A couple of recent cases from the Eastern District of Louisiana provide useful guidance on the limits of maintenance and cure obligations.
Given that failure to pay maintenance and cure can give rise to a claim for punitive damages if the denial was arbitrary and capricious, employers of seaman generally aim to give prompt consideration of such claims and err on the side of caution.
But cure obligations are not absolute and if handled properly and there is a good basis to so, Jones Act employers can properly refuse to pay. That said, just because treatment is not covered under cure obligation because it is palliative, that does not mean that the plaintiff cannot recover the cost of that if he established liability under the Jones Act.
Maintenance and Cure – The Basics
Maintenance and Cure are general maritime law obligations imposed on a vessel owner to provide for a seaman who becomes ill or injured during his service on the vessel.
The obligation is similar to but not the same as worker’s compensation and is a creature of common law rather than statute. The maintenance obligation is based on an employment obligation, and the seaman does not need to show negligence or fault on the part of the employer.
The duty to furnish cure encompasses the obligation to pay for medical expenses up to the point at which the seaman reaches maximum medical improvement. The seaman is entitled to seek treatment for any physician but the employer is not obligated to pay for treatment that is unrelated, unnecessary, or unreasonably expensive. But just because medical treatment is palliative and therefore beyond the scope of the cure obligation, it does not mean that the plaintiff is necessarily without a remedy.
Not Cure but May Still Be Recoverable
In Vaughn v. American Commercial Barge Lines, LLC, the plaintiff deckhand claimed he was injured when he was violently thrown around the galley following collision that his employer had stipulated was the result of its captain’s negligence. He required orthopedic care, most of which was paid for by the employer.
By the time of trial, the only issue was whether he could recover for the costs of certain steroid objections with the defendant arguing that these were palliative. The Court agreed that these were indeed palliative and, therefore, outside the cure obligation. However, the Court held that these were damages caused by the employer’s negligence (which recall had been stipulated) and, therefore, recoverable under the Jones Act.
Palliative and Unrelated Treatment Beyond the Cure Obligation
In Tisdale v. Marquette Transportation Co., LLC, the plaintiff deckhand claimed he injured himself picking up a line. It was undisputed that he was a Jones Act seaman injured in furtherance of the mission of the vessel and therefore entitled to maintenance and cure. There was significant dispute, however, about the extent of the injury and the necessary treatment, with conflicting medical evidence.
The court found that certain treatment was palliative and therefore beyond the scope of the maintenance and cure obligation and that additional surgery recommended by the plaintiff’s treating physician was not related to the accident at issue and therefore not covered. Having made these determinations, the court concluded that the decision to deny payment for them could not have been arbitrary and capricious and dismissed the claims for punitive damages.
The Court stated: “After reasonable investigation, [the employer] denied the cure request based on the medical evidence and expert medical opinion” and therefore “the refusal to pay for this cure demand cannot be said to have been arbitrary and capricious or callous and recalcitrant.”
Note that unlike in Vaughn, liability was disputed and this ruling followed a bench trial on maintenance and cure issues only. Therefore, whether or not the plaintiff in Tisdale could recover under the Jones Act for his palliative treatment remained unresolved but not the treatment the court found unrelated..