LHWCA Claim Eligibility: Determining Covered Injuries and Workers

Navigating the Longshore and Harbor Workers' Compensation Act

The Federal Framework for Maritime Workers' Compensation

The Longshore and Harbor Workers' Compensation Act (LHWCA) is a federal workers' compensation system that provides medical care, wage replacement, and vocational rehabilitation to employees disabled by work‑related injuries occurring on U.S. navigable waters or in adjoining areas such as piers, docks, terminals, and wharves. Enacted in 1927 and significantly amended in 1972 and 1984, the Act covers traditional maritime occupations—longshore workers, ship‑repairers, shipbuilders, ship‑breakers, and harbor construction workers—as well as non‑maritime employees who sustain injuries while working on navigable water. The LHWCA expressly includes occupational diseases, hearing loss, and illnesses within its definition of “injury,” making auditory loss a compensable condition.

To qualify for benefits, an employee must satisfy both a “status” test (engaging in maritime employment) and a “situs” test (the injury occurs on navigable waters or a covered adjoining area). Coverage is mutually exclusive with the Jones Act, which applies to seamen (masters and crew members of vessels). Certain workers are excluded from LHWCA coverage, including most office clerical, secretarial, security, and data‑processing personnel, as well as employees of clubs, restaurants, retail outlets, and marinas not engaged in construction—provided they are covered by a state workers’ compensation law. The Act also excludes federal and state government employees and injuries caused solely by intoxication or willful self‑harm.

Scope of Benefits Under the LHWCA

The LHWCA provides a comprehensive package of benefits. Medical benefits cover all reasonable and necessary treatment related to the work injury, including surgery, prescription drugs, physical therapy, prostheses, hearing aids, attendant care, and transportation costs. There is no time limit for requesting or receiving medical care, and the employee has the right to choose their own physician—there is no network of approved providers. Disability benefits are calculated at two‑thirds of the employee’s average weekly wage (AWW), subject to annual minimum and maximum rates tied to the national average weekly wage. Temporary total disability (TTD) and permanent total disability (PTD) are paid at this rate as long as the disability continues. For permanent partial disability (PPD), the Act contains a schedule that specifies a fixed number of weeks of compensation for the loss or impairment of specific body parts—including 52 weeks for loss of hearing in one ear and 200 weeks for loss of hearing in both ears. Compensation for hearing loss is paid once the employee reaches maximum medical improvement (MMI) and is determined using the American Medical Association’s Guides to the Evaluation of Permanent Impairment. An audiogram administered by a licensed audiologist or an otolaryngology‑certified physician is presumptive evidence of the hearing loss. Vocational rehabilitation services are available to permanently disabled employees who cannot return to their regular job, provided suitable employment opportunities exist within their commuting area. Survivor benefits (up to two‑thirds of the deceased employee’s AWW) and funeral expense reimbursement (up to $3,000) are also provided. The LHWCA is a no‑fault system—employers are liable irrespective of fault, and benefits are exempt from federal income tax.

The Role of Medical Evidence in LHWCA Claims

Objective, evidence‑based medical assessments are critical to establishing entitlement under the LHWCA. Because the Act covers occupational diseases with long latency periods—such as asbestosis, mesothelioma, and hearing loss—claimants must demonstrate a causal connection between workplace exposure and the condition. For occupational disease claims, filing deadlines are extended: notice must be given within one year of the employee becoming aware of the work‑related nature of the disease, and a formal claim must be filed within two years of that awareness. Medical benefits, however, have no time limit.

Auditory loss claims require audiometric testing performed according to prescribed standards, with results interpreted under the AMA Guides. The LHWCA statute explicitly provides that an audiogram meeting the regulatory criteria is presumptive evidence of the amount of hearing loss as of its date. For claims involving hearing loss, the time for filing notice and a claim does not begin until the employee receives an audiogram indicating a loss. This places a premium on accurate, defensible audiological evaluations.

