Defense Base Act & Longshore Act Medical Issues
We work for clients who are denied medical care, medical benefits and compensation that should be provided to injured and sick employees under the Defense Base Act and the Longshore and Harbor Workers Compensation Act.
Medical issues can take up a lot of your time, your daily care, your doctor visits and your FIGHT to get the medical care that you deserve by law.
We Call Our Clients Back ASAP
This is Our Promise
We CALL CLIENTS and we return phone calls. That’s just a matter of respect because we’re a family centered law firm that does things the old fashioned way. Sure we have e-mail, and yes we text clients, but we really prefer to talk to you face to face. In person. And we’ll fly to wherever you are to meet with you as you’re recovering.
We’re never going to put you off: we get right back with answers and if it takes a while, well, that may be because there is no answer–yet. And sometimes we call to tell you that there is not yet an answer.–Certainly not for any other reason because you need and deserve answers.
We Fly to Meet You
We might meet at a hospital, a restaurant, a home, a hotel lobby, anywhere there is a public or private place that you feel 100% comfortable talking to us.
We accommodate your needs and it’s our pleasure to help you to get better to get what you deserve. Garfinkel Schwartz only does Longshore law, Defense Base Act law, Non-Appropriated Fund Act law.
We know how incredibly painful and how terribly hard it is to be injured or sick. Going to doctors. Getting surgeries. Taking medicine. Going to rehabilitation. Then, suddenly, the insurance companies cut you off when you need health care and medical attention the most. It’s NOT fair and that’s why we do this.
Tricks Insurance Companies Use to Deny Your Claims
Hi this is Brian Wiklendt with Garfinkel Schwartz. I’m going to tell you tricks insurance companies use to deny your claim.
I’m here in Maitland Florida today in our office here. We also have an office in Cocoa Beach, Florida which is on the Space Coast. But our practice especially including the Defense Base Act takes me all across the country and pretty much all around the world.
What I’d like to do is talk to you very practically about insurance companies under the Defense Base Act. There are only a few of them that kind of monopolize the market.
Brian Worked In-House for Insurance Companies
We Know What They’re Capable of
I don’t like insurance companies because I used to be in-house counsel for an insurance company for a period of time. For a long period of time I was outside counsel for insurance companies so I know exactly how they work especially how they work under this law which is really, really bad.
No. 1: Watch Out for the Nurse Case Manager
I’ve had clients say that they didn’t get an attorney until they called me because the Nurse Case Manager said that she was going to take care of everything. Or the Insurance Adjuster said, “hey, once you get back home you’ll be treated like a king…blah blah blah.”
The thing you should be aware of just practically speaking is that every time an insurance company does something, they’re doing something to try to minimize your claim.
What I mean by that is if they ask for a recorded statement, why would they need a recorded statement from you? They already know what happened. They know that you were injured at work.
They want to try to find something that they can use against you in the future.
It’s the only reason that they would want a Recorded Statement from you. They have witnesses, they have the company who knows what happened to you, what the injury was. They don’t need that.
No. 2: Beware of Independent Medical Exam
Number two is why would they send you to an Independent Medical Exam at a doctor of their choosing? Wouldn’t that mean that they’re trying to figure a way not to rely on your treating physician who’s telling you that you need these things? You have the right to choose ANY DOCTOR. So do it.
That’s probably the only that’s the only purpose for sending you to an Independent Medical Examination. Is to try to get away with not having to pay for your medical care.
No. 3: Beware of Vocational Assessments!
Third thing, they do a Vocational Assessment. What is a Vocational Assessment?
Well someone from the insurance company interviews you about all of your qualifications all the things that you could possibly do physically even though you could be partially or pretty much permanently disabled.
They’ll be doing this Vocational Assessment to try to find jobs for you to help you get back on your feet? No! They’re doing it to find a job you can do so they can cut your benefits off.
What’s an Independent Medical Examiner?
They’re trying to find jobs they think they can qualify you to do to send those jobs and the qualifications and the physical requirements to send to their Independent Medical Examiner or Peer Review person to sign off and say yeah we can probably prove to a judge that he or she can do these jobs.
Well that obviously will reduce the benefits that they pay and that’s the only reason they do it.
An Independent Medical Examiner is any doctor that the insurance company hires to examine you. They can say that you’re ready to go back to work, that you’re faking symptoms, that you’re making it all up, that your doctor’s care is not necessary. So this is when you need a Defense Base Act Lawyer.
What is a Peer Review?
A Peer Review is worse: It’s the insurance company taking all the paperwork, not even necessarily seeing you or reviewing you in person. It’s an insurance company staffer who is hired to say, “OK, let’s cut the benefits down, he’s fine. Based on what I see here, no, he doesn’t need surgery and let’s get him back to work.”
You will need a lawyer to combat this when this occurs.
So what I always suggest is that because it costs nothing to talk to a Defense Base Act lawyer, not one penny. And no, no one’s going to be calling to sign you up. You have the right to ask any question you want about your case, about your situation.
Maybe you’re just out of the military. You’ve done your tours and you’re just taking your first job as a civilian contractor. The best thing you can do for yourself is to first get on the phone with a Defense Base Act lawyer.
