The Lawyers at Simon – O’Rourke are familiar with the laws and requirements that a Jones Act Employer owes under its cure obligations.
What is Cure?
Basically, cure is the entitlement for medical care for any illnesses or injuries suffered while working in service of a vessel. The injured or ill seaman is entitled to receive this benefit until he reaches Maximum Medical Improvement or MMI.
What is Maximum Medical Improvement or MMI?
MMI is the point where continued medical treatment does not improve the injured person’s medical condition.
MMI does not mean that the injured person’s medical or physical condition is back to the point where it was before an accident.
For example, if a Derrickman injures his back while working on a semi-submersible and has a major spine surgery, he may not be able to pick up heavy objects or twist the way he could prior to the accident.
While his body is not the same as it was prior to the accident. If there is no other treatment after having the surgery to improve his condition as much as possible, he has reached the maximum point where medical treatment could improve his condition.
Once an injured worker reaches MMI, the company no longer has to pay cure.
Additionally, the company no longer has to pay maintenance.
What You Should be Concerned About
Unfortunately, in our experience, the employers and insurance carriers want to stop paying for an injured seaman’s medical care as soon as possible. They do this by sending the injured seaman to see a doctor of their choice. These doctors are commonly called “Company Doctors.”
A company doctors could try to return you the job even though you have not reached your maximum medical improvement.
A company doctor can also argue that you reached MMI even though you know that you are still severely injured and needs more treatment to heal more.
If an injured worker does not feel that he or she is at MMI
before the doctor has certified that the injured worker has reached his or her maximum medical improvement. However, maritime law states that when there is a dispute about whether an injured seaman needs further medical care, the dispute must be resolved in favor of getting the requested medical care.
What Can You Do?
The best thing that you can do is make sure that you receive quality medical care from a medical provider that is looking out for your medical interests and not the company or the insurance company.
You also need to make sure that you receive all the care that you are entitled to, not the basics or even the average care a patient receives.
Your medical condition is extremely important to you and your family. You need to insist the best and most thorough care that you can get.
Choose Your Own Doctor:
US Federal law makes it clear that an employer cannot refuse to pay for the medical care that you need. If an employer’s refusal to meet its maintenance and cure obligations is willful and wanton, you may be entitled to punitive damages.
You should choose your own doctor. You are entitled to see a doctor of your own choice and not required to see only the doctors that the company wants to send you to. By choosing your own doctor, you are taking control over your treatment and ensuring that you are not merely being sent to a company doctor.
What Can Simon-O’Rourke Do to Help?
Simon – O’Rourke is familiar with fighting on behalf of our clients to ensure the companies, insurance companies, company men, adjusters, or “Safety Men” do not merely send them to a “company doctor” that is going to give them a few pain relievers and send them back to work. We will put our experience to work for you and make sure that you receive the cure benefits that you are entitled to.
Call us now at 281-667-4081
The following are examples of costs that should be paid as a part of Cure
- Transportation costs to and from the doctor
- Doctor bills and nursing service fees
- Physical therapy
- MRIs, X-Rays and other diagnostic testing
- Surgery and other invasive procedures, and
- any other medical treatment necessary to help an injured seaman return to as full health as possible.
What About Pre-Existing Conditions?
All injured seamen have a right to file a claim. This right extends to injured seamen who have preexisting conditions.
As long as an employee did not misrepresent his medical condition when he was initially hired, then the employer must accept the employee “as is” and cannot deny claim a because an seaman had a previous injury. This is true even if the previous injury was in the same part of the body.
Such denials are improper, and an employer may be subject to punitive damages.