What a DBA settlement means for your medical care

Start here: this page is education, not advice.

Alara is a nurse-owned home care agency. We are not a law firm, we do not give legal advice, and we have no role in whether you settle. What we can do is tell you what settlements tend to do to care, because that is the part we see afterward.

Every section below ends the same way, and we mean it each time: talk to your attorney.

There are two sides to a claim.

A Defense Base Act claim generally has a wage side and a medical side. The wage side is money for lost earning capacity. The medical side is the care the Act owes you for as long as the injury requires.

Settlements do not always treat both the same way. Some resolve only the wage side and leave medical benefits open. Others close both, trading your lifetime medical care for a one-time payment. Those are very different outcomes, and the paperwork is where the difference lives.

If you do not know which kind you are being offered, talk to your attorney.

Closing medical benefits is permanent.

This is the part worth sitting with. If your medical benefits close, they close. The carrier is no longer responsible for the attendant care, the nursing visits, the equipment, or the years of daily help that come after.

That can still be the right decision. Some families want the certainty. Some want out of a relationship with a carrier that has fought them for years. Those are real reasons. But they only make sense once the number on the table has been compared with the actual cost of the care being given up.

Before you weigh that, talk to your attorney.

The number depends on a number nobody has calculated yet.

Here is what we see most often: a settlement figure gets discussed before anyone has documented what the injured person’s care will cost over a lifetime. The wage side has been calculated carefully. The medical side is an estimate somebody made quickly.

You cannot tell whether an offer is good or terrible without knowing what you are giving up. A lifetime of attendant care is often the largest number in the whole case, and it is frequently the least documented.

What that number should be built from is not mysterious: the hours your physician says you need, the level of caregiver those tasks require, what that care actually costs where you live, and how those hours are likely to change as you age.

What to do with the resulting number is a legal decision. Talk to your attorney.

What a lifetime care cost projection is.

It is a documented projection of what your attendant and nursing care will cost over your lifetime, prepared by clinicians who deliver that care rather than by someone estimating from a desk.

We prepare them free of charge for families and attorneys anywhere in the country. There is no obligation attached, and you do not have to be a Nevada resident or an Alara patient. We do it because a settlement negotiated without one is a guess, and we would rather the guess not be about someone’s future care.

Whether and how to use it in your case, again: talk to your attorney.

Timing matters more than families expect.

Ask for the projection before settlement conversations, not after. Once a number has been anchored in a negotiation, it is hard to move, and a projection that arrives late tends to become a document about what was already lost.

If a settlement discussion has already started, it is not too late to pause it. That pause is a conversation to have with your attorney.

If you already settled.

Bring the paperwork. It depends entirely on what was closed. Some settlements leave medical benefits open, and families do not realize it. If your medicals were closed, there may still be other paths to care — VA benefits if you are a veteran, or another program entirely. We will read what you have and tell you honestly what is there.

And before acting on any of it, talk to your attorney.

Where to start.

If you want to understand what the Act owes you before any of this comes up, the complete Defense Base Act guide lays it out. If you are not sure which program applies to you at all, start with a few questions about your work and your care. On anything touching the settlement itself, talk to your attorney.

Common questions.

Sources: U.S. Department of Labor, Longshore and Defense Base Act.