Workers’ Compensation Qualifications, Medical Benefits, and Treatment in Louisiana
Work injuries are exceedingly common in the United States. In 2020, 2.7 million private employees experienced nonfatal work injuries. In the event that you experience a work injury, you should seek workers’ compensation. Workers’ compensation is designed to cover medical expenses and lost wages for victims of workplace injuries.
Although you have every right to seek workers’ compensation after an injury, employers and their insurance companies often look for ways to underpay your claim or outright deny it. Their main goal is saving money, so they’ll try to undercut the benefits you deserve. Fortunately, attorneys can help you with the workers’ compensation process and ensure you receive the full benefits you deserve for medical bills and lost wages.
For expert workers’ compensation legal support you can count on, contact Lunsford, Baskin, & Priebe PLLC. Our lawyers have assisted victims of workplace injuries across numerous industries including construction workers, office workers, laborers, first responders, ironworkers, and many more. We’ll represent you in and out of court so that insurance companies and employers can’t take advantage of you.
What Medical Benefits Can I Receive Through Workers’ Compensation in Louisiana?
Those applying for workers’ compensation benefits can receive money for medical bills and lost wages. Injured workers are entitled to all reasonable and necessary medical treatments relating to a workplace injury or illness, and they’re eligible for a percentage of their lost income as they recover.
Unfortunately, employers and insurance companies often fight claims. You have every right to receive workers’ compensation in Louisiana, but employers and insurance companies often use unscrupulous strategies to lessen the amount victims receive. For that reason, it’s important to know your rights and the process of receiving workers’ comp benefits. You should also be aware of what benefits you can expect from workers’ compensation.
Available Medical Benefits and Common Injuries
Louisiana employees who are injured on the job or develop an illness from their job can receive benefits for medical bills. Some of the medical expenses that workers’ compensation covers include:
- Medical treatments
- Hospital stays
- Rehabilitation services
- Physical Therapy
- Doctors visits
- Diagnostic testing (i.e., X-rays, MRIs, CT scans, etc.)
- Other types of medical testing
- Bloodwork and lab testing
- Prescription medications
- Medical supplies that are necessary for the ailment
- Additional medical or non-medical treatments recommended by your primary doctor that are recognized by state laws as legal and relating to the injury (this can include chiropractic care, alternative treatments, massage therapy, etc.)
- Travel expenses for obtaining medical treatments and services
In addition to medical benefits, you need to be aware of common injuries that occur in the workplace. Some common injuries include:
- Neck injuries
- Spinal cord injuries
- Back injuries
- Shoulder injuries
- Knee injuries
- First responder illnesses, including cancer, heart disease, and lung disease
How to File for Louisiana Workers’ Compensation
The filing process for workers’ compensation differs from state to state. If you’re injured in Louisiana, make sure you follow these critical steps to receive workers’ compensation:
- Inform Your Employer: You need to inform your employer about the work injury verbally and in writing as soon as you can after the accident. You should seek medical attention before informing them, but you need to tell your employer within 30 days of the accident or else your claim will be denied.
- The Employer Will File the Claim: After you report your claim to your employer, they are required to file the Louisiana Department of Labor Form 1007 and send it to their insurance company within 10 days. You need to get a copy of this form to protect your rights for workers’ comp benefits.
- Appeal to the Louisiana Workforce Commission: If your claim is denied or you don’t receive the full benefits you deserve, you can file an appeal with the Louisiana Workforce Commission.
- Appeal In Court: If you file for an appeal after the Workforce Commission’s decision, you’ll present your case before a judge.
When appealing your case before the Louisiana Workforce Commission and in court, you need expert workers’ compensation legal guidance to help you through the process.
Getting Emergency Medical Care and Treatment After a Workplace Injury
If you’re injured, you should seek medical treatment immediately. Failing to do so can have life-threatening consequences, especially if your injury involves your neck or spine. Delaying medical treatment can also hurt your claim for workers’ compensation. In addition to seeking treatment, you need to start the process of receiving compensation as soon as possible.
