Applying for Workers’ Compensation in Louisiana
Workers’ compensation benefits are available to injured workers to help them cover medical and expenses and lost wages. While workers’ compensation is a no-fault benefit, meaning you don’t have to prove fault to be eligible, applying for and receiving the full amount of compensation you deserve is not always easy.
If you make a mistake when filing your claim or if your employer or their insurance company questions the validity of your injury, your claim could get denied. Successfully applying for workers’ compensation often requires the help of an experienced attorney who has experience handling claim denials and difficult insurers. They can guide you through the process to ensure everything is done correctly so you get your benefits paid in full and on time.
The Louisiana workers’ compensation lawyers at Lunsford, Baskin, & Priebe, PLLC can help workers get the benefits they are entitled to after an on-the-job injury. Our lawyers represent workers from various industries, such as ironworkers, construction workers, truck drivers, general laborers, firefighters, and first responders. Learn more about how to apply for workers’ compensation below, and contact Lunsford, Baskin, & Priebe, PLLC for help with your Louisiana workers’ comp claims.
Louisiana Workers’ Compensation Facts
As mentioned above, workers’ compensation is a no-fault system. If you are injured on the job, you do not have to prove that your injury was the result of someone else’s negligence to be eligible to receive benefits. They are available to you no matter how the incident occurred, so long as it happened as a result of work performed on the job.
When you apply for workers’ comp, you will receive benefits to help you cover medical-related expenses as well as wage replacement for the time that you are out of work while recovering. After applying, it typically doesn’t take long to get approval and for your first check to arrive. However, if any mistakes were made on the application or if your employer’s insurer attempts to deny your claim for any reason, it could delay the arrival of your benefits. This is why it’s important to work with an attorney to make sure you do everything right the first time.
Who is Eligible?
Louisiana requires all employers with one or more employees to carry workers’ compensation insurance. Employees both full-time and part-time are eligible as long as they earn a minimum of $3,000 annually. However, there are some types of workers who are not eligible, such as:
- Undocumented aliens
- Domestic employees
- Licensed real estate agents
- Directors of certain non-profit organizations
- Airplane crews while performing dusting and spraying procedures
- Workers performing mining-related services
What is Covered?
Employees who become injured on the job are eligible to receive workers’ comp benefits no matter what type of injury or illness they sustain. This includes some minor injuries, severe injuries, repetitive motion injuries, and occupational illnesses and diseases.
Common injuries we see as a result of workplace incidents include:
- Back and neck injuries
- Spinal cord injuries
- Repetitive stress injuries
- Shoulder injuries
- Knee injuries
- First responder illnesses, such as cancer or heart and lung diseases
What Benefits Are Available?
Injured workers can receive two types of benefits: medical and wage replacement.
Medical benefits help cover all reasonable and necessary medical expenses related to a work-related injury or illness. These payments can cover doctor visits, hospital bills, prescription medications, physical therapy, medical supplies, and assistance devices such as crutches and wheelchairs.
Wage Replacement Benefits
Wage replacement benefits cover a portion of a worker’s wages that they miss out on while recovering. Generally, this includes two-thirds of your regular average wages, subject to maximum limits, and there are different types of wage benefits available depending on the extent of the injury or illness.
For example, temporary disability benefits are available for workers that can eventually return to work after they have recovered, while permanent disability benefits are an option if the injury leaves the worker more severely and permanently disabled, such as an amputation or loss of eyesight.
How to File a Workers’ Compensation Claim in Louisiana
Information on how to report an incident and file for workers’ compensation should be readily available to you at your place of employment. Sometimes it is provided on posters that may be posted around the workplace, like in the break room, or it may be in your employee handbook or amongst other documents that were given to you when you were hired. If you cannot find the information you need, your human resources department should be able to assist you.
Filing a workers’ compensation claim should not be difficult, but some employers make it more difficult than others. However, it is your right to claim benefits if you were injured on the job. Never let your employer bully you or convince you not to apply. If you have concerns about applying or feel that your employer is treating you unfairly, call the workers’ compensation attorneys at Lunsford, Baskin, & Priebe, PLLC. We are dedicated to handling workers’ compensation cases for all injured workers in Louisiana.