NorCal Medical Consulting specializes in workplace injury assessments, particularly auditory loss, and provides expert‑witness services that align with the rigorous evidentiary standards of the LHWCA. Our evaluations include comprehensive audiometric testing, impairment ratings under the AMA Guides, and detailed medical‑legal reports that document the relationship between occupational noise exposure and hearing impairment. We also assess other occupational diseases and cumulative trauma injuries commonly seen in the maritime workforce. By delivering independent, evidence‑based opinions, we assist attorneys, insurers, and employers in resolving claims efficiently and accurately. Whether the question is the degree of hearing impairment, the presence of a pre‑existing condition, or the necessity of prescribed medical treatment, NorCal’s expertise supports the fact‑finding process that underpins every LHWCA claim.

Who Is Covered Under the LHWCA?

Who Is Covered Under the LHWCA?

The Longshore and Harbor Workers' Compensation Act (LHWCA) covers employees in traditional maritime occupations: longshore workers, ship‑repairers, shipbuilders, ship‑breakers, and harbor construction workers. Coverage applies when work‑related injuries occur on the navigable waters of the United States or in adjoining areas such as piers, docks, terminals, wharves, and areas used in loading, unloading, repairing, or building vessels. Non‑maritime employees may also qualify if they perform work on navigable waters and sustain an injury there.

The Two‑Part Eligibility Test: Status and Situs

Eligibility for LHWCA benefits requires passing two tests. The status test focuses on the nature of the worker’s duties: the employee must be engaged in maritime employment (e.g., longshoring, ship repair, shipbuilding, harbor construction). Merely working for a maritime company is insufficient. The situs test requires that the injury occur on navigable waters or in a covered adjoining area (pier, wharf, dry dock, terminal, building way, marine railway) customarily used for loading, unloading, repairing, or building a vessel. Courts interpret “adjacent” broadly, covering areas close to or in the vicinity of navigable waters.

Harbor Workers and Federal Workers’ Compensation Plans

Harbor workers, including those in harbor construction, are explicitly covered under the LHWCA. To be eligible, their injuries must arise on navigable waters or in designated adjoining areas. Harbor construction workers (e.g., those building piers, docks, or terminals) are traditional maritime employees and meet the status test. The situs test is satisfied when the injury occurs at a covered location—for example, on a dock or while working from a barge.

How the LHWCA Differs from the Jones Act

The LHWCA and the Jones Act are mutually exclusive. The Jones Act covers seamen—workers who spend at least 30% of their time on a vessel in navigation and contribute to its function or mission. Seamen can sue their employer for negligence and recover damages for pain and suffering. In contrast, the LHWCA is a no‑fault workers’ compensation system that provides prompt medical benefits and partial wage replacement without requiring proof of fault. Longshoremen, harbor workers, shipbuilders, and ship repairers are typically covered by the LHWCA, while masters and crew members of vessels fall under the Jones Act.

Coverage Extensions: DBA, OCSLA, and NAFIA

Congress extended LHWCA benefits to three additional worker groups through separate statutes. The Defense Base Act (DBA) covers civilian employees working on U.S. military bases outside the United States, on public work contracts for national defense, and under Foreign Assistance Act contracts. The Outer Continental Shelf Lands Act (OCSLA) extends coverage to employees working on the Outer Continental Shelf, such as those on offshore oil rigs exploring or developing natural resources. The Non‑Appropriated Fund Instrumentalities Act (NAFIA) covers civilian employees of military exchanges, morale‑welfare‑recreational facilities, and similar instrumentalities. These workers receive the same benefits as LHWCA claimants.

Key Exclusions from LHWCA Coverage

The LHWCA specifically excludes seamen (masters or crew of any vessel) because they are covered by the Jones Act. Also excluded are U.S., state, and foreign government employees; workers whose injuries are caused solely by intoxication; and injuries resulting from an employee’s willful self‑harm. Additional exclusions apply if the worker is already covered by a state workers’ compensation system. These include: individuals employed exclusively in office clerical, secretarial, security, or data‑processing work; employees of clubs, camps, restaurants, museums, or retail outlets; marina employees not engaged in construction, replacement, or expansion (except routine maintenance); suppliers, transporters, or vendors temporarily on a maritime employer’s premises not performing covered work; aquaculture workers; and individuals employed to build, repair, or dismantle any recreational vessel under 65 feet in length. The exclusions are designed to prevent double recovery and to ensure that only workers truly engaged in maritime employment and not adequately covered by state law receive federal benefits.