Next, get yourself the form so that you can choose your physician and download the LS-1 Form from the website. It’s the First Choice Doctor Form that you complete before you go overseas. Add it to your checklist and then, keep one with you, and give one to your family. Give a copy to your employer when you’re hurt. Keep it with you and list all the specialists that you may need back home in the states.
Do a search for a neurologist, a psychologist, an orthopedic specialist, a PTSD doctor, any doctor you want to treat you should something occur that’s out of your control. We don’t like to think of the worst case scenario, but you can be prepared.
Then, you have the required paperwork to get them to take you to your doctor at NO CHARGE to you.
What is a Labor Market Survey?
They don’t do it for your benefit. After the Vocational Assessment there’s what’s called a Labor Market Survey done on you. And that they try to search for and find jobs that pay enough money that it will affect your bottom line as to what your compensation rate should be in the future.
In other words they try to qualify you to do a job so they can cut you off.
A Labor Market Survey is when they find you a job. You may be a translator, but you have PTSD. They’ll scan the labor market for ANY job, menial, physical or not relevant to you and probably under your level of skill and pay. They assess your physical ability and tell the judge, “he can do this job,” just to minimize or cut your benefits off.
They one time told a client that he could work in horse racing as a handicapper. That’s how hard they work to find you a job. But when you have an attorney to fight for you, you’ll be able to fight it with the truth. You’re not left to hang out and figure out how you’re supposed to take the ridiculous jobs they suggest.
What is a Functional Capacity Evaluation?
Another two things the insurance companies do to try to minimize your claim or get away with not paying you are:
Number One: they want you to go to a Functional Capacity Evaluation. They’re looking for exaggeration, they’re looking for any type of thing that they can think of to say that you’re not trying your best, doing exercises and doing these different bending and lifting things that you may or may not be able to do.
And they only simply do the Functional Capacity Evaluation to try to get you back into the work force under their terms and not under your or your doctor’s terms. So be aware of the Functional Capacity Evaluation as well.
Beware: They Will Do Surveillance on You
Finally a lot of times if the case is really and it looks like long-term care is going to be needed, including possible surgery, it’s not unlike, it’s not, it’s not uncommon for the insurance company to do surveillance on you.
Other Tricks: Questioning Your Statements
And that’s just another one of the tools that they have in their arsenal to try to get you trapped up and explaining during maybe in an initial written statement or oral statement they ask you for maybe in a deposition if you’re not represented. They’re going to try to twist your words and say “you acted like you couldn’t do anything, and we saw you in your yard cutting your grass, picking up your kids…blah blah blah and then they’ll try to say that you’re untrustworthy to the judge.
So those are all the things that the insurance companies do to people regardless of you individually because you’re just simply a number to them and they want to try to minimize the number that they’re going to have to pay you.
What Does a DBA Lawyer Do? Fight for Client Claims
So that’s all I (Brian Wiklendt) do for a living: I fight for the true value of the claims, the medical claims, the financial benefits, for people that I represent but it’s one definitely worth pursuing.
Insurance Companies are NOT Helping You
Like I said sometimes they act like they’re trying to help you out and doing all these things. There’s absolutely no reason why they would do any of these things other than to try to minimize what they have to pay you.
And so anytime you start to feel a little uncomfortable about these things that they’re trying to do that’s the time you’ve got to call an attorney.
Don’t Fight Alone: You Don’t Have To
If you don’t call me, please call somebody else that specializes in the Defense Base Act because it’s complicated, and they have giant resources and an entire industry on their side playing these games to try and reduce or completely cut off your benefits.
So again I’m Brian Wiklendt with Garfinkel Schwartz. I’ll come to you to your home town. You can call me anytime 24 hours a day at 1-800-393-2999. Check out my website, our website is www.DefenseBaseActLaw.com
Brian Wiklendt again signing out thanks for listening in Maitland Florida.
Who Are You Going to Talk To?
We are who we say we are: I’m Brian E. Wiklendt a federal lawyer that practices Defense Base Act Law and Longshore Act Law and Non-Appropriated Funds Act Law. You’ll first speak to me or to my paralegal Doreen Cabral. Doreen is also going to answer the phones and manage communication.
We don’t handle 10 different kinds of law. Just Longshore Act and Defense Base Act. You won’t get calls from a stranger to do your intake. You’ll hear from me: Brian, or from Doreen. I’ve been doing this since 1996 personally, Doreen since 1982. We know what we’re doing and we are happy to help you.
You’ll meet and work with us every step of the way through your case from the paperwork, which we will help with. All the way to your final settlement hearing.
And we take all the risk. I’m going to be very blunt with you if you have a case or if you don’t have a case. I’m going to evaluate what’s going on and listen to everything that you say. Everything you tell us, on the phone, on e-mail, in-person, in court, is confidential. Even if you decide we’re not the law firm you want, we keep your confidential information private. We look forward to hearing what happened to you.
