A Defense Base Act
Claim Overview

If you are hurt on the job, we are the team that can help you.Barry R. Lerner


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In an effort to ensure your understanding of this claim, we would like to take a moment of your time to explain the legal proceeding, notice requirements, and documentation which we will require in order to assist us in the prosecution of your claim. Now that we have filed your claim with the U. S. Department of Labor (DOL), we must now wait for them to notify the insurance carrier that a claim has been filed and that we represent you. You will receive a copy of that notification. We must wait 30 days from the date of that letter before we can take any further action. If the 30 days passes, and the insurance company has not paid you or authorized medical care, we can then ask the DOL to send your file to the Office of Administrative Law Judges for a trial. A Judge is the only one that can force the insurance company to pay you or authorize medical care.


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We understand that you will be receiving medical treatment near your home with doctors with whom you are comfortable. It is extremely importantly you keep our office notified of the names, addresses, and telephone numbers of each and every doctor that you treat with during your medical recovery. You have already executed a HIPAA compliant medical release, which allows us to speak to your treating physician and obtain a copy of your records. We can only communicate with the doctors that we are aware of, thus it is your obligation to keep our office continually advised of each and every doctor you treat with. Please do not consider diagnostic testing to be immaterial. Should you attend a diagnostic test (MRI, CAT scan, etc.), please provide us the name, address, and phone number of the facility, so that we may obtain the appropriate records. Additionally, you have the right to be reimbursed for your prescription expenses along with your mileage expenses traveling to and from your physicians. In order to assist you, we are enclosing a mileage reimbursement request. We would suggest that you make multiple copies of this form, fill the form as you gather your requests and send them to our office periodically so that we can assist in ensuring timely reimbursements. Please send in your prescription requests as well.

During the course of your medical recovery, you may be entitled to wage compensation benefits. These benefits are paid during the course of your disability as outlined by your treating physicians. If your treating physician writes a report indicating that you are unable to work as a result of your work related injuries, then you may be entitled to temporary total disability benefits which should represent two-thirds of your pre-accident average weekly wage. Your pre-accident average weekly wage is calculated by reviewing your wages earned during the fifty two (52) weeks preceding your work accident. The law has both a minimum and maximum compensation rate and you can call the office for the rates for your date of accident.

If you believe the insurance company is not paying you the correct amount of compensation based upon your prior earnings, please advise our office immediately. We will request that you provide our office a copy of all the payroll records or documentation you have. (i.e. pay stubs, direct deposit receipts, tax returns, 1099’s, W‑2’s…)

At some point your treating physicians may advise you that you can work on a limited basis, with restrictions. We call this a Alight duty@ release. During this phase, you should first contact your employer to see if they have any work available within your restrictions. If your employer does not have work available, we would encourage you to look for work within the restrictions imposed by your doctors. If you are treating with more than one physician, we would only recommend you seek employment after ALL of your physicians agree that you can work light duty.

If you are unable to secure light duty employment, you may be entitled to ongoing compensation. If you do secure a light duty job, and this job pays less than you were earning prior to your accident, the insurance company may have the obligation to pay you two-thirds (b) of the difference between your pre-accident earnings and your light duty job.

As you continue with your medical treatment, there may be a point in time where you doctor(s) tell you that there is nothing more they can do for you and that you are at maximum medical improvement. Once this happens, it is very important you contact our office immediately. The law provides future compensation upon maximum medical improvement, however the calculations and class of benefits depends on your injuries.

There may come a time when your doctors allow you to return to work and you are fortunate enough to find work. If this new job pays more than you were earning before you got hurt, then your compensation will end. If you are able to work for 12 consecutive months earning more money then your right to future compensation will be forever discharged. However, if your doctor expresses a concern that, regardless of your new job, your medical condition may continue to deteriorate, you must advise our office immediately. This is very significant and will require that we file a claim to ensure your wage claim is protected due to a worsening of your medical condition. If we are not notified about a possible future deterioration, we cannot file the protective claim.

We understand that you will be receiving medical treatment near your home with doctors with whom you are comfortable. It is extremely importantly you keep our office notified of the names, addresses, and telephone numbers of each and every doctor that you treat with during your medical recovery. You have already executed a HIPAA compliant medical release, which allows us to speak to your treating physician and obtain a copy of your records. We can only communicate with the doctors that we are aware of, thus it is your obligation to keep our office continually advised of each and every doctor you treat with. Please do not consider diagnostic testing to be immaterial. Should you attend a diagnostic test (MRI, CAT scan, etc.), please provide us the name, address, and phone number of the facility, so that we may obtain the appropriate records. Additionally, you have the right to be reimbursed for your prescription expenses along with your mileage expenses traveling to and from your physicians. In order to assist you, we are enclosing a mileage reimbursement request. We would suggest that you make multiple copies of this form, fill the form as you gather your requests and send them to our office periodically so that we can assist in ensuring timely reimbursements. Please send in your prescription requests as well.

If the insurance company denies your claim, we understand this could cause severe financial hardship on you and your family. It is important to remember that if you decide to file for Bankruptcy protection, you must list this DBA claim as a potential asset in any bankruptcy filing. Failure to list this claim in a bankruptcy proceeding could possibly result in the dismissal of your DBA claim.

We hope this correspondence provides you some insight into how your case will proceed. During the case, should we need to go to trial, we will require your compliance with discovery information. We may ask you to forward us documents, answer questions, or participate in your claim. It is extremely important that you recognize that any time we request your assistance to either provide documents or answer questions, that you do so expeditiously, as there are time constraints placed upon the parties, and we would not want to delay your claim by not providing this information timely.

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