What Injuries and Illnesses Are Covered?

The Longshore and Harbor Workers' Compensation Act (LHWCA) defines "injury" broadly to include accidental injuries, occupational diseases, hearing loss, and illnesses that arise out of and in the course of maritime employment. This inclusive definition ensures that a wide range of work‑related conditions—from sudden traumatic events to slowly developing long‑term exposures—are eligible for compensation, medical care, and vocational rehabilitation.

What Types of Injuries Does Workers' Compensation Typically Cover?

Common accident types on docks, shipyards, and terminals include slips, trips, and falls from heights or scaffolding; machinery and vehicle accidents (e.g., crane, forklift, or conveyor incidents); falls into the water (near‑drowning or drowning); electrocutions; fires and explosions; and material‑handling accidents. These events can produce traumatic brain injuries, spinal cord injuries, fractures, amputations, burns, serious lacerations, and crushing injuries.

Occupational diseases are equally covered. The LHWCA explicitly includes illnesses that develop from workplace exposure to harmful conditions or substances. Examples are asbestosis and mesothelioma from asbestos, auto‑immune diseases, skin diseases, asthma from chemical exposure, and repetitive stress injuries such as carpal tunnel syndrome and hearing loss. Many occupational diseases have long latency periods and may not become apparent until after retirement; even so, they remain compensable under the Act.

What Criteria Must an Injury or Illness Meet to Be Eligible for LHWCA Coverage?

For any injury or illness to be compensable under the LHWCA, the claimant must satisfy two foundational tests: the status test and the situs test. The status test requires that the employee be engaged in "maritime employment"—work directly related to traditional maritime duties such as longshoring, ship building, ship repair, or harbor construction. The situs test demands that the injury occur on navigable waters of the United States or in adjoining areas customarily used for loading, unloading, repairing, or building vessels (e.g., piers, wharves, dry docks, terminals, building ways, or marine railways).

Additionally, the injury must arise out of and in the course of employment. There must be a causal connection between the work and the harm. The system operates on a no‑fault basis: the employee does not need to prove employer negligence. In return, the LHWCA is the exclusive remedy against the employer—the worker cannot sue the employer for pain and suffering or other damages beyond the statutory benefits.

Certain categories of workers are excluded, most notably seamen (masters or crew members) who fall under the Jones Act, and employees who are covered by state workers' compensation laws for non‑maritime roles (e.g., clerical, security, retail, or marina employees not engaged in construction). Injuries caused solely by intoxication or willful self‑harm are also not covered.

Hearing Loss: A Compensable Condition Under the LHWCA

Hearing loss is explicitly recognized as a compensable occupational disease under the LHWCA. The Act schedules permanent partial disability (PPD) for hearing loss: 52 weeks of compensation for loss of hearing in one ear, and 200 weeks for loss of hearing in both ears (33 U.S.C. § 908(c)(13)). Entitlement begins once the employee reaches maximum medical improvement.

The degree of hearing loss is determined using the American Medical Association (AMA) Guides to the Evaluation of Permanent Impairment. An audiogram administered by a licensed or certified audiologist or a physician certified in otolaryngology is presumptive evidence of the loss. The audiogram must be provided to the employee at the time it was taken, and no contrary audiogram from that date may be produced.

A critical procedural rule: the time to file a notice of injury or a claim for hearing loss does not begin to run until the employee receives an audiogram indicating a loss of hearing. This means the statute of limitations is triggered by the diagnosis, not the exposure, which is especially important for gradual noise‑induced hearing loss that may take years to become apparent.

The LHWCA's broad definition of "injury" ensures that maritime workers receive comprehensive protection, whether the harm is immediate or develops over a career. Accurate medical documentation—including audiograms, exposure histories, and impairment ratings—is essential for establishing a successful claim.

