Maintenance and cure

What Is Maintenance and Cure?

Maintenance and cure is a foundational legal doctrine within maritime law that ensures seafarers who become injured or fall ill while in service of a vessel receive essential financial support and medical care. This ancient principle obligates a vessel owner or employer to cover an injured seaman's daily living expenses, known as "maintenance," and necessary medical treatment, termed "cure," until they reach maximum medical improvement (MMI). Maintenance and cure benefits are a no-fault system, meaning they are owed regardless of whether the employer was negligent or the seaman contributed to their own injury, providing immediate financial relief to those working in hazardous conditions at sea.³⁷, ³⁸ Unlike workers' compensation systems applicable to land-based employment, maintenance and cure specifically addresses the unique vulnerabilities of seafarers.³⁵, ³⁶

History and Origin

The concept of maintenance and cure has roots stretching back centuries in various ancient maritime codes, reflecting a long-standing recognition of the perilous nature of seafaring. Early formulations of this duty can be traced to medieval sea codes, such as the Rolls of Oléron, which emerged around 1150 AD in France and were later adopted in England. ³³, ³⁴These codes established the shipowner's obligation to provide for sick or injured sailors. The principle was formally recognized in the United States through common law, with Associate Supreme Court Justice Joseph Story notably discussing it in the 1823 case Harden v. Gordon. This early recognition underscored the notion that seamen, given their inherent vulnerability and distance from shore-based medical facilities, required special protections. ³¹, ³²The doctrine developed to shield seafarers from the severity of life at sea and to encourage them to undertake voyages with greater confidence, knowing their basic needs would be met in case of illness or injury.
³⁰

Key Takeaways

• Maintenance and cure is a no-fault system in maritime law, obligating employers to provide living expenses and medical care to injured or ill seafarers.
  ²⁹* "Maintenance" covers daily living costs, such as food and lodging, while "cure" encompasses all reasonable and necessary medical expenses.
  ²⁸* Benefits continue until the seafarer reaches Maximum Medical Improvement (MMI) or is fit for duty.
  ²⁷* This doctrine is a core aspect of general maritime law and applies regardless of employer negligence or seafarer fault.
  ²⁵, ²⁶* Employers can face significant penalties, including punitive damages, for arbitrary or willful failure to pay maintenance and cure.
  ²⁴

Interpreting Maintenance and Cure

Maintenance and cure is interpreted broadly in favor of the seafarer, reflecting the unique hazards and dependencies inherent in maritime employment. The "in service of the vessel" requirement is liberally construed; it does not necessarily mean the seaman must be actively working at the moment of injury but rather that the injury or illness occurred during the period of employment, whether on the vessel, ashore during authorized leave, or in transit to or from the vessel.
²³
The amount of "maintenance" typically covers basic living necessities and is often determined by the reasonable cost of such expenses in the seaman's locality. "Cure" covers a wide range of medical expenses, including hospital visits, surgeries, medications, and physical therapy, extending until a qualified physician determines that no further medical treatment will improve the seaman's condition. ²¹, ²²While the obligation is clear, disputes can arise regarding the determination of MMI or the scope of covered expenses.
²⁰

Hypothetical Example

Consider Maria, a deckhand on a cargo vessel. While working on a routine voyage, she slips on a wet deck and suffers a fractured leg, rendering her unable to perform her duties. Under the doctrine of maintenance and cure, her employer, the vessel owner, immediately becomes obligated to provide her benefits.

First, Maria is entitled to "cure." This means the employer must cover all reasonable and necessary medical expenses related to her leg injury, including the initial emergency treatment, subsequent surgeries, physical therapy sessions, and prescription medications. The employer's obligation for cure continues as long as Maria's medical condition is improving or until a doctor declares she has reached maximum medical improvement.

Second, Maria is entitled to "maintenance." Since she cannot work due to her injury, her employer must provide her with daily living expenses, such as the cost of her rent, utilities, and food, while she recovers ashore. These payments help sustain her until she is fit to return to work or reaches MMI. Even if Maria's fall was purely accidental and not due to any negligence on the part of the vessel owner, she would still be entitled to these benefits. This system ensures that injured seafarers receive crucial support without the burden of proving fault.

