Louisiana Permanent Total Disability Benefits
If a worker becomes injured or disabled after being involved in a workplace accident, they are entitled to receive workers’ compensation indemnity (wage loss) benefits. Workers’ compensation is a no-fault system, so workers are eligible without needing to prove fault after the incident.
There are a couple of different types of disability indemnity benefits that a worker can receive. If they become permanently disabled due to a severe or catastrophic injury and are unable to return to work, they will be eligible for Permanent Total Disability (PTD) benefits.
Though medical benefits through workers’ compensation help employees cover all necessary medical expenses related to their injury, disability benefits, such as PTD, will only cover a portion of the employee’s lost wages. Indemnity benefits are complex and it can be challenging to understand and calculate the benefits you are entitled to. Working with an experienced attorney in these situations can ensure that you receive the full amount of benefits that you are owed.
The Louisiana workers’ compensation lawyers at Lunsford, Baskin, & Priebe, PLLC help injured workers get the benefits they are entitled to after an on-the-job injury. Our lawyers represent ironworkers, construction workers, truck drivers, general laborers, firefighters, and first responders injured on the job. Learn more about Louisiana indemnity benefits and PTD below, and contact Lunsford, Baskin, & Priebe, PLLC if you have any questions.
Understanding Louisiana Workers’ Compensation and Indemnity Benefits
Workers’ compensation laws are considered a no-fault system, meaning that injured workers have a right to file a claim and receive benefits without the need to prove fault. Indemnity benefits specifically are available through workers’ compensation and help cover lost wages due to an injured employee’s inability to work. Essentially, indemnity benefits are a type of disability benefit.
Unfortunately, these benefits do not cover all lost wages. Injured workers are only eligible to receive ⅔ of their average weekly wage made four weeks before the accident. That ⅔ average of your weekly salary is what you will receive each week you are disabled and unable to work.
The Four Types of Indemnity Benefits
There are four types of indemnity disability benefits available to those who are suffering from a workplace injury or illness:
- Temporary Total Disability Benefits (TTD): An injured employee who cannot work due to a workplace illness or injury is eligible to receive ⅔ of their average weekly income until their physician says they can return to work.
- Permanent Total Disability Benefits (PTD): Injured workers that are fully disabled and unable to ever return to work can receive ⅔ of their average weekly income indefinitely or as a lump sum.
- Supplemental Earnings Benefits (SEB): An injured employee who cannot work at full capacity and earn at least 90% of what they were making previously is eligible for benefits for up to 10 years. They will receive ⅔ of the difference between what they earned before the accident and what they can earn once they return to work.
- Permanent Partial Disability Benefits (PPD): An injured worker who loses the use of a body part or has a limb amputated but can still work in some capacity will be eligible to receive ⅔ of their weekly income, contingent on the percentage of their determined disability.
While workers are only eligible to receive one type of the above-listed benefits at a time, they may later qualify for a different benefit and can switch.
Who is Eligible for Permanent Total Disability Benefits?
To be eligible to receive Permanent Total Disability benefits, it must be determined that the injured worker is physically unable to return to work. This decision will be based on the evidence that the worker provides in court to show proof of their inability to obtain employment similar to what they were doing before or return to their previous job.
Evidence and information that the court will use to determine eligibility for Permanent Total Disability benefits can include:
- Medical documents
- Physician statements
- Statements from a Vocational Rehabilitation expert
- Work history
- Educational background
- The worker’s age
- The worker’s physical capacity
- The worker’s intellectual capacity
- The severity of the worker’s condition and their functional limitations
- Their transferable work skills, or lack thereof
- The worker’s ability to re-train or be re-educated to work in another profession
- The worker’s rehabilitation attempts
By default, some catastrophic injuries automatically ensure a worker’s eligibility. These injuries can include:
- The loss of both hands
- The loss of both arms
- The loss of both feet
- The loss of both legs
- The loss of both eyes
- The loss of any combination of two of the above
- Certain spinal cord injuries that result in paralysis
- Certain traumatic brain injuries
- Severe burns that cover more than 25% of the body
Keep in mind, there are some situations when it may be difficult to obtain Permanent Total Disability benefits. For example, if the injured worker returns to work in any capacity, even if they are in pain and struggling, the court may decide that they are ineligible to receive benefits.
They may also be found ineligible if they cannot prove that there is no other work that they can do in their condition. For example, someone who held a job in construction previously may be able to now work a more sedentary job in their condition. Even if they would still be in pain while sitting at a desk, and even if no jobs like that are presently available, the court may decide that the worker cannot receive benefits.
However, even if an injured worker is determined to be ineligible for Permanent Total Disability benefits, they may still be able to receive another type of disability benefits, such as Supplemental Earnings Benefits (SEB). Injured workers may also qualify for Social Security Disability (SSD) benefits regardless of their eligibility for workers’ compensation indemnity benefits. The rules and standards for receiving Social Security Disability benefits differ from the receipt of Permanent Total Disability benefits.
Although you may not necessarily qualify for Permanent Total Disability benefits after being eligible for Social Security Disability benefits, a workers’ compensation judge can use the findings in an SSD case to determine eligibility for PTD. The judge can use the information regarding the employee’s limitations from the SSD case, but they don’t have to abide by the findings. The judge of a PTD case doesn’t have to follow the same decisions of the SSD case.
Another important note is that receiving Permanent Total Disability benefits can impact the amount you receive for Social Security Disability benefits. Receiving a one-time lump sum of Permanent Total Disability benefits can affect your social security and Medicare later in life.
If a worker does gain Permanent Total Disability benefits, workers’ compensation insurance companies can request that a judge “reverse the offset” of the benefits, which means that the Social Security Administration increases Social Security Disability benefits so that the insurance company can reduce Permanent Total Disability benefits by the same amount.
Payment of Permanent Total Disability Benefits in Louisiana
If a worker is determined to be unable to return to work, they will likely be eligible for PTD benefits. However, the payment of benefits varies from state to state.
According to Louisiana Rev Stat 23:1221(2), the legislature on Permanent Total Disability Benefits is as follows:
- For any injury-producing permanent total disability that restricts the injured employee from being able to work and earn wages, they will receive 66 ⅔% of their average weekly wage for the duration of their disability. (There is no cap to the number of weeks they can receive these benefits).
- Compensation for permanent total disability shall not be awarded if the employee is engaged in any employment or self-employment regardless of the nature or character of the employment. This includes, but is not limited to, any and all odd-lot employment, sheltered employment, or employment while working in any pain.
- Compensation for permanent total disability shall be awarded only if the employee proves by clear and convincing evidence, unaided by any presumption of disability, that the employee is physically unable to engage in any employment or self-employment, regardless of the nature or character of the employment or self-employment.
- If the injured employee subsequently has or receives any earnings, including, but not limited to, earnings from odd-lot employment, sheltered employment, or employment while working in any pain, the employee shall not receive PTD benefits but may receive SEB benefits if applicable.
An Experienced Louisiana Workers’ Compensation Attorney Can Help
Dealing with a permanent total disability due to a workplace injury can be traumatizing. Injured workers that experience severe and catastrophic injuries that leave them permanently disabled often struggle with emotional anguish in addition to dealing with the financial burden of being unable to work for the rest of their lives.
Our professional, dedicated team has years of experience practicing exclusively in the area of workers’ compensation law. We’ll take on the task of making sure you get your PTD benefits promptly and fully paid, including appealing claim denials if necessary.
For help with a Louisiana workers’ compensation claim, contact the workers’ compensation lawyers at Lunsford, Baskin, & Priebe, PLLC, for a free consultation.