How to File a Claim and Key Deadlines

What are the immediate steps after an injury under the Longshore Act?

When a maritime worker suffers a job-related injury, the first steps are critical for both health and legal protection. The employee should notify their supervisor or employer representative as soon as possible—ideally immediately after the incident. Prompt reporting creates a clear record and triggers the claim process.

The injured worker is entitled to seek medical care and, critically, has the right to choose their own physician. There is no network of approved providers under the LHWCA. The employee can select any doctor who meets the Act's definition of a physician—including MDs, surgeons, podiatrists, dentists, clinical psychologists, optometrists, and osteopathic practitioners licensed by state law. Chiropractors are considered physicians only for treating spinal subluxation verified by x-ray. This right to choose an initial treating physician is guaranteed; the employer cannot impose a doctor.

What are the written notice deadlines for an injury claim?

After the injury, the employee must provide written notice to the employer using Form LS-201 (Notice of Employee's Injury or Death). This notice must be given within 30 days of the injury, or within 30 days of becoming aware of the injury. For occupational diseases that develop gradually, the notice period is triggered when the employee becomes aware—or should have become aware—of the work-related nature of the condition.

Failing to provide this written notice within 30 days can jeopardize compensation benefits. However, medical care remains available even if the notice is late. The law provides exceptions: failure may be excused if the employer had actual knowledge of the injury, if the employer was not prejudiced by the delay, or if there was satisfactory reason for the late notice.

What is the statute of limitations for filing a formal claim?

The cornerstone of the claim process is the formal claim document. The employee must file Form LS-203 (Employee's Claim for Compensation) with the Office of Workers’ Compensation Programs (OWCP) within a specified timeframe. The deadline varies based on the type of injury:

• For accidental injuries: The claim must be filed within one year after the date of injury, or within one year after the last voluntary payment of compensation if the employer was paying benefits without a formal award.
• For occupational diseases: The claimant has two years from the date they first become aware of the relationship between the disease, their disability, and their employment. This longer period recognizes that conditions like asbestosis, hearing loss, or autoimmune diseases may take years to manifest.
• For hearing loss specifically: The filing deadline does not begin to run until the employee receives an audiogram that indicates a hearing loss. The audiogram must be performed by a licensed or certified audiologist or a physician certified in otolaryngology.

The statute of limitations for hearing loss claims also has a separate rule: the one-year filing period runs from the employee's last injurious exposure to occupational noise or from when the employee becomes aware of the relationship between the hearing loss and employment, whichever is later.

Are medical benefits subject to any time limit?

No. One of the most important protections under the LHWCA is that medical benefits have no time limit. The right to request and receive medical treatment for a work-related injury is never time-barred. Even if the employee fails to file a timely compensation claim, medical care remains available. The employer must provide all reasonable and necessary treatment related to the work injury for as long as the nature of the injury or the process of recovery requires. This includes prescription drugs, physical therapy, prostheses, hearing aids, attendant care, and travel costs.

What happens after a claim is filed?

Once the claim is filed, the employer or its insurance carrier has several options:

If the employer or carrier denies benefits by filing Form LS-207, the employee can contest the decision by contacting the Longshore Claims Examiner. The OWCP will attempt informal resolution first, often through a non-binding recommendation. If no agreement is reached, the next step is a formal hearing before an Administrative Law Judge (ALJ), requested using Form LS-18. The ALJ follows federal procedure, examines evidence, and issues a binding decision on liability, disability, and benefits.

What about retaliation for filing a claim?

Section 49 of the LHWCA makes it unlawful for an employer to discharge or discriminate against an employee solely because they filed a claim or testified in a hearing. Knowingly filing a false claim, however, is not protected. Penalties for retaliation include reinstatement, back pay, and civil penalties paid into the Special Fund.

Quick reference: Key deadlines under the LHWCA

Benefits and Compensation Rates

What is the maximum compensation rate under the Longshore and Harbor Workers' Compensation Act?

