Claims Strategy

Back, Knee and Shoulder Injuries: The Hidden Majority of DBA Claims

Musculoskeletal injuries from heavy lifting, rough terrain vehicle operations and physically demanding base work account for a substantial portion of all DBA claims filed. Many are settled for far less than their true value.

Published January 24, 2026 9 min read
Physical therapy for musculoskeletal injury

Back pain, knee injuries, and shoulder conditions are among the most common reasons overseas contractors seek medical attention — and among the most consistently under-valued in DBA claims. The physical demands of overseas contract work are substantial, and the long-term musculoskeletal consequences are often significant.

The Physical Demands of Overseas Contract Work

The range of physically demanding roles in overseas contract work is extensive. Logistics and supply workers handle heavy equipment and freight in conditions that would not meet domestic occupational safety standards. Construction and maintenance contractors work on uneven terrain with inadequate ergonomic equipment. Security contractors wear heavy body armour for extended periods. Vehicle operators endure sustained vibration on poor road surfaces. All of these exposures create musculoskeletal risk.

Pre-Existing Conditions and Aggravation

Carriers frequently defend musculoskeletal claims on the basis that the condition is pre-existing and unrelated to the overseas service. While genuine pre-existing conditions are relevant to the claim, the DBA covers aggravation of pre-existing conditions — if overseas service has materially worsened a pre-existing condition, that worsening is compensable. A medical opinion that carefully addresses the aggravation question is essential in these cases.

Valuation Challenges

Musculoskeletal claims are frequently settled for less than their true value because the long-term functional consequences are not adequately documented. A claimant who can return to some form of work may still have significant permanent partial disability that carries substantial compensation value. A thorough functional capacity evaluation and impairment rating by a qualified occupational medicine physician is important in all but the most straightforward cases.

Spinal Injuries and Surgery

Spinal injuries — particularly lumbar disc herniations and cervical conditions — are among the highest-value DBA claims when properly developed. Where surgery has been performed or recommended, the medical evidence and vocational impact are particularly significant, and early legal involvement to manage the evidence development is strongly advisable.