Hurt working the docks — or working on base? The same federal law owes you care for life.
The Longshore and Harbor Workers' Compensation Act covers port and harbor workers. Its extensions cover the people who run base exchanges, commissaries, and recreation facilities. Either way, one rule holds: the insurance carrier owes your medical care for as long as the injury requires — including care at home. It is one of the benefits injured workers miss most.
This page is for you if…
You worked the waterfront
Longshoremen, crane operators, ship repairers, terminal and harbor workers — injured loading, unloading, building, or repairing vessels, or working the docks and terminals that serve them. Serious injuries on the waterfront come under the Longshore Act, not state comp.
You worked at the exchange, commissary, or MWR
Civilian employees of base exchanges, commissaries, clubs, lodging, and recreation programs — including at Nellis and Creech — are covered by the Longshore Act's rules through a law called NAFIA. Hurt on the job at one of these? Federal comp rules apply to you, and they are stronger than most people expect.
Five things worth knowing before your next call with the carrier.
The law requires treatment for as long as the nature of the injury requires. When your doctor prescribes nursing or attendant care at home, the carrier is responsible for it. No cap. No episode limit.
The Act gives the injured worker free choice of treating physician. If you were steered to "their" doctor, that was a choice you had all along.
When attendant care is prescribed, a family member can frequently be employed through a licensed agency — trained, nurse-supervised, and on payroll for the work they've been doing free.
MMI affects wage checks. Medical and attendant care that maintain your condition continue. If someone implied otherwise, that's not what the law says.
Some settlements trade lifetime care for a one-time payment. Before anyone signs, the cost of your future care should be documented properly — that decision belongs to you and your attorney, and it should never be made on the carrier's numbers alone.
A quick self-check
- You were injured working the ports/harbors — or as a civilian employee of a base exchange, commissary, club, or recreation facility
- Your claim was accepted, and your medical benefits are still open
- You need hands-on help at home — bathing, dressing, mobility, daily care
- You live in Nevada — or you want a free lifetime-care cost projection wherever you are
Not sure about one of them? That's exactly what a first phone call is for.
Three names, one set of rights.
The Longshore Act is the parent law. Two extensions apply its rules to other workers, and the benefits are the same in each: medical care for as long as the injury requires, free choice of physician, and attendant care at home when a physician prescribes it.
Defense Base Act
Extends the same rules to civilians injured working outside the U.S. for a company on a U.S. government contract — security, logistics, construction, translation. The Defense Base Act guide →
NAFIA
The Non-Appropriated Fund Instrumentalities Act extends them to civilian employees of exchanges, commissaries, clubs, and MWR programs. Covered on this page, and in the article for base workers.
Get your future care priced before any settlement conversation.
We prepare free, documented projections of what lifetime attendant care actually costs — for families and attorneys, on any Longshore-family case, anywhere in the country. Whether you settle is between you and your attorney. Our job is making sure nobody is guessing with your future.
Representing a Longshore, DBA, or NAFIA claimant?
Free lifetime attendant-care cost projections for future-medical valuation, on any case nationwide. Nurse-owned delivery for Nevada-resident clients — written-authorization discipline, hour-accurate documentation, family caregivers on payroll.
What injured workers ask us
Is this the same as the Defense Base Act?
Sister laws. The Longshore Act covers port and harbor workers in the U.S. The Defense Base Act extends the same rules to contractors overseas. NAFIA extends them to base exchange, commissary, and MWR employees. Same benefits, same lifetime medical care, same rights — we work all of them.
I work retail at the Nellis Exchange. A federal maritime law covers me?
Strange but true. Congress extended the Longshore Act's rules to civilian employees of military exchanges and recreation programs. If you were hurt on the job, the carrier owes your medical care under those rules — including care at home when prescribed.
The carrier sent me to their doctor. Do I have to stay?
The law gives you free choice of treating physician. Talk to your attorney about how to exercise it properly — and know that your doctor, not the carrier's, drives what care gets prescribed.
Can my wife or son really be paid to take care of me?
Often, yes. When attendant care is prescribed, a family member can frequently be hired through a licensed agency — trained, supervised by a nurse, and paid for the care they're already providing. It has to be prescribed and authorized properly, and that paperwork is our part of the work.
Do you serve California port workers?
Hands-on care is currently delivered in Nevada. Guidance and cost projections are free anywhere. If you're in Southern California, call anyway — we'll tell you honestly what is available where you are today, and our answer is getting better every quarter.
What does any of this cost me?
Guidance and cost projections are free. Care itself is billed to the insurance carrier under written authorization — not to you.
One call. A nurse. Straight answers.
Whether you're a longshoreman, a base worker, or the spouse doing the caregiving — the first conversation is free, and it's with a nurse who works federal cases every day.
Call a nurse — (702) 814-9630Alara Home Care is a Nevada-licensed, nurse-owned home care agency. We are not a law firm and do not provide legal advice; decisions about claims and settlements belong to you and your attorney. Care described on this page is provided when prescribed by a treating physician and authorized in writing by the responsible insurance carrier. Cost projections and benefit education are informational services provided at no charge and are not a guarantee of benefits or authorization.