WHAT YOU SHOULD KNOW...   LOUISIANA WORKERS’ COMPENSATION

The Office of Workers’ Compensation

The Office of Workers’ Compensation was created in 1983 within the Louisiana Department of Labor to administer the provisions of the Workers’ Compensation Act and was vested with exclusive jurisdiction to resolve disputes in workers’ compensation matters. There are ten field offices located throughout the state that provide the framework for the resolution of disputes regarding a claim for benefits, the entitlement to benefits, or other relief under the Workers’ Compensation Act.

The following information is provided as general information concerning the rights and responsibilities of all parties under the State of Louisiana Workers’ Compensation Act.

What is Workers’ Compensation?

Workers’ Compensation is a legal remedy whereby an employee that is injured on the job is automatically entitled to certain benefits. The benefits can include medical care for the injury, disability compensation, rehabilitation services and death benefits. The benefits are the obligation of the employer to the employee.

Who is covered by the Workers’ Compensation Law?

Most employees in Louisiana are covered from the day they start employment. “Employees” may be full or part-time, seasonal or minors.

What Injuries are Covered by the Law?

The event causing the injury must arise out of and be within the course of your employment. Generally, the fault of the employer or employee does not affect the compensability of an injury. However, no compensation may be allowed if the injury was caused by the employee’s willful intention to injure himself or another employee; by the employees deliberate failure to use adequate protection that was provided to him; or by the injured employee’s intoxication at the time of injury, unless resulting from activities in pursuit of the employer’s interests, or from activities in which the employer procured and encouraged the use of the beverage or substance. An employee may not be entitled to benefits if he or she is the aggressor in an unprovoked physical altercation. The employee may not be entitled to benefits if it is determined that he/she was a participant in “horseplay” at the time that the injury occurred.

Who Pays the Medical Bills?

Your employer or its insurance company is required to pay all approved reasonable and necessary expenses for services provided by a physician or hospital, for physical therapy, prescriptions, and for travel necessary to obtain these services. Any services over $750 and any non-emergency hospitalization must be pre-approved by your employer or the workers’ compensation insurer. If you have paid any of your medical expenses, you should send itemized receipts to your employer or it’s insurer for reimbursement.

WHAT YOU SHOULD KNOW...LOUISIANA WORKERS’ COMPENSATION

How is Compensation Paid?

You may be entitled to weekly compensation benefits if your injury prevents you from returning to work form more than seven calendar days. Benefits are payable beginning on the eighth day and you should receive your first benefit check within 14 days after you notified the employer of the injury. You will be paid for the first 7 days ONLY if you are unable to work over 42 calendar days. During the period of temporary disability, you are entitled to receive indemnity payments equal to 2/3 of your average weekly wage at the time of injury. The maximum benefit is 75% and the minimum benefit is 20% of the statewide average weekly wage. Maximum and minimum benefits are determined annually and apply to all claims occurring between September 1 and August 31 of the following year. The compensation benefit received and the maximum (or minimum) benefit that applies to that claim are determined according to the date of the accident causing the injury and are not adjusted annually for increases or decreases in the maximum (or minimum) benefit allowed. You may obtain the maximum and minimum rates by calling the Office of Workers’ Compensation.

May I Dispute My Claim?

If you have a problem with your claim, you should first contact your employer or its insurance carrier. If you cannot resolve the problem, you should contact the Office of Workers’ Compensation at the district office nearest to you. You will be provided a disputed claim form, LDOL-WC-1008, to complete and return to the appropriate office. A filing fee of $30 will be collected, but is not required at the time of filing. However, you may be required to pay a $25 fee at the time of filing to cover the costs of service by the Secretary of State.

You may consult an attorney if you wish, but it is not required. If you hire an attorney, you can be charged up to 20% of the first $10,000 recovered and 10% of any recovery above $10,000, and you will have to pay the attorney’s expenses. The fees and expenses may be deducted from your payments. Your local bar association may be able to recommend an attorney who is experienced in workers’ compensation.

Am I Entitled to my Old Job?

Your employer is not required to hold a job open for you when you are unable to perform the duties of your job or to create a new job for you when you are able to return to work. However, your employer cannot discharge you solely because you filed a workers’ compensation claim.

What if I Cannot Return to my Old Job?

Under certain circumstances, you may qualify for vocational rehabilitation. Rehabilitation services are intended to return a disable worker to work, with a minimum of retraining as soon as possible after an injury occurs.

How Long Is My Claim Open?

There are separate time limits for filing claims for medical and disability benefits. Filing a claim for one type of benefit generally does not stop the time from running as to the other.

Claims for medical benefits generally must be filed within one year of the date of the accident causing the injury. However, if your employer or its insurance company has paid medical expenses, the period for asserting a claim is extended for 3 years from the last payment of a medical benefit.

Claims for disability benefits, often called weekly or indemnity benefits, generally must be filed within on year of the date of the accident causing the injury. If your employer or its insurer has paid disability benefits, you may still assert a claim for temporary total, permanent total, or permanent partial disability if you do so within one year after the last payment of disability. Claims for supplemental earnings benefits may be made for up to 3 years after the last payment of any class of disability.