Those injured in the workplace are required to receive approval from the company’s insurance company before receiving medical care from a new provider, but if your doctor deems it a genuine medical emergency and you’re receiving treatment in the ER, you do not need to wait for approval.
Choosing Your Workers’ Compensation Primary Physician
Your employer’s insurance company may try to convince you to see a workers’ compensation doctor, but you are allowed to choose your own medical providers. In fact, you should typically avoid choosing the doctor your employer or insurance company wants because they often try to downplay the severity of injuries. They often side with the insurance company rather than seek your optimal treatment.
Primary physicians play a key role in both your medical treatment and your workers’ compensation benefits, so you need a doctor who has your best interest in mind.
After picking your primary physician, the doctor the insurance company wants will be used as a “second opinion” in case there’s a disagreement when it comes to treatment. If there’s a case in which medical opinions differ, you may need an Independent Medical Exam (IME) from a doctor designated by the court system or your state workers’ compensation division.
If you’re in doubt about choosing your primary physician, consider consulting with a workers’ compensation attorney. Your lawyer will fight for your best interest and not your employer’s. They can offer invaluable guidance to receive optimal care and workers’ compensation benefits.
Do I Have Control Over All Medical Decisions?
Although you have every right to choose your primary physician, there are some elements of your medical treatment that are outside of your control. Your employer’s insurance company will typically determine:
- Where you receive diagnostic tests
- Your physical therapy location
- Your pharmacy
Reasons Why You Could Be Denied Workers’ Compensation
Although you should receive workers’ compensation for your injuries, there are cases in which you can be denied. These include:
- Failing to report the injury on time
- Not filing a claim soon enough
- Your employer disputes the claim
- Lack of evidence that the injury was work-related
- Pre-existing conditions
- Testing positive for illicit drugs or alcohol
Appealing Denied Medical Treatment in Louisiana
The Louisiana Medical Treatment Guidelines will determine whether your workers’ compensation insurance company will deem it necessary for you to receive medical treatment. Although whether you receive treatment is based on these guidelines, the insurance company will typically interpret the guidelines frugally to deny or underpay for your treatment, or they may even go against the guidelines.
You can appeal the insurance company’s decision to the State Medical Director. If you’re initiating the process of appealing, you need skilled workers’ compensation attorneys at your side, such as the lawyers at Lunsford, Baskin, & Priebe. We have a proven track record of helping denials be overturned by the State Medical Director or in court.
Paying Medical Expenses with Workers’ Compensation Benefits
Your employer’s insurance company is required to provide the state guidelines for the drugs, supplies, medical care, surgery, and non-medical treatments that have to do with your injury or illness. From this documentation, you’ll learn what medical treatments are covered by workers’ compensation.
Any medical treatment that goes beyond $750 needs to first be approved by your employer’s insurance company unless you receive treatment in the ER for a medical emergency.
After receiving your medical bills, you need to submit them to your employer or the workers’ compensation insurance company immediately. The insurance company is required to pay out all approved medical treatments within 60 days. If the bill was submitted electronically, your employer’s insurance company only has 30 days.
How Long Do I Have to Apply for Workers’ Comp Benefits In Louisiana?
After experiencing a workplace injury or illness, you have one year to file a workers’ compensation claim. If you don’t file within a year, you will not be able to recover benefits. If you receive workers’ compensation benefits but you need further benefits after the initial coverage runs out, you have three years from the time in which you received your last benefit to file for future compensation.
You Need Expert Louisiana Workers’ Compensation Lawyers
If you experienced a workplace injury, you need the full benefits of workers’ compensation for your medical bills and lost wages. Unscrupulous employers and insurance companies may try to cheat you out of the full benefits you deserve, but you ensure you receive the maximum benefits possible by working with Lunsford, Baskin, and Priebe. We’ll make sure you receive the full benefits you deserve and we’ll fight on your behalf in the appeal process if necessary.