Defense Base Act Compensation Blog

The Modern Day DBA Casualty

Dear Representative Kucinich

Dear Rep. Dennis Kucinich,

 Has AIG any credibility left?

Open any newspaper and AIG jumps out at you in big, black letters.

Mention AIG and you get a look of disgust and a full understanding requiring nothing more said.

Congress convenes a hearing.

Unfortunately, unless the committee has reviewed multiple case files, examined how the insurance company absolved themselves of liability, tracked the effects and examined how the chain of events intertwine and unfold, how can the right questions be asked?

And, if they do, what do they do with the answers?   Can they separate the truth from the lies?   Can they ID and challenge bogus, PR, or self-defense testimony?

 Why does the OALJ overlook criminal violations of the Longshore Act and the United States Code they find in conducting formal hearings?

(Iraq and Afghanistan has been sending us back broken bodies for how many years now?) 

 The insurance company terminates a war-injured’s life (disability compensation and medical treatment) using Federal Forms LS-207 and 208 based on allegations they list in Box 12 of the form.   The insurance company’s termination results in medical and financial damage to the injured.   They cannot work so they cannot pay their bills.   The  family suffers.  

 This suffering is based on allegations the insurance company is not required to substantiate prior to terminating life.    The insurance company could charge a quadriplegic with running a marathon on free weekends, terminate his life and not worry about the DOL’s acceptance.

 If the war injured provides the DOL evidence showing the allegations the terminator listed in Box 12 were false, the form is not flagged for further investigation or sent to any other agency or office for action.   It is buried in one man’s file amongst thousands of other files.   The man-hours required to dig these phony forms out to see if any suspicious pattern emerges would be formidable.    DOL’s claim examiners see this every day.   

Is this not tantamount to stumbling over a rape victim and saying nothing?

 Suggestion:  Randomly select LS-207 & 208 forms from a pile of those used by the insurance companies to terminate their liability to a war-injured.   Ask the insurance company representative the Committee has called before them to explain.    I would be surprised if the insurance rep was unable to drag up individual cases at will on his laptop.  

  Second, look for patterns and then call the insurance claims adjusters before the Committee for questions.    Use their answers to form additional questions.

 For instance:

 Did the termination of this war-injured’s medical treatment for X (months, years), lead to exacerbation of the injury? Did this delay increase the cost charged to the taxpayer?

 Let’s examine the billing of Case xx-xxxx.

Were the charges in Box 12 proven to be factual, legitimate? 

How much money was charged back to the taxpayer for attorney fees and court costs?    

How much money did the insurance company profit (or lose) from this case?

Compare the cost of the legal action vs. the cost of the medical treatment controverted.

Was the insurance company able to charge back more money to the taxpayer by sending the case to legal rather than covering the medical treatment of the injured?    

Let’s examine Case xx-xxxx.

Who made the decision and what facts dictated the selected course of action?

Was any additional information requested from the injured before the company denied his life?

What was the result of these terminations? 

Did the case go all the way to a formal hearing?

Was it settled before or after a formal hearing date was scheduled?

Has any settlement included a “non-disclosure” stipulation?

If yes, why would a case controverting benefits for a war-injured need a non-disclosure clause?

 Does an increase in cases controverted and turned over to law firms have a corresponding increase in administrative fees billed to and paid by the taxpayer?

 Examine the cases looking for a pattern of Forced Desperation & Settlement.

Were the denied claimant forced into financial desperation by the IC’s termination of benefits?

Were the reasons for controversion listed in Box 12 of the LS forms legitimate?

Did the claimant agree to the IC’s offered settlement solely out of a driving need to feed his family?

Did any representative of the IC, at any time, access the claimant’s credit reports?

 If yes, work up a timeline.

 In cases grouped by similarities, were there any common threads?

Claim adjuster?  Lawyer?  Law firm?

 Case analysis:

Are any of the claim’s adjusters assigned and reassigned on cases?

(IC:  Of course, to redistribute case loads to provide better service to the claimant. Really?)

Do these reassignments cause a delay in the resolution of cases; delays in medical treatments or the reinstatement of benefits?

Are the claimant’s receiving their benefits when these reassignments take place?

Are those benefits controverted?

Are the reassignments logistic or strategic?

 IME analysis:

Why send a claimant 102.8 miles from home to attend an Independent Evaluation when 17 qualified doctors are available within 20 miles of the claimant’s home?

Why were these particular IMEs selected?

Can they be truly considered “Independent” when the sole survival of their practice depends on working for and testifying for insurance company interests?

Are these IMEs as up-to-date on procedures and diagnostics as are those 17/20 DOCs who actually cut into the human body?  

Why is video-documenting the IME’s evaluation objected to by the IC?

Documenting the evaluation would affirm that what the IME finds is what the IME writes in his report.

Want to add your own questions? Use the comment form. Don’t ask me your question(s), aim it for the Committee. I cannot guarantee the Committee will even read them, but I will guarantee they will know they are there. Hint: know the answer before asking the question, if possible.


