Other States and USL&H Coverage

Other States Coverage

Purpose

When employees travel or temporarily work in states other than the employer's home state, Other States Coverage extends workers' compensation protection to those states.

How It Works

Critical Limitation (Exam-Testable)

CANNOT extend to monopolistic states: Ohio, North Dakota, Washington, Wyoming

For monopolistic states, employers must:

1. Purchase separate coverage from the state fund
2. Obtain stop gap coverage for employers liability
3. Cannot use Other States endorsement

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Monopolistic State Funds

The Four States + Territories:

Key Characteristics:

• Employers MUST purchase from state fund (private insurers prohibited for WC)
• Each state uses different classification systems
• Self-insurance may be allowed for large employers
• State funds DO NOT include employers liability
• Stop gap coverage required for Coverage B protection

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Federal Workers' Compensation Programs

Certain workers are covered by federal programs rather than state workers' compensation:

USL&H Act (Longshore and Harbor Workers' Compensation Act)

Enacted: 1927 (33 U.S.C. §§ 901-950)

Covered Workers:

• Longshore workers
• Harbor workers
• Ship repair, building, and breaking workers
• Workers on navigable U.S. waters
• Workers on adjoining piers, wharves, dry docks, terminals

EXCLUDED from USL&H:

• Seamen, sailors, masters, crew members (covered by Jones Act)
• Clerical and office workers
• Security personnel

Benefits: Similar to state WC—including 66⅔% wage replacement

Dual Jurisdiction States: In some states (AL, AK, CA, NY, etc.), injured workers can seek benefits under BOTH federal USL&H AND state workers' comp.

Jones Act (Merchant Marine Act of 1920)

Covered Workers: Seamen—masters or members of a vessel's crew

Key Features:

• Allows seamen to sue for employer negligence (not no-fault)
• Can recover pain and suffering damages (unlike workers' comp)
• Provides same protections as FELA for railroad workers

Mutual Exclusivity (Exam-Testable):

• Jones Act and USL&H are MUTUALLY EXCLUSIVE
• If you qualify for one, you do NOT qualify for the other
• "Master or member of crew of any vessel" = Jones Act (NOT USL&H)

FELA (Federal Employers Liability Act)

Covered Workers: Interstate railroad workers

Key Features:

• Allows railroad workers to sue for negligence
• Can recover pain and suffering damages
• NOT a no-fault system—must prove employer negligence
• Essentially replaces workers' compensation for railroad workers
• Higher potential awards than standard workers' comp