Common Medical Issues:
- Post Traumatic Stress Disorder (PTSD)
- Traumatic Brain Injuries
- Respiratory Illnesses
- Constrictive Bronchiolitis
- IED Explosion Injuries
- Back Injuries
- Loss of Limb
- Muscle Tears
- Severe Burns
- Broken Bones
- Hearing Loss
- Gunfire Wounds
Covered Medical Care Under the Longshore Act and Defense Base Act includes:
- Physical Therapy
- Medical bills
- Non-scheduled permanent partial disability
- Permanent partial disability
- Permanent partial disability for retirees
- Permanent total disability
- Temporary partial disability
- Temporary total disability
If you’re like most people who are injured or sick, you desperately need the health care, prescriptions, surgeries, rehabilitation, and physical therapy to recover. You want to get better so you can not only care for yourself, but for your family.
Medical care is your primary concern, so it’s our concern. You are the reason we work so hard. Our goal is to help get you the medical benefits that you were denied and that you deserve. This is a challenge for anyone who doesn’t have medical care because you can’t afford to go to the doctor.
We Advance Medical Evaluation Costs
Garfinkel Schwartz advances the costs of your medical evaluation. This means that we pay for the evaluation at a doctor of your choosing. We do not pay for medical care, however, by having the medical evaluation you’re able to prove to the insurance companies that yes, there is indeed a medical condition.
Often, employers and insurers try to prevent the medical examinations by an independent doctor who has not been provided by the insurer. An insurance company’s doctor will not always allow the tests for medical conditions that can prove you have:
- Traumatic Brain Injury
- Respiratory Illness
However, Garfinkel Schwartz will pay for the tests because this provides clients with proof that there is indeed a medical condition.
If the doctor shows that there is nothing wrong, then those results will be provided. The goal is to be tested by an independent, non-insurance company doctor in any city, state or country that you need. You need unbiased, honest medical evaluations to help you prove that yes, there is a medical condition.
You Pay No Legal Fees
The Defense Base Act Law was created to protect people from having to pay for medical care, or from having to pay an attorney to fight for medical care against powerful insurance companies. You pay no legal fees.
Garfinkel Schwartz is paid by the Department of Labor. There is a stringent billing process and form that cannot be altered. All legal bills are reviewed meticulously. All hours, all costs are covered by the Department of Labor in Defense Base Act and Longshore Act cases. You should not worry about legal fees when you’re already trying to get medical care.
Likewise, you should not have to pay for a medical condition that was received while working for the U.S. government or the Department of Defense as a contractor. You are owed benefits if you have a lack of earning capacity in your future. If you are permanently or partially disabled, Garfinkel Schwartz will fight to get you the medical benefits that the law provides you.
We will pay for medial evaluations if we do take your case and we take all the risk. By law, employers and insurance companies have to pay medical benefits, future medical benefits and compensation when there is an injury or illness proven to the insurance companies.
Learn More on Our YouTube Channel
You can learn more by watching videos on the Garfinkel Schwartz YouTube channel. We explain some of the tactics that insurance companies and DoD employers use to deny you medical care that is rightfully yours.
Lead counsel Brian Wiklendt explains the Defense Base Act Law, the Longshore Act, answers questions about how we get things done for you. Brian introduces our law firm and how we work with people just like you across the country. We fly to you if we take on your case. That way you can heal while we proceed with your case.
Garfinkel Schwartz is a Maitland, Florida, and Cocoa Beach, Florida, law firm. We are federal lawyers who work with private military contractors, civilian contractors, defense contractors, Department of Defense sub-contractors, federal contractors, government service employees who work in war zones or combative locations overseas in Syria, Afghanistan, Iran, Iraq, Africa, Europe, Russia, or any other country.
Garfinkel Schwartz provides Longshore Act help to longshoremen and women, harbor workers, shipbuilders, port workers and U.S. federal waterways, coasts and docks workers who were injured or sick on the job. They’ve been badly hurt while unloading holds in ports of call; port cities like Port Canaveral, Florida, working on docks and harbors loading and unloading ship cargo. Diving accidents, or having had limbs crushed or injured in shipping accidents.
Garfinkel Schwartz will do everything possible to provide clients superior legal services by providing the communication that we would want if we were the client or if we were the patient.
We’ve All Been Patients
“We have all been patients and we are working with folks who have been in the medical system for so long that we try to put ourselves in the shoes of our clients and their families that support them,” Alan Garfinkel said.
“We understand that it’s the wives and the daughters and the sisters and the brothers and the sons who are all affected by this. And we take the clients’ situations personally. We want to be sure that everyone is treated like family. We are available for the families to support them and their needs. This is our approach to our business by helping one family at a time.”
Garfinkel Schwartz Helps You Find the Best Medical Care
Why is medical care such a big part of what Garfinkel Schwartz provides clients? Because the Defense Base Act and Longshore Act law protect your rights to medical care and compensation. The laws provide you with medical care from doctors of your choice. Your successful recovery, your survival, your comfort, you peace of mind comes to you when you have a healthy mind and body.
The insurance company is required to pay for your all reasonable medical care. And if we are hired by you, we can help get you access to the medical recommendations on treatments, surgeries, medications they have to pay.