Louisiana Workers’ Compensation Benefits & Settlements

 

If you are hurt on the job in Louisiana, unable to work due to the injury and if your injury is covered by Louisiana Workers’ Compensation Act, your employer and its workers’ compensation insurer are obligated to pay indemnity benefits, necessary and reasonable related medical bills, travel expenses and vocational rehabilitation benefits. In the event of death, benefits are payable to your survivors.  Before settling your Louisiana Workers’ Compensation Claim, you should be familiar with the various types of benefits owed and issues specific to workers compensation settlements.

Workers compensation payments are made regardless of fault on the part of the employer or employee. In exchange for the benefits, the employee generally waives the right to sue his or her employer in tort for pain and suffering damages.  After a work related injury and perhaps a vistit to the hospital emergency room, the first thing an injured worker will need to do is to figure out who the employer’s workers compensation insurer.

LOUISIANA WORKERS COMPENSATION INSURERS  After an accident, an employer often refuses to provide the injured employee with the name of its insurer in an attempt to try to discourage the employee from making a claim. If this is the case, get a Louisiana workers’ compensation lawyer. Action on your part—a letter to the employer or filling a disputed claim—may be required to determine who the insurance carrier is. Popular insurance companies include: Louisiana Workers’ Compensation Corporation (LWCC), CNA, AIG, Liberty Mutual, Travelers, Sea Bright Insurance Co., The Hartford, and Chartis.   If you decide you do not want to get a lawyer in involved at this stage of the claim, you can also try to determine who the insurer is by clicking onto “Workers Compensation Coverage Verification” in the lower left hand corner of this Louisiana Department of Labor page.  Below are the types of Louisiana Workers Compensation benefits you may be eligible for:

INDEMNITY BENEFITS FOR LOST WAGES Indemnity benefits are typically two-thirds of your average weekly wage. Indemnity benefits include temporary total disability, supplemental earnings benefits, permanent partial disability and permanent total disability.

MEDICAL BENEFITS Accident related medical bills are paid by the employer and its workers’ compensation insurer. The workers’ compensation insurer’s approval is required for treatment beyond $750 unless the care is provided under emergency conditions.

A health insurer’s payment of job injury medical expenses will extinguished the injured employee’s claim against her employer for those medical expenses under the Louisiana Workers’ Compensation Act. However, the claim is not extinguished for direct payment by the employee, a relative or friend of the employee, or by Medicaid, or other state medical assistance programs.

Furthermore, if a health insurer has paid the medical expenses, the health insurer has a right of reimbursement against the employer and their workers’ compensation insurer for medical bills it paid in connection with an employee’s workers’ compensation claim.

CHOICE OF PHYSICIAN The injured employee has the right to choose one treating physician in any field or specialty. The employer or insurance carrier’s permission is required to change treating physicians within the same field or specialty after the employee’s initial choice. An emergency room physician is not considered the choice of the employee.

If the employer or its insurer provides the injured employee with a choice of physician form to select his or her own physician, the injured employee is not required to choose the company’s doctor; rather, they may choose their own physician. However, an injured employee must submit to an examination by a company doctor paid for by the company or its insurer as often as may be reasonably necessary.

VOCATIONAL REHABILITATION BENEFITS Generally, if you are unable to return to your job of injury or an alternative job with the same employer, the employer is required to do a labor market survey to find jobs available in your geographic area for job duties approved by your doctor.

Louisiana Workers Compensation – Help with Labor Market Survey ChartMILEAGE BENEFITS All related expenses reasonably and necessary for obtaining services, medicines, and prosthetic devices should be paid.

LUMP SUM LOUISIANA WORKERS COMPENSATION SETTLEMENTS

There is no Louisiana Workers Compensation settlement calculator.  The value of any possible Louisiana Workers Compensation settlement hinges  on many  things, one of the most important, is the injured worker maintaining his or her rights to indemnity, medical, mileage and vocational rehabilitation benefits.  What benefits are owed and still being paid?  What is owed and not being paid? What is now owed? A lawyer may be helpful in helping an injured worker keep his or her benefits. It is usually easier to maintain benefits than to attempt to restart them once they are lost.

