Workers' Compensation FAQs
A. Workers' compensation refers to a number of different benefits provided to most Louisiana workers who suffer job-related injuries or illnesses under the Louisiana Workers Compensation Act.
A. Workers' compensation benefits apply to injuries caused by the employee's work or aggravated by the employee's work. This includes workplace accident injuries such as slips and falls, heavy lifting, and injuries from repetitive motion such as carpal tunnel syndrome
A. Workers' compensation provides the following benefits:
- Medical Expenses: If you are injured on the job, you are entitled to have 100% of your work-related medical and hospital bills paid by your employer or its insurer. You are also entitled to be reimbursed for your travel expenses to all health care providers for medical treatment related to your injury.
- Vocational Rehabilitation: If you are unable to return to the same job you had before you were injured, or unable to earn the same wages you were earning at the time of your injury, then you are eligible for vocational rehabilitation benefits. The employer must hire a vocational rehabilitation counselor to assist you back into the work force. Under some circumstances, you may be eligible for re-training. This can be a tricky time during your claim, and an attorney can best guide you through the process.
- Temporary Total Disability Benefits (TTD): While you are recovering from a work - related injury, you are entitled to temporary total disability benefits. This generally amounts to a portion of the wages you would have received if you had been able to work during this period of time. This compensation should continue until a treating doctor determines that the injury has improved to the point that you can return to work. The length of time you receive these benefits depends on when the doctor releases you to return to work or restricted duty.
- Permanent Partial Disability Benefits (PPD): If the injury causes permanent harm, you may be entitled to recover permanent partial disability benefits based on the extent of disability the work-related injury has caused. The benefits are paid based on a schedule that calculates benefits based on the percentage of anatomical loss. However, each week you receive TTD benefits offsets the number of weeks that you are eligible for PPD benefits. If you sustain a statutorily declared catastrophic injury, the law allows a lump sum payment of $30,000 which is not subject to any offsets or attorney fees.
- Supplemental Earnings Benefits (SEB): If a doctor releases you to work in a restricted capacity and you are unable to earn 90% of your pre-accident earnings, then the employer will supplement your income. The employee is only eligible for SEB for up to 520 weeks. Again, any week paid as TTD will offset the number of weeks the employee receives SEB.
- Permanent Total Disability Benefits (PTD): If you can prove by clear and convincing evidence that you cannot return to work in any capacity, whatsoever, then you may be eligible to receive PTD benefits for the rest of your life. These benefits are very rare in Louisiana, but can be proven under certain circumstances.
- Death Benefits. If the employee dies as a result of a work related injury, then the qualified surviving dependents (those persons who relied on the deceased employee for their support) will receive death benefits. The amount of benefits varies based on the number of dependants. If the decedent does not have any dependants, each surviving parent can receive a $75,000 lump sum payment. The employer must also pay $7,500 for funeral expenses.
A. In order to receive workers' compensation benefits, you should immediately notify your employer of your work-related injury or illness. A delay in notification may impact your ability to receive benefits. Once you have notified your employer of your medical condition, they are required to pay indemnity benefits and medical expenses.
A. Yes. You can see your own doctor. However, you may be required to submit to an examination by the company doctor.
A. If you are denied benefits, you must file a Disputed Claim for Compensation with the Office of Workers' Compensation. Your complaint is filed on a "1008 form." This process can take anywhere from six to nine months, or longer.
A. No. You are not able to receive both unemployment benefits and workers' compensation benefits at the same time.
A. The amount of money you receive for your injury or illness depends on your compensation at the time of the injury and your future medical needs.
A. Yes. Surviving spouses and dependants are entitled to a percentage of the workers' compensation benefits until they die or remarry. If a spouse remarries, the employer must pay two years of benefits in a lump sum.
A. You are not required to have an attorney to bring a workers' compensation claim, however it is a good idea to contact one to help you through the process and ensure you receive the compensation you deserve.
A. No. Under Louisiana law you cannot be fired because you filed a workers' compensation claim. However, your employer doesn't have to keep your job open for you or make one available for you when you're able to resume working.
A. Absolutely. If you are currently on Medicare and your case settles for more than $25,000, then you must obtain approval from the Centers for Medicare and Medicaid Services (CMS). If you have a reasonable expectation to be on Medicare within the next 30 months, and the value of your settlement is over $250,000, you must obtain CMS approval as well. The law requires that workers' compensation settlements take Medicare's potential interests into account. This is done through the creation of a Medicare Set-Aside (MSA) which is money set aside for future work-related medical treatment. There are complex rules concerning when a MSA is necessary, and how the MSA can be spent. However, if it is done properly, Medicare will pay for work-related medical expenses once the MSA is properly depleted.
A. Attorney fees are based on a contingency contract, and the attorney will only receive payment if payments are made to an injured worker through his or her efforts. Attorney's fees are capped by law to 20% of the injured worker's recovery. Under some circumstances, the judge can order the employer or insured to pay attorney fees.