The maximum compensation rate under the LHWCA is adjusted each fiscal year based on the National Average Weekly Wage (NAWW). For fiscal year 2026 (October 1, 2025 through September 30, 2026), the maximum compensation rate is $2,082.70 per week, which equals 200% of the NAWW of $1,041.35. The minimum rate for total disability is 50% of the NAWW, or $520.68 per week. These annual adjustments ensure that benefit levels keep pace with changes in national wage trends.

Types of disability and how they are compensated

Disability under the LHWCA is defined as the inability to earn the same wages the employee was receiving at the time of injury. Benefits vary by the type and severity of the disability.

Temporary total disability (TTD) pays two-thirds (2/3) of the employee’s Average Weekly Wage (AWW), subject to the minimum and maximum rates. These payments continue while the employee is recuperating and unable to work at all.

Temporary partial disability (TPD) also pays 2/3 of the lost earning capacity – that is, the difference between the AWW and the employee’s current earnings. TPD benefits are limited to a maximum of five years.

Permanent total disability (PTD) pays 2/3 of the AWW for life, with annual adjustments based on increases in the NAWW. Loss of both hands, arms, feet, legs, or eyes is automatically considered permanent total disability.

Permanent partial disability (PPD) comes in two forms. Scheduled PPD covers the loss or impairment of specific body parts, such as arms, legs, fingers, or ears. For hearing loss, the schedule provides 52 weeks of compensation for loss of hearing in one ear and 200 weeks for loss of hearing in both ears. These payments begin once the employee reaches maximum medical improvement and are paid regardless of whether the employee returns to work. Unscheduled PPD applies to injuries to the head, neck, back, or other non‑scheduled body parts. It pays 2/3 of the lost wage‑earning capacity and continues as long as the disability persists, without annual adjustment.

Medical benefits: broad coverage and freedom of choice

The LHWCA entitles injured workers to all reasonable and necessary medical treatment related to the work injury. This includes surgeries, prescription medications, physical therapy, diagnostic tests, prostheses, hearing aids, attendant care, and travel costs to and from medical appointments. There is no network of approved providers; the employee has the right to choose their own physician, as long as the physician meets the statutory definition (M.D., surgeon, podiatrist, dentist, clinical psychologist, optometrist, osteopath, or in limited cases a chiropractor for spinal subluxation).

Medical benefits have no time limit – the right to care never expires, even if a formal compensation claim is not timely filed. However, non‑emergency treatment must be authorized by the employer or its insurance carrier before it is provided.

Death and survivor benefits

If a work injury causes or contributes to the employee’s death, survivor benefits are payable to eligible dependents. The benefit amount is up to two‑thirds (2/3) of the deceased employee’s AWW, distributed according to a statutory formula: a surviving spouse receives 50% of the AWW, with an additional 16⅔% for each child, up to a total of 66⅔%. If there is no spouse, one child receives 50% and two or more children receive 66⅔%. Benefits to children generally end at age 18 (or 23 if a full‑time student) and may continue for a disabled adult child. The Act also provides a funeral expense reimbursement of up to $3,000. Survivor benefits are adjusted annually for increases in the NAWW.

Vocational rehabilitation for long‑term recovery

Employees who suffer a permanent disability that prevents them from returning to their former job may be entitled to vocational rehabilitation services. These services include assessment, testing, counseling, job development, training, and job placement assistance. To qualify, the employee must be receiving or likely to receive compensation, have a permanent disability, and have suitable return‑to‑work opportunities within their commuting area. The employer or its carrier typically pays for authorized rehabilitation services; in some cases, the OWCP Special Fund covers the costs.

Who Determines Compensability and What Penalties Exist?

Who determines whether an injury or disease is compensable?

Medical professionals play the first critical role in the LHWCA process. When a worker reports an injury or suspects an occupational disease, a treating physician provides diagnostic evidence—such as audiograms for hearing loss, imaging studies, or clinical exams—that links the condition to work‑related exposure. The physician’s opinion must meet the statutory definition of a "physician" under the Act (MD, surgeon, podiatrist, dentist, clinical psychologist, optometrist, osteopathic practitioner, or chiropractor limited to spinal subluxation confirmed by x‑ray). This medical documentation forms the foundation of the claim and is required for any award of compensation or medical benefits.

