Where Does Maintenance and Cure Come From?
Your client fell on a vessel deck, tore a rotator cuff, and their employer stopped paying medical bills after six weeks. Before you file anything under the Longshore Act or Jones Act, there is a more immediate remedy available. Maintenance and cure is a shipowner's obligation to provide living expenses and medical treatment to seamen injured or fallen ill in the service of the vessel. It applies regardless of fault.
This obligation traces back to the medieval codes of Oleron and the Hanseatic League, making it one of the oldest legal duties in Western law. U.S. courts have enforced maintenance and cure since the early 1800s, and the Supreme Court confirmed its broad scope in Calmar Steamship Corp. v. Taylor (1938). The duty arises from the employment relationship itself, not from any statute. Congress has never codified it. Courts treat it as a quasi-contractual obligation rooted in the special nature of maritime employment.
For practitioners working DBA and Longshore cases, maintenance and cure matters because the same injury can trigger overlapping remedies. A worker who qualifies as a seaman under the Jones Act is entitled to maintenance and cure in addition to any Jones Act negligence claim. Understanding where maintenance and cure fits in the remedial framework is essential for advising clients on their full range of options.
Who Qualifies for Maintenance and Cure?
Eligibility hinges on seaman status. The Supreme Court established the current test in Chandris, Inc. v. Latsis (1995): the worker must (1) contribute to the function of a vessel or fleet of vessels, and (2) have a connection to the vessel that is substantial in nature and duration. Courts generally look for a worker who spends roughly 30% or more of their time aboard a vessel in navigation.
The threshold is lower than most practitioners expect. You do not need to be a captain or deckhand. Courts have extended seaman status to cooks, engineers, divers, crane operators aboard derrick barges, and casino workers on riverboat gambling vessels. The critical factor is the substantial connection to an identifiable vessel or fleet.
Workers who do not qualify as seamen may still be covered under the Longshore and Harbor Workers' Compensation Act (LHWCA) or the Defense Base Act, depending on their work location and employer. The jurisdictional boundaries between the Jones Act, LHWCA, and DBA are some of the most contested issues in maritime employment law.
One common mistake: assuming that a worker who files an LHWCA claim cannot also be a seaman. These are not mutually exclusive at the filing stage. If there is any question about seaman status, investigate maintenance and cure rights before conceding LHWCA-only jurisdiction.
What Does Maintenance Cover?
Maintenance is a daily living allowance paid to the injured seaman while they recover. It covers the reasonable cost of food and lodging that the vessel would have provided had the seaman remained aboard and healthy. The rate is not tied to the seaman's wages. It is based on actual living costs.
Courts have varied widely on the appropriate daily rate. The Fifth Circuit in 2023 approved rates ranging from $30 to $60 per day depending on the seaman's geographic location and actual expenses. Some collective bargaining agreements set specific maintenance rates. Where no CBA applies, the court determines a reasonable amount based on evidence of the seaman's actual food and lodging costs ashore.
The maintenance obligation begins when the seaman is released from the vessel due to injury or illness and continues until the seaman reaches maximum medical improvement (MMI). This can last months or years depending on the injury. There is no statutory cap on duration. The employer pays maintenance for as long as the seaman has not reached MMI, even if that period extends well beyond what workers' compensation would provide.
Maintenance is not offset by other benefits. If the seaman receives disability payments from another source, the employer still owes maintenance separately. This stacking of benefits is one of the features that makes maritime remedies more favorable than standard workers' compensation in many cases.
What Does Cure Require?
Cure is the employer's obligation to provide medical treatment for the injury or illness until the seaman reaches maximum medical improvement. Unlike maintenance, which is a cash payment, cure requires the employer to pay for actual medical care: hospital stays, surgery, rehabilitation, medication, and specialist consultations.
The scope of cure is broad. The employer must provide treatment that is reasonably necessary to address the condition. Courts have consistently held that the employer cannot select the cheapest available option if a more appropriate treatment exists. The seaman has the right to choose their own physician, though the employer can request an independent medical examination.
One of the most litigated issues in cure is the MMI determination. Employers frequently argue that the seaman has reached maximum medical improvement earlier than the treating physician believes. The burden falls on the employer to prove MMI by competent medical evidence. A seaman's own physician's opinion that further treatment could improve the condition generally defeats an employer's MMI defense.
