The short answer.
The Defense Base Act requires treatment for such period as the nature of the injury requires. That standard is not limited to hospitals and clinics. When a treating physician prescribes nursing or attendant care in your home, the responsible insurance carrier is responsible for that care too.
There is no cap on it. There is no episode limit. It does not stop after a set number of visits or a set number of months. If the injury still requires the care, the care is still owed.
Two different things live under “home care.”
It helps to name them separately, because they are prescribed differently and they show up differently on an authorization.
- Attendant care is hands-on help with daily living: bathing, dressing, grooming, moving safely from room to room, getting to the bathroom, eating.
- Nursing care is skilled clinical work: wound care, medication management, watching a condition that changes and reporting what changed.
Many injured contractors need some of each. A severe orthopedic injury can mean months of skilled nursing and years of attendant care. A traumatic brain injury can mean daily supervision and cueing that looks nothing like a nursing visit but is exactly the care the Act contemplates.
Three things have to line up.
- Your claim is accepted, and your medical benefits are still open.
- Your treating physician prescribes the care, and describes what you need help with.
- The carrier authorizes it in writing, for a stated number of hours.
The third step is where care stalls most often. A prescription that says “home health as needed” gives an adjuster nothing to authorize. A prescription that names the tasks and the hours gives them something they have to answer. The complete Defense Base Act guide →
What a useful prescription actually says.
Your doctor is writing the document your care depends on. The strongest ones are specific. They name the accepted injury. They name the tasks you cannot do without help. They state how many hours a day, and how many days a week. They say how long the need is expected to last, and whether it is expected to be permanent.
Vague orders get slow answers. Specific orders get authorizations. If your doctor has not written for home care before, that is worth a conversation before the appointment, not after it.
Maximum medical improvement does not end your care.
This is the single most common thing families get wrong, usually because someone implied it on a phone call.
Maximum medical improvement is a milestone about your wage benefits. It means your condition is not expected to improve further with treatment. It does not mean your medical benefits close. Care that maintains your condition — that keeps you safe, clean, fed, and out of the hospital — continues for as long as the injury requires it.
If you have been told your care is winding down because you reached MMI, that is not what the law says. Talk to your attorney, and call us.
What it costs you.
Authorized care for the accepted injury comes at no cost to you. It is billed to the responsible insurance carrier under the written authorization, not to your family and not to your household insurance.
A family member can often be the one paid to do it.
When attendant care is prescribed, a family member can frequently be employed through a licensed home care agency — trained, supervised by a nurse, and paid for the care they have been giving for free. It is one of the least known parts of the Act. We wrote a separate piece on getting paid to care for your injured spouse.
Where Alara fits.
We deliver hands-on attendant and nursing care for DBA patients in Las Vegas and Southern Nevada, and we staff only on written carrier authorization, so your care never turns into a billing argument in your living room.
Outside Nevada, education, benefit guidance, and lifetime attendant-care cost projections are free to families and attorneys anywhere in the country. If you are not sure which program is yours, start with a short set of questions about your work and your care.
Common questions.
Does the Defense Base Act cover home care?
Yes. The Act provides medical care for as long as the injury requires, and when a treating physician prescribes attendant or nursing care at home, the responsible insurance carrier is responsible for it when it is properly authorized.
Is there a limit on how many hours of attendant care I can get?
The Act does not set an episode limit or a visit cap. The hours come from what your treating physician prescribes and what the carrier authorizes in writing, which is why a specific prescription matters so much.
Does my home care stop when I reach maximum medical improvement?
No. Maximum medical improvement affects wage benefits, not medical care. Treatment and attendant care that maintain your condition continue for as long as the injury requires.
What does DBA home care cost me?
There is no cost to you for authorized care for the accepted injury. It is billed to the responsible insurance carrier under the written authorization.
Sources: U.S. Department of Labor, Longshore and Defense Base Act.