If the employer or its insurance carrier questions the medical evidence, they may order an independent medical examination (IME). The IME physician, also licensed under the same definitions, evaluates the worker and prepares a report that the carrier uses to decide whether to accept or deny the claim. The IME does not replace the treating physician’s role but provides an additional perspective that the OWCP claims examiner will consider during review.

The Office of Workers’ Compensation Programs (OWCP) claims examiner steps in after the initial claim filing. The examiner reviews the completed Form LS‑203 (Employee’s Claim for Compensation), medical records, wage information, and any IME reports. During this stage the examiner may schedule an informal conference with the worker, employer, or carrier to discuss discrepancies and attempt to resolve the dispute without a formal hearing. If the informal conference yields a non‑binding recommendation, the examiner’s opinion guides the parties but does not compel payment.

When the claim remains contested after the informal conference, the case proceeds to a formal hearing before an Administrative Law Judge (ALJ) of the Department of Labor. The ALJ conducts a de novo review, hears testimony, evaluates medical evidence, and issues a binding decision on compensability, benefit amounts, and any penalties. Either party may appeal the ALJ’s decision to the Benefits Review Board; further appeals can go to the U.S. Court of Appeals and, ultimately, the U.S. Supreme Court. Thus, while medical professionals supply the essential diagnostic link, the ultimate determination of compensability rests with the OWCP claims examiner (through informal resolution) and, if needed, the Administrative Law Judge through formal adjudication.

What penalties exist under the Longshore and Harbor Workers' Compensation Act for employers or insurers?

The LHWCA imposes several civil and criminal penalties to ensure compliance. Under 33 U.S.C. § 938, an employer or carrier that fails to secure payment of compensation as required may be fined up to $10,000, imprisoned for up to one year, or both. This provision applies when the employer does not obtain the necessary insurance or self‑authorization to cover LHWCA liabilities.

If compensation is due but the employer or carrier withholds payment without reasonable grounds, the Act adds a 10 percent penalty on the amount owed. This extra charge is designed to discourage unjustified delays and to make the worker whole for the period of nonpayment.

Discrimination against an employee who files a claim or testifies in a hearing is prohibited by Section 49 of the LHWCA (codified at 33 U.S.C. § 948a). Violations can result in the employer being ordered to provide back pay, reinstatement of the worker to their former position, and civil penalties payable to the Special Fund (also known as the Second Injury Fund). The civil penalty amount varies but is intended to deter retaliatory actions such as termination, demotion, or harassment.

False statements made to deny or reduce benefits are treated seriously under 33 U.S.C. § 931(c). An employer or carrier that knowingly makes a false statement to avoid liability may be fined up to $10,000 and face up to five years imprisonment. This provision addresses fraudulent conduct, such as fabricating medical evidence or misrepresenting the worker’s employment status.

Finally, the LHWCA allows the OWCP to seek recovery from the Special Fund when an employer or carrier is insolvent. While not a penalty per se, this mechanism ensures that workers still receive benefits even when the responsible party cannot pay, and the Fund may later seek reimbursement from the defaulting employer.

These penalties collectively reinforce the Act’s no‑fault framework by compelling timely coverage, prompt payment, non‑discriminatory treatment, and honest communication throughout the claims process.

Special Considerations: Hearing Loss and Retirees

Hearing Loss as a Compensable Injury Under the LHWCA

The Longshore and Harbor Workers' Compensation Act explicitly includes compensable hearing loss under the LHWCA. To receive benefits, the hearing loss must arise from workplace noise exposure that occurs while the employee is performing maritime duties on navigable waters or in adjoining covered areas such as piers, docks, or terminals. The injury must also meet both the status test and situs test under the LHWCA.

Scheduled Permanent Partial Disability for Hearing Loss

When hearing loss becomes permanent and the worker reaches maximum medical improvement, compensation is paid according to the schedule in Section 8(c) of the LHWCA. The law provides 52 weeks of compensation for the complete loss of hearing in one ear and 200 weeks for the complete loss in both ears. The amount paid each week is two-thirds of the worker's average weekly wage, subject to annual minimum and maximum compensation rates under LHWCA set by the Department of Labor.