Cure also extends to pre-existing conditions that are aggravated during service. If a seaman had a prior back injury that worsened while working aboard the vessel, the employer owes cure for the aggravation. The employer takes the seaman as they find them, consistent with the general maritime "eggshell skull" principle.
What Happens When Employers Refuse to Pay?
The consequences for refusing or unreasonably delaying maintenance and cure are severe. The Supreme Court in Atlantic Sounding Co. v. Townsend (2009) held that punitive damages are available when an employer willfully and wantonly fails to pay maintenance and cure. This decision transformed the enforcement landscape.
Before Townsend, the primary remedy for nonpayment was compensatory damages plus attorney's fees. Courts could award damages for the aggravation of the seaman's condition caused by the delay in treatment. But punitive damages were unavailable, which gave some employers an economic incentive to delay payments and force litigation.
After Townsend, the calculus changed significantly. Punitive damages have no fixed cap in maintenance and cure cases. Juries have returned punitive awards several times the amount of unpaid maintenance and cure. The threat of punitive exposure now motivates many employers to pay promptly even when they dispute the claim.
Attorney's fees are also recoverable in maintenance and cure actions. Under Vaughan v. Atkinson (1962), the Supreme Court held that an employer who arbitrarily and unreasonably refuses to pay maintenance and cure must pay the seaman's legal costs. This fee-shifting applies even without a punitive damages finding.
For practitioners, the Townsend framework creates significant leverage in settlement negotiations. An employer facing potential punitive damages for delayed payment has a strong incentive to resolve maintenance and cure disputes quickly, even if the underlying liability questions remain contested.
How Does Maintenance and Cure Interact with Jones Act Claims?
A seaman injured by employer negligence can pursue both maintenance and cure and a Jones Act negligence claim simultaneously. These are separate remedies with different standards and different damage components. They are not alternative theories. They are cumulative.
Maintenance and cure is a no-fault remedy. The seaman need not prove employer negligence. The only requirements are seaman status, service to the vessel, and an injury or illness arising during that service. Jones Act claims, by contrast, require proof of employer negligence, however slight. The Jones Act borrows the relaxed causation standard from the Federal Employers' Liability Act (FELA), making it easier to establish than ordinary negligence but still requiring some proof of fault.
The damages differ as well. Maintenance and cure provides daily living expenses plus medical treatment. The Jones Act provides compensation for lost wages, pain and suffering, loss of earning capacity, and other tort-style damages. There is some overlap in medical expenses, which courts handle through setoff or election of remedies at the damages stage.
Strategically, maintenance and cure is often the faster remedy. Because it does not require proving negligence, a seaman can demand immediate payment while the Jones Act claim progresses through discovery and trial preparation. Filing a maintenance and cure demand letter early in the case puts pressure on the employer and establishes a timeline that can support a later punitive damages claim if the employer fails to respond.
How Does Maintenance and Cure Relate to LHWCA and DBA Claims?
The jurisdictional line between maintenance and cure (available to seamen) and LHWCA/DBA benefits (available to non-seaman maritime and overseas workers) is one of the most contested boundaries in maritime employment law.
A worker covered exclusively under the LHWCA or DBA does not receive maintenance and cure. These are separate remedial schemes. The LHWCA provides scheduled benefits for disability plus medical treatment. The DBA extends LHWCA benefits to workers on overseas military bases and under government contracts abroad. Neither scheme includes the maintenance component (daily living allowance) that seamen receive.
The gray area exists where a worker's duties straddle the line between seaman and longshoreman. Offshore platform workers, for example, may spend part of their time on vessels (seaman work) and part on the platform (LHWCA work). Courts use the Chandris substantial connection test to determine which regime applies, but the factual analysis is often close.
For DBA practitioners, maintenance and cure becomes relevant when a claimant was injured while performing vessel-related work overseas. A diver working off a military support vessel in the Persian Gulf might qualify as a seaman rather than a DBA-covered worker. Correctly identifying the applicable regime determines whether the claimant receives maintenance and cure (no-fault, potentially more generous) or DBA benefits (also no-fault, but with statutory benefit structures).
ClaimTrove's investigation engine helps identify the employer, carrier, and contract context that informs jurisdictional analysis for claims at the boundary between DBA coverage and traditional maritime remedies.