***These pages faxed to Committee and posted here**


T. Lee Marshall “Streetgang”

KBR Convoy Bulk Fuel Truck Driver

LSA Anaconda, Balad, Iraq 2004-2005  

5 Responses to “Dear Representative Kucinich”

  1. Widow in California said

    I think the IME’s should have to prove that at least 60 percent of their annual income comes from another source other than testimony for insurance company claims. I feel 40 percent is more than fair and it would keep these doctors honest. Also the claimants wouldn’t have to be examined by doctors that are no longer keeping up on advanced medical technologies and discoveries. Would they trust a doctor to do brain surgery that hasn’t picked up a scalpel for 10 years? The way it is set up now only encourages biased opinions. When I was interviewed by the attorney’s “psychiatrist of choice”, he was stuck on asking me the same question, but he would reword it. He would start to slip into another subject only to sneak in another question that still pertained to his subject of choice. I am a calm, passive person by nature. However by the end of this depo I had raised my voice several times. I am not one to show anger, but agravation sets in when for three hours they ask you the same thing but reword the question over and over. Hey Guys, the sky is still blue no matter how we look at it. I can only imagine how a wounded contractor must feel when these games are played on them. I consider that abusive treatment when they subject an already wounded person to that type of treatment. I am not the ONLY one who thinks so either. The attorney’s for the insurance companies have actually stooped to “mud slinging” accusations that have nothing to do with the actual facts of the case. However it could give a judge a false impression of someone. Once an impression is put in someones mind it is hard to erase. Let us hope our judges see through their petty tactics.

  2. Terry Steward said

    Mr. Marshall,
    I read your list of questions. You put a lot of though into them. Also, I watched the hearing on June 18, 2009 put on by Dennis Kucinich. I thought he (and the committee) did a good job with their questions. But, I now think they could accomplish a lot more with another hearing using your questions. Your questions may be, depending on the answers, grounds for criminal complaints against the CEO’s and managers of the AIG, CNA

  3. jlbadd boy said

    What do you do when the Senior Claims adjuster will even listen to her Attorney and start paying someone. Instead she continues to ignore one hoping you will go away. Kitty Dixon from the Dallas office has no heart and her respond is when you tell her you need money is ” Tuff get a job” I think no one from AIg from the top down has any heart. JL

  4. brit guy said

    All of the insurance companies should be listed they are all as bad.
    A quick summary
    Oct 2008 offer to attend an IME
    We do not plan to have you seen by a physician while you are in the USA.
    As soon as the Dr provides me with your permanency rating we will be prepared to discuss settlement. Any settlement will be based solely on the rating given for the indemnity portion of the settlement and we will also allow some additional funds for any future medical treatment.
    As you are aware, the Dr. feels you will continue to heal without any formal treatment, therefore any settlement amount for the medical portion of your claim will reflect a compromised settlement.

    I had seen my consultant only a couple of weeks prior to this email and it did not tally with what he had told me. I asked him in an email if there had been a change in his opinion here is his reply.
    I have never stated to them that you will require no treatment in the future and indeed have specifically stated in my clinic letters that there is a chance that you may require more surgery at some point. They must be aware that requiring no immediate treatment and never requiring any treatment in the future are 2 different things?!
    If I was you I would ask them to clarify what they mean as their e-mail leaves a suspicion that they may be trying to duck out of covering any future treatment you need. I would get them to state in writing that this is not the case.
    Good luck and all the best
    Have they no they have not.

    Well an informal conference was held in the middle of the year.
    Recommendation was to await a report from my Dr this they got they didn’t like it. They then sent me to a Dr of their choice an expert on my injuries. He painted a bleaker outlook than all the other Dr’s again an expert in his field insurance companies response silence.
    Outcome await another informal conference.
    This has now dragged on for 18 months as you can see there is clear evidence of my injuries verified by
    x-ray cat scans and physical examination.
    I therefore find it somewhat of an outrage to have a representative from AIG sit at the hearing bemoaning the problems they have in establishing the facts.
    My case is not being handled by any you list so charge them all with the same offence they are all as guilty as each other.

  5. Alex Fazly said

    I thought I was the only one having problem with AIG, and their Rep. Cynthia Campbell-Lloyd and her supervisor Kitty Dixon. They discontinued my compensation check without any explanation, and when I called Cynthia she didn’t bother to call back or email me. So, I called her Supervisor Kitty Dixon and her response was Cynthia is looking into it and referred me back to Cynthia. I got frustrated and didn’t know what else to do, so this time I wrote to Kitty’s Superior Chad Clemens, CCing Kitty and Cynthia. Once again I got the same response that Cynthia is looking into this matter. Finally, I called the DOL in Long Beach, CA and complained to them regarding my situation. The Rep. at DOL made a three way conference call with Cynthia and myself and basically warned her if this happened again they will have to also pay additional 10% penalty.

    I received my check the following day sent via overnight Fed-Ex. There are good people at the Labor Department who cares. Give them a call if everything else fails.

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