Audiogram and AMA Guides Requirements

For a hearing loss award, the impairment must be measured using an audiogram administered by a licensed or certified audiologist or a physician certified in otolaryngology. The audiogram is presumptive evidence of the hearing loss as of its date if it is provided to the employee at the time of testing and no contrary audiogram from the same period is produced. The degree of impairment is determined according to the American Medical Association's Guides to the Evaluation of Permanent Impairment (AMA Guides).

Occupational Disease Claims for Hearing Loss

Hearing loss caused by prolonged exposure to workplace noise is treated as an occupational disease. The employer where the employee was last exposed to the injurious noise is responsible for paying benefits. The claimant has two years from the date they first become aware of the relationship between the hearing loss, their disability, and their employment to file a formal claim (Form LS-203). There is no time limit to request medical benefits for hearing loss, even if a compensation claim is not timely filed.

Special Rules for Retirees with Occupational Hearing Loss

Retirees who develop hearing loss due to past workplace exposure face unique rules. If the occupational disease is diagnosed more than one year after the employee voluntarily retired, the compensation for permanent partial disability for retirees under LHWCA is not based on the former average weekly wage. Instead, the benefit is calculated using the National Average Weekly Wage (NAWW) at the time of diagnosis and the percentage of impairment determined under the AMA Guides. Importantly, retirees may be entitled to permanent partial disability benefits even if they experience no wage loss, because the scheduled award recognizes the physical loss of function.

Are Harbor Workers Eligible for Federal Workers' Compensation Plans?

Yes, harbor workers are eligible for federal workers' compensation under the LHWCA. To qualify, the injury must occur on the navigable waters of the United States or in adjoining areas like piers, docks, terminals, and wharves used in loading, unloading, repairing, or building vessels. The LHWCA provides medical care, disability benefits, and vocational rehabilitation for work-related injuries or illnesses, including hearing loss. Harbor construction workers, longshore workers, ship repairers, and shipbuilders are among the covered employees. Hearing loss claims require meeting both the status test and situs test, and the injury must be causally connected to maritime employment.

Key Requirement: Work-Related Noise Exposure

To establish eligibility for hearing loss benefits, the claimant must prove that the hearing loss is due to noise exposure in the workplace and that the exposure occurred while performing tasks falling under the LHWCA's definition of maritime employment. Medical evidence, including serial audiograms and an expert opinion linking the loss to occupational noise, is essential. Audiograms must be performed by a licensed audiologist or an otolaryngologist-certified physician to be considered presumptive evidence. The hearing loss must also meet the minimum threshold for impairment as defined by the AMA Guides.

Practical Steps for Filing a Hearing Loss Claim

Workers who suspect a work-related hearing loss should notify their employer as soon as possible using Form LS-201 (Notice of Employee's Injury or Death) within 30 days. A formal claim must be filed with the Office of Workers' Compensation Programs within one year of the injury or within two years of becoming aware of the relationship for occupational disease. Retirees should note that the two-year period begins when they first understand the connection between their hearing loss and past employment. Medical benefits remain available without time limit, so even if a compensation claim is late, necessary treatment—including hearing aids—should be covered.

Coordination with State Workers' Compensation

Workers may receive benefits under both a state workers' compensation system and the LHWCA, but the total compensation cannot exceed the higher weekly rate. State benefits reduce the employer's obligation under the LHWCA. Hearing loss claims under the LHWCA are not subject to the more restrictive requirements of many state laws; for example, the LHWCA does not impose a minimum binaural impairment threshold beyond the AMA Guides standard. This can make federal benefits more generous for maritime workers with gradual noise-induced hearing loss.

Understanding Your Rights Under the LHWCA

Eligibility: The Two-Test Framework

To receive benefits under the Longshore and Harbor Workers’ Compensation Act (LHWCA), an injured worker must satisfy two distinct requirements: the status test and the situs test.