Practical Applications

Maintenance and cure plays a critical role in the framework of maritime rights and serves as a fundamental protection for seafarers worldwide. For vessel owners and operators, it establishes a non-delegable legal obligation to their crew. This duty begins the moment a seaman is injured or falls ill in service to the vessel and persists until MMI is achieved.
¹⁹
In practice, this means employers must have systems in place for prompt medical attention and financial disbursements. For instance, regulations from bodies like the U.S. Coast Guard, while primarily focused on safety and incident reporting, underscore the broader responsibilities of marine employers to their crew, including ensuring proper care in the aftermath of incidents. ¹⁸The provision of maintenance and cure is distinct from other potential claims a seaman might have, such as those under the Jones Act, but it often runs concurrently, ensuring injured workers are not left without basic necessities or medical care. ¹⁷Compliance with these obligations is vital for vessel owners to avoid potential lawsuits and additional liabilities.
¹⁵, ¹⁶

Limitations and Criticisms

While maintenance and cure offers crucial protections, it has certain limitations and has faced legal scrutiny. The employer's obligation to pay maintenance and cure typically ceases once the seafarer reaches Maximum Medical Improvement (MMI), meaning further medical treatment will not improve their condition, even if they are not fully recovered or able to return to their prior work. ¹³, ¹⁴This "ceiling" can be a point of contention, as a seaman might still have ongoing medical needs or be permanently disabled after reaching MMI.

Another area of dispute can arise if the seaman intentionally misrepresented or concealed material medical facts during their pre-employment medical examination, and their injury is causally linked to that concealed condition. In such cases, the right to maintenance and cure may be denied.
¹²
Historically, some employers have been criticized for delaying or denying maintenance and cure payments. In response, courts have emphasized the importance of timely provision of these benefits. The U.S. Supreme Court, in Atlantic Sounding Co. v. Townsend, affirmed that punitive damages may be awarded in cases where a vessel owner's failure to provide maintenance and cure is found to be "willful and wanton" or "arbitrary and capricious." This ruling serves as a deterrent against employers improperly withholding benefits. ¹¹Despite these limitations, the doctrine remains a cornerstone of seafarer protection in maritime law.

Maintenance and Cure vs. Jones Act

Maintenance and cure and the Jones Act are both critical components of maritime employment law designed to protect seafarers, but they serve distinct purposes and operate under different legal principles.

Maintenance and cure is a no-fault benefit, meaning an injured or ill seafarer is entitled to daily living expenses (maintenance) and medical care (cure) regardless of whether the employer was at fault or the seaman contributed to their own injury. It provides basic necessities and medical attention until maximum medical improvement is reached. This right originates from ancient common law traditions of the sea.

In contrast, the Jones Act (formally the Merchant Marine Act of 1920) is a federal statute that allows a seafarer to sue their employer for damages if their injury or illness was caused, even in part, by the employer's or a fellow crew member's negligence. ⁹, ¹⁰A successful Jones Act claim can result in compensation for broader losses, including pain and suffering, lost wages beyond the period of cure, and loss of future earning capacity. ⁸While maintenance and cure provides essential, immediate care, the Jones Act offers a pathway for full compensation when employer fault is involved, making it a critical aspect of seafarer rights.

FAQs

Who is considered a "seafarer" or "seaman" for maintenance and cure purposes?

Generally, a "seafarer" or "seaman" is a person employed on a vessel in navigation, whose duties contribute to the vessel's function or mission, and who has a substantial connection to the vessel or a fleet of vessels in terms of both nature and duration. This definition helps differentiate them from land-based workers.
⁶, ⁷

How long do maintenance and cure benefits last?

Maintenance and cure benefits typically last until the injured or ill seafarer reaches Maximum Medical Improvement (MMI). MMI is the point at which a qualified physician determines that no further medical treatment will improve the seafarer's condition.
⁴, ⁵

Can a seafarer choose their own doctor for cure?

Yes, a seafarer generally has the right to choose their own medical providers for their cure. They are not obligated to accept treatment from doctors selected by their employer, though employers are responsible for the costs of reasonable and necessary medical treatment.
³

What happens if an employer refuses to pay maintenance and cure?

If an employer refuses to pay maintenance and cure, an injured seafarer can pursue legal action to compel payment. Courts view the refusal to provide these benefits seriously, and in some cases, if the refusal is deemed "willful and wanton," the seafarer may be entitled to recover attorney's fees and even punitive damages from the employer. ¹, ²This enforcement mechanism helps ensure that employer responsibilities are met.

Is maintenance and cure taxable income?

The taxability of maintenance and cure can be complex and depends on specific circumstances. Generally, the portion of maintenance and cure that reimburses for medical expenses is not considered taxable income. However, the portion covering living expenses (maintenance) might be taxable, similar to other forms of income. It is advisable for seafarers to consult with a tax professional or legal counsel regarding their specific situation.