Who is going to ask the Tough questions - Why ACE Insurance Company, ESIS, and other Disability Insurance Carriers do this???? It singles out Disabled Veterans (maybe not military, but war veterans the same), is prejudicial, and a violation of EEOC law. The practices discriminate against the disabled. Allot have of these veterans have PTSD, the last thing they need is to be constantly blindsided!!
Overseas Contractors Beware!
Does the Philosophy ""It is easier to ask Forgiveness, than Permission!"" have any business in the way Insurance Carriers service their Claimants accounts? If you insure the disabled from our war efforts, under the Longshore and Harbor Workers' Compensation Act, 33 U.S.C. § 901–950 (The Act), I say NO!
ESIS Incorporated, a division of ACE Insurance Company does this as Standard Operating Procedure. They will either drop your benefits at their leisure, without notice, or explanation, or drastically reduce your benefits. Then when you finally get the forms they provided to the Department of Labor(DOL), ""Information Copy,"" it is weeks after the benefits were affected. If your benefits are terminated, it is over a frivolous unverifiable assumption. Do they have to provide evidence first and get approval before the termination of benefits? NO, they just do it! If you prove their assumption wrong, they won't change it. ESIS Inc. makes you take them to court, through Administrative Law Judge (ALJ) Review Process. My ALJ review took three years!
Then when you win your ALJ case, they use another entity to conduct a job survey to find the average wage for positions you qualify for in your area. ESIS Inc. takes this survey to fix your wage-earning capacity in the same way they terminate your benefits, behind closed doors, in secrecy, and without approval. They determine that you could have performed positions that you may never have seen your entire life and never would have qualified for, let alone have been able to perform. But they said you could do it—that's that—and as a result they only have to pay two thirds the difference, drastically reducing your benefits. In my case my benefits dropped almost two thirds.
Even though the DBA specifically allows for the introduction of evidence by the claimant, ESIS doesn't provide you the opportunity. They make the changes and provide the DOL an Information Copy. The Act, 33 U.S.C § 908(h) places the responsibility of the establishment of the Claimants wage-earning capacity in the hands of the Deputy Commissioner, not the insurance carrier, ""[T]he deputy commissioner may, in the interest of justice, fix such wage-earning capacity as shall be reasonable."" NOTE: Is there any Justice in what ESIS Inc., their law firm, or ACE insurance companies are doing?
Regarding your benefits, the Regional office of the DOL does not feel they have the authority to order them back—so along comes yet another ALJ Review. All along, who is expected to pay for all these legal fees? The claimant, because the DOL doesn't compensate Lawyers enough to make it worth their while. If you live in an area with no Harbors or Longshoremen, there are no lawyers in your area to help. So, you either don't fight or do it Pro Se (Represent Yourself).
If you agree with me, then send a resounding statement by not thinking of ESIS Incorporated or any ACE Insurance Company subsidiaries, when buying your Longshore and Harbor Workers' Compensation Insurance policy to protect your employees or deciding on which company to invest in. When employees get harmed in the line of work, they don't deserve to be continually harmed and harassed by the insurance company who is suppose to care for them! If you said YES to the question above, shame on YOU, but you have that right. Good luck keeping employees, once they get wind of how they get treated when they are injured. If you invest in them, know that you are investing in a firm who is knowingly taking advantage of the disabled.
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