The status test examines the employee’s duties. The worker must be engaged in maritime employment, such as a longshore worker, ship repairer, shipbuilder, ship-breaker, or harbor construction worker. The Act also covers non‑maritime employees who are injured while performing work on navigable waters.

The situs test considers where the injury occurred. The injury must happen on the navigable waters of the United States or in an adjoining area, including piers, wharves, dry docks, terminals, building ways, or marine railways customarily used for loading, unloading, repairing, or building a vessel.

Covered Injuries and Conditions

The LHWCA defines “injury” broadly. It includes accidental injuries, occupational diseases, hearing loss, and illnesses arising out of employment. Common examples include traumatic injuries from falls, machinery accidents, and electrocution, as well as chronic conditions such as asbestosis, mesothelioma, and noise‑induced hearing loss.

Occupational diseases often develop slowly. For these claims, the responsible employer is the one where the worker was last exposed to the injurious substance. A claimant has two years from the date they first become aware of the relationship between the disease, their disability, and their employment to file a claim for compensation. Importantly, there is no time limit on claiming medical benefits for an occupational disease.

Strict Filing Deadlines

Timely reporting and filing are critical. An employee must provide written notice of the injury to the employer within 30 days using Form LS‑201. A formal claim for compensation must be filed with the Office of Workers’ Compensation Programs (OWCP) within one year of the injury or within one year of the last voluntary compensation payment.

For hearing loss claims, the time to file does not begin until the employee receives an audiogram indicating a loss of hearing. Failure to meet these deadlines can jeopardize compensation, but medical care remains available even if a claim is not filed on time.

Available Benefits

The LHWCA provides a comprehensive package of benefits.

Medical benefits cover all reasonable and necessary treatment related to the work injury, including surgery, prescriptions, physical therapy, prostheses, hearing aids, and travel costs. There is no network of approved providers; the employee may select any physician who meets the statutory definition. There is no time limit on requesting or receiving medical care.

Disability benefits replace a portion of lost wages. Compensation is calculated as two‑thirds of the employee’s Average Weekly Wage (AWW), subject to annual minimum and maximum rates set by the Department of Labor. Types of disability include:

For hearing loss, scheduled permanent partial disability (PPD) provides 52 weeks of compensation for loss of hearing in one ear and 200 weeks for loss in both ears.

Vocational rehabilitation is available to permanently disabled employees who cannot return to their regular job and have suitable employment opportunities within their commuting area.

Death benefits are paid to eligible survivors at up to two‑thirds of the deceased employee’s AWW, plus funeral expenses up to $3,000.

The Importance of Medical Documentation

Strong medical evidence is essential to a successful LHWCA claim. Injured workers should seek prompt medical attention and maintain thorough records of all diagnoses, treatments, and physician opinions. For hearing loss claims, the law requires that audiograms be administered by a licensed audiologist or a physician certified in otolaryngology and that hearing loss determinations follow the American Medical Association’s Guides to the Evaluation of Permanent Impairment.

Workers are entitled to choose their own treating physician. However, changing doctors without the permission of the employer, insurance carrier, or OWCP is not permitted unless for good cause.

Navigating Disputes

If an employer or insurance carrier denies a claim, they must file a Notice of Controversion (Form LS‑207) stating the reasons. The worker can then contact an OWCP claims examiner, participate in an informal conference, and, if necessary, request a formal hearing before a Department of Labor Administrative Law Judge. Appeals may proceed to the Benefits Review Board and the U.S. Court of Appeals.

Retaliation is prohibited. An employer may not discharge or discriminate against an employee solely for filing a claim or testifying in a hearing.

Given the complexity of LHWCA claims, consulting an experienced maritime attorney or contacting the OWCP directly is strongly recommended.

NorCal Medical Consulting’s Role

NorCal Medical Consulting specializes in providing expert assessments and evaluations for LHWCA claims, particularly for auditory loss. Their team of medical professionals offers evidence‑based opinions on work‑relatedness, impairment ratings under AMA Guides, and the permanency of hearing loss. These independent medical examinations and reports help claimants, attorneys, and insurers navigate the claims process with credible, defensible documentation.