Understanding “Maintenance and Cure” After a Maritime Injury

Maintenance and cure have been a form of compensation for injured and sick maritime employees for a very long time, as the right to maintenance and cure is deeply rooted in maritime common law. Provided for under maritime law, employer-provided maintenance and cure is a policy ensuring that maritime workers receive the medical care, treatment and financial support that the injured workers need while they recover from an injury or illness that they sustained while working. Maintenance and cure is paid for injuries as well as illnesses suffered by the worker.

Maintenance and cure laws are designed to favor the injured worker. For instance, if there are any doubts or ambiguities as to how the injury occurred, these doubts and ambiguities are resolved in favor of the injured worker. Similarly, maintenance and cure are no-fault benefits, meaning that they are provided to an injured worker regardless of whether the injury is the vessel owner’s, the employer’s, or the worker’s own fault. Even if the worker had a pre-existing condition, if working aboard the ship caused an injury that exacerbates the worker’s pre-existing condition, the worker will still be entitled to maintenance and cure.

Maintenance

The “maintenance” portion of maintenance and cure is intended to cover the maritime worker’s room and board expenses (i.e., day-to-day expenses) for the duration of his or her recovery period (i.e., until the worker is fit to return to duty) or until the worker is deemed to have reached maximum cure by a physician. A failure by the employer to pay adequate maintenance can open the employer up to a punitive damages claim by the injured worker.

A wide array of expenses are covered by maintenance benefits. Essential living expenses are covered by maintenance, including rent or mortgage payments, essential utility bills (electric, water, gas, etc.), property taxes, homeowner’s insurance, and food costs, but maintenance cannot be used to cover non-essential household expenses, such as internet, phone, cable, and car payments.

Cure

Cure specifically refers to the injured maritime worker’s reasonable and necessary medical expenses. At the outset of the injury or illness, this means that the employer is responsible for providing care while aboard the ship and taking steps to get the injured or sick worker to treatment on land as soon as possible.

Upon arrival on land, cure is also meant to cover the costs associated with any emergency medical care and the cost of transporting the injured worker to and from the emergency care. After the injury or illness has stabilized, cure is intended to cover doctor’s visits, surgeries, diagnosis, testing, hospital bills, expenses related to therapy and other courses of treatment, medical devices and aids needed by the worker (i.e., hearing aids, wheelchairs, medical implants, etc.), and any transportation to or from appointments or medical treatment.

The injured worker is permitted to choose his or her own doctors or specialists during the course of his or her treatment. The employer, or the employer’s insurance provider may offer other doctors for a second opinion of the worker’s cure state, or may seek to terminate paying for the injured employee’s treatment before the worker has reached maximum cure. If there is a discrepancy over whether treatments should be continued, these discrepancies are resolved in favor of the injured worker receiving more treatment.

What Is The Duration, Rate and Payment Schedule Of Maintenance and Cure?

An injured employee will generally receive the benefits of maintenance and cure until a doctor has assessed his or her medical condition and determined that the worker has reached the maximum medical improvement that is possible based on the individual, his or her injury, and the amount of recovery that is possible to achieve. This does not necessarily mean that the worker has recovered 100% from the injury. For example, in situations where a worker suffers a permanent injury, such as a permanent disability, the payment of maintenance and cure will terminate when the worker’s treating physician determines that the worker has recovered as much as he or she is ever going to. Maintenance and cure benefits will not be paid for the life of the worker’s permanent disability.

Payment of Maintenance and Cure

Maintenance and cure are paid for by either the injured worker’s employer, or the employer’s insurance provider, but each is paid in a slightly different way.

  • Since maintenance is intended to cover the living expenses of the injured worker for the duration of recovery, maintenance is paid to the injured worker on either a weekly or biweekly basis. How much maintenance an injured worker receives depends on his or her actual normal household living expenses. If the injured worker lives in an area with a high cost of living, and his or her normal monthly household expenditures are $2,000, this is how much the injured employee will receive in maintenance. Maintenance is paid according to the worker’s actually household expenses. However, the amount of maintenance paid to the injured worker might be reduced if the worker is a union member with a union contract indicated that the worker is only entitled to a lower amount of maintenance.
  • Cure, on the other hand, is meant to cover any and all expenses related to the injury and treatment of the injury, and as such cure will be paid as medical expenses are accrued. These expenses are paid for directly by the injured worker’s employer or the employer’s insurance provider.