Understanding the Limitations of Jones Act Maintenance and Cure Benefits
Seamen, perhaps more than other industry workers, are prone to illness and injury when they are at work, especially while working on an ocean-going vessel. Whereas other employees have workers’ compensation benefits available to compensate them for injuries sustained at work, seamen have maintenance and cure benefits. All American seamen injured while on a vessel are eligible to claim these benefits from their employers.
Qualified seamen covered by the Jones Act include all men and women, from captains to crewmembers, working at least thirty-percent of their employed time on a water vessel in commercially navigable waters.
What Are Maintenance and Cure Benefits?
Established under maritime law, maintenance and cure (M&C) benefits refer to the financial support that an injured seaman can claim from an employer when injured while on a qualified vessel, either on or off-duty. All seamen are eligible for these benefits when they are injured at work, regardless of the cause of the injury.
If you are an injured maritime worker, you are not required to prove that your employer or co-worker was negligent in order to receive the M&C benefits. You need only prove that the injury occurred while you were readily available on or in service of a qualified vessel.
M&C benefits are also available to seamen who fall ill in the course of work. If a disease originates, recurs or worsens while you are working on a vessel, M&C benefits should be provided to you. Again, all you need to prove is that the illness arose while you were aboard your vessel. The negligence of the employer or crew members is irrelevant.
What Do These Benefits Cover?
Maintenance benefits cover the daily living expenses of an injured seaman. It includes room and board expenses such as rent, property tax, homeowner’s insurance and mortgage. It also includes all necessary household expenses such as utilities, clothes, and food. It does not cover household expenses that are not necessary such as cable, internet, and telephone.
Cure benefits cover medical expenses arising from the illness or injury. An injured seaman’s employer will pay for all medical expenses including:
- Medical scans and tests
- Out-of-pocket expenses such as transport to and from the hospital.
Cure benefits do not cover elective procedures that are not designed to help you heal. They also do not cover injuries sustained outside work.
Employers who fail to provide these benefits can be sued by the injured worker, often leading to much higher settlement amounts, including punitive damages. If your employer knowingly and unreasonably refuses you M&C benefits when you are entitled to them, you may be entitled to an award of punitive damages, over and above standard M&C benefits.
If your employer is refusing these benefits, you should have your doctor write a strong letter to your employer discussing your injuries and their causes. You will want a thorough paper trail with your employer in order to prove that they unreasonably withheld M&C benefits.
Does an Injured Worker Receive M&C Benefits Indefinitely?
No. An injured seaman will only be entitled to receive these benefits until recovery or until the point of maximum medical improvement (MMI). MMI is the point where a doctor determines that your condition cannot improve, even with additional treatment.
Therefore, the moment a doctor grants you a clean bill of health and signs release forms or when a doctor determines that you have reached MMI, the ax falls on M&C benefits.
Some employers have been known to subject seamen to independent medical examinations conducted by physicians who do not know what the seaman’s job involves. Injured seamen have a right to a second medical opinion should independent physicians determine they have recovered and can return to work.
Union Membership Can Affect Maintenance
In some states, unions have predetermined maintenance rates applicable to all workers under contract. If the pre-determined rate is $800, then all injured seamen will only be entitled to receive $800 in maintenance until they have recovered or reached MMI.
Maintenance and Cure Are Not Your Only Benefits Under the Jones Act
As we talked about earlier, M&C benefits are not indefinite. If your injuries or illness was caused by employer negligence, you may bring a Jones Act negligence or unseaworthiness lawsuit against your employer, in addition to receiving M&C benefits. You may not receive double damages, but you are entitled to different, additional benefits for things like pain and suffering and future medical payments.