Workers’ compensation is a type of insurance program financed by mandatory employer contributions, although it’s designed to protect employees if they suffer work-related injuries or diseases.
Qualified employees may be entitled to recover lost wages, medical expenses, disability payments, and costs associated with physical therapy and rehabilitation. Coverage is provided, regardless of who is at fault for the injury. It can be the employee, employer, co-worker, or a third party.
Louisiana workers’ compensation law requires a vast majority of employers to carry this type of insurance. If you’ve been injured on the job, we’ve prepared this article covering every facet to help you understand your rights.
To qualify for Louisiana workers’ compensation benefits, here are the basic requirements you must meet.
Injuries arising out of and in the course of employment are generally covered. However, the injuries must be severe enough to require more than first aid or be classified as catastrophic.
Slips and falls, for example, can result in catastrophic injuries like broken bones, paralysis, traumatic brain injury, spinal cord injury, facial injury, and amputation or loss of limb. Unfortunately, small cuts, wounds, abrasions, etc. cannot amount to a workers’ comp claim.
You may not be covered for injuries sustained outside the office or working environment or due to substance abuse. Commuting injuries are generally not covered. But there are few exceptions, such as when you’re injured while delivering goods to a client.
It’s not only one-time injuries that can warrant a workers’ comp claim. Employees can also develop injuries like carpal tunnel syndrome because of repetitive job stress. They can also be exposed to hazardous chemicals at work, leading to occupational diseases like cancer, heart disease, silicosis, and mesothelioma.
The workers’ comp insurance program covers costs related to your medical treatment. This includes hospital expenses, prescriptions, and the cost of traveling to receive medical services. Temporary and permanent disability benefits may also be awarded to cover your lost wages, depending on the nature of your injuries.
Under the workers’ compensation Louisiana law, an injured employee can receive up to $657 per week as temporary total disability benefits until he or she reaches maximum medical improvement (MMI). Precisely, you’ll get two-thirds of your average weekly wages. These benefits cover the lost wages during the period you are not fit to work.
If you can never go to work as you used to or train for another job to earn wages, you’ll receive the same benefits as an employee with a temporary total disability. However, the permanent total disability benefits will be awarded as long as you remain disabled.
For a permanent partial disability case, you are also entitled to the same benefits as above, but the duration varies. Well, this depends on how the doctor rates your disability, the total loss of use of the affected body parts, and injuries to organs, spine, or head. It’s possible to receive the benefits for up to 520 weeks.
If you’ve sustained catastrophic injuries, you could receive up to $50,000 in a lump sum.
While the workers’ compensation Louisiana law requires reporting work injuries to an employer within 30 days, it’s recommended to report the details of the accident immediately.
You should also seek medical attention as soon as possible. Please note that you need to be examined by a physician, even if you think the injury is not severe. You should feel safe only when the physician has ruled out internal injuries, brain injury, and other injuries that can be dangerous in the long-term.
You have the right to go to your preferred treatment facility or doctor but cannot switch doctors without your insurer’s or employer’s approval. Also, if the cost of treatment for any of your injuries is more than $750, approval from your insurer is required before doctors can start offering treatment.
It’s your employer who will initiate the workers’ comp claim. He or she will submit a copy of your injury report, formally known as the First Report of Injury form, to the insurance company.
After receiving your injury report, the insurer will submit it to the Louisiana Office of Workers’ Compensation Administration (OWCA). This commission will review your case to determine eligibility before investigating your claim.
Depending on your injuries, OWCA may require that you undergo a physical examination by an independent medical practitioner. Your employer’s insurer can choose to approve or deny your claim after the review process.
Yes, Louisiana worker’s compensation law gives you the right to file a Disputed Claim for Compensation to initiate your appeal. Unless your employer’s insurer is willing to reach a settlement agreement, you’ll have to prepare for a hearing before a workers’ comp judge.
You should find an experienced work accident attorney in Louisiana to help you collect evidence and build a strong case so that you can prove your claim. Your lawyer can also represent in the Circuit of Appeals if the workers’ comp judge rules against your case.
Whether you need to file a dispute or only a workers’ comp claim, The Mahone Firm can help you in every step of your claim process. Call (504) 564-7342 to request a free case evaluation.