Maintenance and cure covers sickness and injuries such as when a seaman trips and falls on board a vessel, injuring his leg or back. But does maintenance and cure cover an illness that is not so apparent in so far as it is asymptomatic? In other words, is a ship company liable for the illness of a worker, unbeknownst even to himself? A federal circuit court considered this issue, and found that cancer, even when not known by the crewmember, is covered by maintenance and cure as long as it occurred or was aggravated during the seaman’s service.
The rule of maintenance and cure is broad: a seaman is entitled to maintenance and cure for any injury or illness that occurs or becomes aggravated while he is serving the ship. This rule intentionally does not deny recovery for asymptomatic diseases. As long as any illness occurred or is aggravated during the seaman’s service, he is entitled to maintenance and cure. In other words, a manifestation requirement does not exist. The injury need not manifest, i.e. show symptoms, during a seaman’s service to be covered by maintenance and cure. The illness simply needs to have occurred or have been aggravated during the seaman’s employ.
The underlying principle behind allowing a seaman to recover for cancer is to maintain maintenance and cure as a flexible doctrine: it must evolve with new technology to equate with the realities of medical science today. Although a rule imposing liability on an employer for an injury that was known neither to the employer nor the employee during employment seems odd, admiralty is different, and maintenance and cure is a broad remedy. Courts must be liberal in interpreting it for the benefit and protection of seamen, and maritime lawyers need to be aggressive and vigilant in defending these interpretations – and it is not to be defeated by restrictive distinctions nor narrowly confined.
