13.4 Other States, USL&H, and Federal Acts

Where the Policy Applies: Item 3.A vs Item 3.C

The Information Page controls geography:

A state can be listed in 3.A or 3.C — never both. If an employer begins work in a brand-new state that is neither listed, there may be a coverage gap. Listing "all states except those with monopolistic funds and [3.A states]" in 3.C is a common broad approach.

Other States Insurance in Practice

Use Item 3.C when an employer might expand into states it is not operating in yet:

• If a state is listed in 3.C and the employer later begins operations there, Part One coverage automatically applies as if the state had been listed in 3.A from the start.
• A state the employer is already operating in at inception belongs in 3.A, not 3.C.
• Monopolistic-fund states cannot be covered by Other States Insurance — coverage there must come from the state fund.

Exam tip: "plans to expand later" -> 3.C; "already working there now" -> 3.A.

USL&H Act (Maritime Shore-Based Workers)

The Longshore and Harbor Workers' Compensation Act (USL&H) is a federal workers' comp law covering employees injured on the navigable waters of the United States or adjoining areas (piers, docks, terminals, shipyards) used in loading, unloading, repairing, or building vessels.

• It is a no-fault comp system like state law, but federal, with higher benefit scales than most states.
• State WC policies exclude USL&H obligations unless added by the USL&H Coverage Endorsement (WC 00 01 06), which extends Part One to USL&H.
• USL&H covers shore-based maritime workers — not the crew of a vessel (that is the Jones Act, below).

Major Federal Acts and the Jones Act

Several federal statutes cover workers outside state systems:

Critical contrast: USL&H and state comp are no-fault. The Jones Act and FELA are fault-based — the worker must sue and prove the employer's negligence. The Jones Act covers the crew of a vessel; USL&H covers the shore-based workers who load and service it.

Voluntary Compensation Endorsement

Some workers are exempt from a state comp statute (e.g., certain farm laborers, domestic, or casual employees) and so are not automatically entitled to benefits. The Voluntary Compensation Endorsement lets the employer offer those employees statutory-equivalent benefits voluntarily. If the worker accepts the benefit, that typically releases the employer from a tort suit; if the worker rejects benefits and sues, the matter shifts to Part Two.

Item 3.A vs. Item 3.C — Where the Policy Applies

The WC policy's Information Page controls geography. Item 3.A lists states where coverage applies on a primary basis at inception. Item 3.C (Other States Insurance) lists states where coverage automatically extends if the employer later begins operations there during the term — but only states named in 3.C (or "all states except those in 3.A and the monopolistic states") are covered. A state listed in neither 3.A nor 3.C is uninsured for an employee who gets hurt working there — the classic exam trap when an employer expands into a new state without endorsing it.

Other States Insurance in Practice

If an employer hires a worker in a 3.C state, the insurer pays that state's statutory benefits as if it were a 3.A state. The fix for a truly new operation is to add the state to 3.A by endorsement. Monopolistic states can never be picked up by 3.C — coverage there must come from the state fund.

USL&H and Maritime Workers

The Longshore and Harbor Workers' Compensation Act (USL&H) is a federal WC law covering maritime employees (longshoremen, ship repairers, harbor workers) injured on navigable waters or adjoining piers/docks — workers not seamen but beyond state WC. USL&H benefits are higher than typical state benefits, so the exposure is added by the USL&H Coverage Endorsement specifying the federal act. A dockworker loading cargo is USL&H; a clerical worker inland is state WC.

The Jones Act and Other Federal Acts

The Jones Act (Merchant Marine Act) covers seamen (crew members) and, unlike no-fault WC, lets an injured seaman sue the employer for negligence — so it is a liability exposure handled by maritime employers liability/P&I, not standard WC. Other federal acts include the Federal Employees' Compensation Act (FECA), the Federal Employers' Liability Act (FELA) for railroad workers (also negligence-based), the Defense Base Act, and the Federal Black Lung program. The tested distinction: USL&H and FECA are no-fault; the Jones Act and FELA are negligence/fault-based suits.

Voluntary Compensation Endorsement

The Voluntary Compensation Endorsement extends WC-style benefits to employees not subject to a WC statute (certain farm or domestic workers, or workers in a jurisdiction with no compulsory law), offering statutory-scale benefits in lieu of a tort suit — closing a gap the standard policy leaves.