits when your company has Jones Act insurance, you must first file an injury report. You will typically file this report with the vessel’s captain or senior officer (the captain or senior officer should provide a form for you to complete). The captain or senior officer should prepare a Report of Marine Accident, Injury, or Death (CG-2692) and then send both reports to the appropriate department within the company. This department will then start the claims process with the company’s insurer.
It is at this stage that you may hear from the insurance company directly. As is typical of insurance companies, Jones Act insurers don’t like to provide coverage if they don’t have to. As a result, if your company has Jones Act insurance, you can expect to face an uphill battle. In order to protect yourself, it is extremely important to have an experienced attorney on your side. Your attorney can deal with the company’s insurer for you—and he or she can also take the additional steps that are necessary to recover the full compensation you deserve.
Do You Have Questions About Your Jones Act Workers’ Compensation Case? We Can Help
If you have been injured at work on a vessel and have questions about the Jones Act claim benefits or workers compensation and which you may be eligible to collect from your employer, the Willis Law Firm can help. We have decades of experience advising and representing injured maritime workers across the nation. We’ll help you pursue compensation from your employer’s Jones Act insurance plan or through damages in a lawsuit. When you schedule a free consultation with our firm a maritime injury attorney will carefully examine your case and explain all of the benefits you may be legally entitled to.