The Longshore and Harbor Workers’ Compensation Act (LHWCA) provides a workers' compensation program covering certain maritime workers to provide wage loss and medical benefits. Maritime workers must fulfill various requirements to qualify for LHWCA benefits for their on-the-job injuries, including “status” and “situs” tests. The “status” test will identify if the employee’s job falls into a covered category, while the “situs” test identifies if the work location is covered.
HealthSmart Casualty Claims Solutions evaluates claims by performing the status and situs tests, then manages claims cost-effectively for our clients while ensuring appropriate benefits are provided to the employee.
- Determine responsibility for claims with thorough investigations
- Ensure claims are legitimately filed by individuals who meet “status” and “situs” standards
- Identify claims that pose greatest risk to engage legal counsel at the earliest time possible
- Encourage employer’s legal counsel to engage when legal defense becomes necessary
When legal counsel is necessary, we provide the necessary documents to our clients’ attorneys and works diligently in the review of evidence and helps in the decision process of whether to pursue litigation further or to accept liability. When a claim is accepted for payment, we make indemnity payments on behalf of the client in a timely manner and within the regulatory time frames. This includes payments to medical-related vendors as mandated by the federal fee schedule.