The injured worker or surviving dependents (in case of death) never need to settle their claims for future benefits and neither does the employer and insurance company.  The injured worker cannot force the insurance company and employer to pay all of her future indemnity, medical mileage and vocational rehab benefits all at one time; that can only be done by agreement of the parties.  Although the injured worker who is receiving weekly payments will probably live a long life, the insurance company will argue that he or she might die tomorrow in a car accident or some other reasons unrelated to the work accident, making the comp claim near worthless.

Some things to consider when valuing and settling a Louisiana Workers Compensation case include the following:

• What type(s) of indemnity benefits are being paid? Are all benefits being paid? Is there a time limit (number of weeks, age limit, limitation on remarriage etc) on the type of benefits being paid?
• When was the last indemnity, medical, mileage or vocational rehabilitation benefit paid? What are the time periods for asserting rights to unpaid benefits?
• Has a disputed claim for compensation been timely filed on any unpaid benefit? If so, who is the judge presiding over the case?  Do the documents, witnesses and other evidence support the claims?
• Has the accident related medical condition stabilized?
• Is the medical condition causing the disability or death related to the accident?
• Is there some condition the injured worker did after the accident that prevents him from finding employment?
• What are the treating doctor’s recommendations for future medical care?
• Has the Average Weekly Wage been calculated correctly? Does it include overtime, vacation pay or any other taxable wage benefit?
• Is the correct comp rate being paid?
• Is the Labor Market Survey legitimate? Does the job really exist?  Is the injured worker able to do it given his education and training?  Did the treating doctor approve the position?  Is he physically capable of performing the real position set forth in the Labor Market Survey?  Often times the description in the Labor Market Survey is inaccurate..
• What is the injured worker’s life expectancy?
• In the event of death, have the funeral expenses been paid?
• Social security disability or retirement benefits received?
• Social security disability spread language about life expectancy included in the proposed settlement documents? What impact will the settlement have on Social Security Disability benefits being received?
• Are past, indemnity, medical, mileage benefits owed; have hospitals, doctors, physical therapists and other providers been contacted to see if all healthcare providers have been paid?
• Outstanding liens, including Medicaid, Medicare, Child Support, Attorney fees, costs, anything else etc.
• Future medical care and prescription medication,
• Medicare’s interest in the settlement- has an accurate Medicare Set Aside been submitted to CMS for approval?
• Will both the indemnity and medical be settled at the same time?
• What is the value of any other claims (tort, discrimination, unpaid wage, wrongful termination etc) owed by the employer?; Settlement language for these other types of claims will probably be included in the Settlement Documents and Release.
• What the actual settlement documents and release say and what they are supposed to say? – More often than not, they do not say what was promised by the insurance company and employer and need to be revised;
• The value of any related third party claim and whether it makes sense to settle both the comp claim and third party claim at the same time;
• What, at the end of the day, does the injured worker expect to do with the rest of his life, for work, medical treatment, etc.

 

LOUISIANA DEPARTMENT OF LABOR DISTRICT OFFICES There are several Louisiana Workers Compensation District Offices that serve specific parishes. For a complete list of the Judges, Mediators, Dispute Resolution Specialists, mailing addresses, phone numbers, fax numbers, email addresses and Parishes served, see this chart.

Lavis Law Firm handles disputed claims for compensation and workers comp settlements at the Louisiana Office of Workers Compensation District Office, which are located in Harahan, New Orleans, Houma, Lafayette, Lake Charles, Baton Rouge, Covington, Alexandria, Monroe and Shreveport.

If you need help or have any question about your job injury, call me, a Louisiana workers’ compensation lawyer, at 866-558-9151, or submit your inquiry online. Please be advised that you may be facing important legal deadlines so don’t delay.