Workers’ Compensation

I was injured on my job. What benefits am I entitled to?

If your injury or illness is found to be job-related, you may be entitled to receive medical care for the injury or illness, disability compensation for a portion of your list wages, rehabilitation services, and, in the event of your death, benefits payable to your survivors.

What happens if I am denied workers’ compensation benefits?

An option you have is to file a Disputed Claim for Compensation, which is an administrative law proceeding through one of ten offices in the State of Louisiana. This process could take six to nine months, or longer if the case is appealed.

Who pays for my workers’ compensation benefits?

Workers’ compensation benefits are paid by your employer, if he is self-insured, or by his workers’ compensation insurance carrier. There are certain exempt employers. No benefits are paid by the Office of Workers’ Compensation Administration (OWCA).

When will I get my first compensation check?

Your first payment should be paid on the fourteenth day after your employer has knowledge of your injury resulting in loss of income. There is a 7-day waiting period for which you will not be paid benefits. However, if you miss more than 42 consecutive days, you will be paid for the 7-day waiting period.

How much will my weekly benefits be?

The amount of benefits you may be entitled to receive during your period of temporary disability is based upon the average weekly wage paid to you for the four full weeks prior to your injury. You may receive sixty-six and two thirds percent (66 2/3%) of that amount, but not more than three quarters of the statewide average weekly wage. The state’s average weekly wage is determined each year by the Louisiana Employment Security Commission, and the worker’s compensation maximum & minimum benefits are adjusted each September 1st. You may contact the Office of Worker’s Compensation to determine the correct rate.

I am not getting my workers’ compensation check. What should I do?

First you should contact your employer or your employer’s insurance carrier. If you cannot resolve the problem with them, you should contact your nearest Workers’ Compensation District Office. There you may want to file a disputed claim for compensation.

How do I know if I am covered by the worker’s compensation act?

As a general rule, the law applies to every employee who is hired in the State of Louisiana or who is injured in Louisiana with the exception of some individuals employed as household domestics, all members of the crew of any airplane engaged in dusting or spraying operations as it relates to agricultural or farming, all employees of the Federal Government, Sheriff’s Deputies (with the exception of Orleans Parish), employees of railroads in interstate or foreign commerce; vessels in interstate or foreign commerce, volunteer workers and any person working as a licensed real estate broker or salesman.

Can I choose my own doctor?

An injured worker has the freedom to choose his or her treating physician and may switch from one specialty of care to another without having to seek approval of the employer/insurer. The worker must, however, have permission to switch from one provider to another within the same field of specialty.

While the injured worker has the freedom to select the treating physician, the physician must have approval from the employer/ insurance carrier to continue treatment beyond $750 worth of care unless the care is provided under emergency conditions. However, the withholding of such consent is not to be arbitrary and capricious or without probable cause.

There may come a time when your employer will require you to be examined by a physician of his or her choice. Your failure to submit to any reasonable examination may cause your compensation payments to be temporarily suspended until you do so.

What if my doctor and my employer’s doctor disagree about my medical condition?

If your physician and your employer’s physician do not agree about your medical condition, you may be entitled to an Independent Medical Examination. If you find yourself in this situation, a request for Independent Medical Examination may be made by either party.

I keep getting medical bills for my workers’ compensation injury. What should I do with them?

All medical bills should be sent to your employer or the insurance carrier. Please do not send bills to OWCA. This will only delay payment.

While my case is going to trial, what am I supposed to do for money?

Assistance, such as food stamps, may be available through social services. You may also want to contact local charities or churches in your area.

What is a lump sum settlement?

A lump sum settlement is an agreement where the insurer/employer agrees to pay the present value of the disputed claim at once, and his/her future obligations to the injured workers are fully and finally released. To determine the value, the sum of payments owed the claimant may not be discounted at a rate greater than eight percent per annum.

I want to settle my claim. How much will I get?

There is no formula for establishing a settlement value of a workers’ compensation claim. It depends on your compensation at the time of your injury.

Can my employer fire me because I filed a workers’ compensation claim?

Under Louisiana Law, your employer cannot terminate your employment because you filed a workers’ compensation claim. However, your employer does not have to keep a job open for you or make one available when you are able to return to work.

Does my employer have to retrain me for another job?

The employer/insurer may do a job study or survey to find which jobs are available in your area, for the duties approved by your doctor.

Can I be reimbursed for mileage?

All related expenses reasonably and necessarily incurred for obtaining services, medicines, and prosthetic devices should be paid. You should submit appropriate itemization to your workers’ compensation insurance carrier or adjuster.

What is workers’ compensation fraud?

Workers’ compensation fraud occurs when someone willfully makes a false statement or conceals information in order to receive workers’ compensation benefits or prevents someone from receiving benefits they may be entitled to.

Can I work and receive workers’ compensation benefits at the same time?

No. If you are unable to perform your regular job duties because of your work-related injury, you cannot obtain another job. However, if you are released to light duty, you must report any income to your employer or his insurer. Your failure to properly report any income earned while receiving workers’ compensation benefits could subject you to civil and/or criminal prosecution.

Since I’m not able to work while I’m receiving workers’ compensation benefits, can I apply for unemployment benefits?

You cannot receive workers’ compensation benefits and unemployment insurance benefits at the same time unless you are receiving permanent partial disability payments.

Can I be paid benefits from social security disability, an employers’ disability plan and worker’s compensation at the same time?

Yes, but your worker’s compensation weekly benefits may be reduced according to the Act. However, this is not a simple dollar for dollar offset. Each offset is calculated individually according to the claimant’s circumstances

When should I hire an attorney to represent me in a workers’ compensation claim?

Workers typically need to hire a workers comp lawyer when they are refused benefits to which they are entitled, are told that they can return to work before they are actually medically able, or are denied extended or permanent disability despite significant disabling injury. If your employer sends you to a doctor who declares that you are able to return to work even though you don’t believe you are yet able, or tries to get you to return to work to a special job created to accommodate your injury, you should consider speaking to a comp lawyer right away.

The reason is this: while a typical injured employee does not know the law, a typical employer is very much aware of how the compensation system works, and how to terminate an employee’s benefits. An injured worker who returns to work in a specially created position may well find that, two weeks later, the position is eliminated and he is laid off – but is no longer eligible for workers comp. Similarly, many employers utilize doctors who are much more interested in maintaining a good continuing relationship with the employer than with accurately diagnosing the employee – too many declarations of continuing disability will likely cause the employer to send injured employees to a different doctor. A lawyer can help you protect your rights when one of these “hired gun” doctors tries to block you from getting necessary treatment, cut off your benefits or send you back to work too early.

It is beneficial to go to a lawyer who handles a lot of Worker’s Compensation cases. Typically, those lawyers will know the administrative judges or hearing officers who preside over comp hearings, and may also know the doctors and defense lawyers who are trying to block your claim. Using an attorney who knows the ins and outs of the system can help ensure that you collect the benefits that are due or, if you are so inclined, get a maximum pay-off to settle your compensation claim.