Follow the steps below to apply for workers’ compensation:
1. Report the Incident and Your Injury to Your Employer
Aside from seeking emergency medical attention for your injuries, one of the first steps you should take following the accident is to report what happened to your employer. You can do this either before or after seeking medical attention, just make sure you do so as soon as possible. Louisiana requires that you report the accident within 30 days, but the sooner you notify your boss, the sooner the claims process will get rolling. You should also obtain a copy of the report for your records to ensure your employer doesn’t try to claim there is no evidence of it occurring.
2. Ensure a Claim is Filed
After you have reported the incident, it is your employer’s responsibility to file a First Report of Injury with their insurance provider. Once the injury is officially reported, the insurance company will then submit a claim to the Louisiana Workforce Commission. It is not uncommon, however, for employers or insurers to delay filing reports and claims. Make sure you check in with your employer regularly to ensure the report and claim have been filed.
3. Correct Mistakes and File an Appeal if Necessary
If there are any mistakes in the report, such as a misspelled name or an incorrect date, your claim may initially get denied. Make sure to have these errors corrected as soon as possible. If it was only a simple mistake, your claim should get approved once the errors have been corrected. However, if there are further disputes about your claim, you may need to file an appeal with the Workforce Commission.
In Louisiana, you have one year to appeal a dispute over wages and three years to appeal a dispute over medical benefits. After your appeal has been filed, you will be instructed to schedule a hearing before an administrative law judge. If the judge further denies your claim, you have 30 days to file another appeal to the Circuit Court of Appeals.
Filing an appeal can get even more complicated and technical than the initial claim process. If your workers’ compensation requires an appeal, it will be challenging to handle on your own without the help of a lawyer. An experienced attorney can help you through the process and advocate for your rights to ensure you receive the full amount of benefits you deserve.
Reasons Why Workers’ Compensation Claims Get Denied
When applying for workers’ compensation, it’s easy to make mistakes that can lead to a denial that requires you to file an appeal. However, if this happens it can delay your benefits and even lead to a full denial. Below are some of the most common reasons that workers’ comp claims get denied. Keep these in mind to avoid making mistakes of your own.
Your injuries are not severe enough:
While workers should file a claim no matter how small the injury, it can still get denied if it doesn’t meet certain standards — for example, if no medical treatment is necessary or if it does not affect your daily life or your ability to return to work.
You did not report the incident in time:
State laws determine how long you have to initially report the incident to your employer as well as how much time you have to then file an official claim. If either of these deadlines is not met, the employer or the insurance may deny your claim.
You made false claims about your injury:
If you lie about anything relating to your injury, even if it did still happen on the job, your claim could be denied. Additionally, some employers and insurance companies will try to find proof or evidence to say that the injury was not work-related and happened elsewhere.
Your injury is connected to a pre-existing condition:
A common basis for denial is that you had a pre-existing condition that is the true source of your ailment. When this isn’t the case, we can help you prove it by producing medical records from before and after the accident and introducing evidence of your lifestyle before the accident. If a workplace injury aggravated a pre-existing condition, you might be entitled to compensation for aggravation of the condition.
You avoided immediate medical attention:
After sustaining a workplace injury, the injured worker needs to seek medical attention right away, even if the injury was minor. Lack of medical evidence can lead to a denial. Even if you decide to seek treatment at a later date, it may still be difficult to prove that the injury did not worsen or initially occur from something else outside of work.
You were intoxicated when the incident occurred:
In some cases, employers may deny a workers’ comp claim if the employee was intoxicated or under the influence of drugs at the time of the injury. This includes the abuse of legally prescribed medications as well as using illegal drugs. Claims can also be denied if the accident was caused by “willful intent.”
Contact An Experienced Louisiana Workers’ Compensation Attorney
The process of filing for workers’ compensation can be tricky, and it’s easy for mistakes to be made. Additionally, you may find yourself up against an insurance company trying to deny your claim or reduce the benefit amount. Our dedicated workers’ comp lawyers can help you at every stage of the workers’ compensation process in Louisiana to ensure you get the compensation you deserve.
For help with your workers’ compensation claim, contact the workers’ compensation lawyers at Lunsford, Baskin, & Priebe, PLLC for a free consultation.