The Defense Base Act provides critical workers’ compensation protection for civilian contractors injured while supporting U.S. government operations overseas. Despite this protection, many valid claims are denied or delayed, often leaving injured contractors without income or medical coverage when they need it most.
Understanding why Defense Base Act claims are commonly denied helps contractors respond effectively and protect their legal rights.
Failure to Timely Report the Injury
One of the most frequent reasons for denial is late reporting. Contractors are generally required to notify their employer of an injury within thirty days. For occupational diseases, such as respiratory illness or hearing loss, the timeline may be longer, but insurers still closely scrutinize notice requirements.
In overseas environments, injuries are often reported informally or delayed while the contractor attempts to work through symptoms. Insurance carriers may argue that late notice prevented proper investigation, even when the delay was reasonable given the circumstances.
Disputes Over Whether the Injury Was Work-Related
Another common defense is the claim that the injury did not arise out of employment. Insurers may argue that an accident occurred during personal time or that the injury was caused by unrelated activities.
The Defense Base Act includes the Zone of Special Danger doctrine, which can cover injuries that occur outside normal work hours if employment placed the contractor in a dangerous or isolated environment. Many denials hinge on whether this connection is properly documented and explained.
Allegations of Pre-Existing Conditions
Insurance carriers frequently deny claims by asserting that the injury or illness existed before deployment. This is especially common in cases involving back injuries, joint problems, cardiovascular conditions, or psychological injuries.
Under the Defense Base Act, aggravation of a pre-existing condition is compensable. If overseas employment worsened or accelerated an existing condition, benefits may still be owed. Medical records and expert opinions are often critical in overcoming this defense.
Insufficient Medical Evidence
Claims are often denied due to a lack of detailed medical documentation. Vague diagnoses, incomplete treatment records, or failure to clearly link the condition to overseas employment give insurers room to challenge the claim.
Contractors who rely solely on employer-selected physicians may face reports that minimize or downplay the severity of injuries. Independent evaluations can help establish the true nature and cause of the condition.
Challenges to the Severity or Duration of Disability
Even when an injury is accepted, insurers may deny or terminate wage benefits by claiming the contractor is able to return to work. Disputes frequently arise over maximum medical improvement, work restrictions, and ongoing disability.
These disputes can significantly impact wage replacement benefits and long-term financial stability, particularly when contractors cannot return to comparable overseas work.
How Contractors Can Respond to a Denial
A denied claim is not the end of the process. Contractors have the right to challenge denials through the U.S. Department of Labor. Responding effectively requires careful documentation, timely filings, and a clear presentation of how the injury relates to overseas employment.
Medical records, witness statements, employment contracts, and deployment history often play a central role. Early action is important, as missed deadlines can permanently bar recovery.
Protecting Your Rights After a Denial
Defense Base Act claims are often denied not because they lack merit, but because insurers aggressively contest liability. Contractors injured overseas face unique challenges, including delayed treatment, limited records, and complex jurisdictional issues.
Understanding the most common denial tactics allows contractors to respond strategically and protect access to medical care and wage replacement benefits.
Responding When Your Claim Is Challenged
When a Defense Base Act claim is denied, informed action makes a difference. For guidance on responding to denials and protecting your rights under the Defense Base Act, contact Barnett, Lerner, Karsen & Zobec, P.A.
Disclaimer: This article is for informational purposes only and does not constitute legal advice. Each Defense Base Act claim is unique. For advice specific to your situation, consult a qualified attorney.