Indemnity Benefits in Louisiana
Workers who are injured on the job are eligible to receive workers’ compensation benefits to help them cover medical expenses or lost wages. The medical benefits typically cover all necessary medical expenses relating to workplace injury. However, wage replacement benefits, also known as indemnity benefits, often only cover a portion of the wages you miss out on while you are recovering.
Calculating indemnity benefits can be challenging, and if you make any mistakes when applying for workers’ compensation, it could result in you receiving fewer benefits than you are owed. When applying to receive indemnity benefits, it is helpful to work with an experienced workers’ compensation attorney to ensure your average weekly wages are correctly calculated.
At Lunsford, Baskin, & Priebe, PLLC, we are dedicated to helping workers get the benefits they are entitled to after an on-the-job injury. We have experience representing workers from various industries, such as ironworkers, construction workers, truck drivers, general laborers, firefighters, first responders, and more. Learn more about Louisiana indemnity benefits below, and contact Lunsford, Baskin, & Priebe, PLLC if you have any questions.
Understanding Louisiana Workers’ Compensation and Indemnity Benefits
If you are injured on the job, you are eligible to receive benefits without needing to prove fault. This is because workers’ compensation is a no-fault system. With other injury claims, you often need to prove that another party was guilty to receive compensation, but this is not the case with workers’ comp benefits. Once you are injured, you simply report the incident and have your claim filed. Once it is approved, you should start receiving your benefits shortly after.
However, it’s important to note that it is not uncommon for workers’ comp claims to get denied for various reasons. Though you aren’t required to prove fault, there are other reasons a claim may get denied. Another issue is that you may not receive the full amount you are owed if your wages are not properly calculated.
Indemnity benefits are based on your average weekly wages, but they do not cover all lost wages. They are essentially a type of disability benefit that helps you while you are temporarily or even permanently disabled from your injury, but they are not meant to completely replace your entire income.
Who is Eligible for Indemnity Benefits?
All employers with one or more employees in the state of Louisiana are required to carry workers’ compensation insurance to protect themselves and their employees. 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:
- Domestic employees
- Licensed real estate agents
- Directors of certain non-profit organizations
- Workers performing mining-related services
*Federal employees, maritime workers, and some transportation workers are also ineligible for state compensation benefits. This is because these industries provide their own private workers’ compensation systems.
Types of Indemnity Benefits in Louisiana
The type of indemnity benefits you will receive will depend on the extent of your injury and disability. The different types include the following:
Temporary Total Disability Benefits (TTD)
If you are unable to perform your typical work duties in any capacity but are expected to fully recover, you will be eligible to receive temporary total disability benefits. TTD benefits provide injured workers with ⅔ of their average weekly wages until their doctor approves their return to work.
Permanent Total Disability Benefits (PTD)
If your injury is so extensive that you are unable to work and will be permanently disabled for the rest of your life, you will be eligible to receive permanent total disability benefits. PTD benefits provide workers with ⅔ of their average weekly wages either as a lump sum or every week indefinitely.
Supplemental Earnings Benefits (SEB)
If your injury allows you to perform some but not all of your work duties, you may be eligible to receive supplemental earning benefits. If you can work to earn at least 90% of what you were previously making, you can receive SEB benefits for up to 10 years. SEB benefits provide you with ⅔ of the difference between what you were earning before the accident and what you can earn once you return to work.
Permanent Partial Disability Benefits (PPD)
If you suffer the loss of a limb or cannot use a certain part of your body but are still able to work in some capacity, you will be eligible to receive permanent partial disability benefits. PPD benefits provide workers with ⅔ of their average weekly wages contingent on the percentage of their determined disability.
Catastrophic Injury Benefits
If you suffer from what is considered a catastrophic injury, you may be eligible to receive a lump sum of up to $50,000.
Catastrophic injuries can include:
- Loss of eyes
- Amputation of the hands, arms, feet, or legs
- Third-degree burns covering more than 40% of the body
If you are not able to earn the same amount of income as you were before the accident or if you are no longer able to perform your job but may be able to work at full capacity in another industry, you are entitled to vocational services and retraining to help you gain the skills necessary to find another job.
If you (the injured worker) die within two years of receiving your last medical treatment as a result of the workplace incident, your partner and/or dependents, such as children, may be entitled to weekly indemnity benefits. If there are no surviving dependents, your older children or surviving parents will be entitled to a lump-sum payment of $75,000. Burial expenses may also be covered by the employer or their insurer up to $8,500.
How Long Do Indemnity Benefits Last?
Generally, TTD benefits are the most common in workers’ comp claims, and those will last as long as you are unable to work. The amount of time that they last will depend on how long your recovery period is until your physician approves your return to work.
Those who are more permanently disabled may be able to receive benefits for up to 10 years through SEB or indefinitely through PPD benefits as described above. However, if an injured worker was first on TTD benefits for six years and then switched over to SEB, they would only be eligible to receive those benefits for four years instead of ten.
How Much Money Do You Get From Indemnity Benefits in Louisiana?
Your weekly benefit amount will be determined by taking ⅔ of your average weekly income from the four weeks prior to the injury occurring. That ⅔ amount is what you will receive each week for a length of time determined based on which type of disability benefits you are receiving.
However, Louisiana does have a cap on the weekly amounts. The maximum weekly benefit amount is capped based on the average weekly wage in the state of Louisiana, which changes yearly. Overall, workers can receive up to that amount per week for up to a total of 520 weeks if eligible for Supplemental Earnings Benefits.
It’s important to note that the ⅔ is based on your gross wages, which is the amount you earn before tax deductions. If you are salaried, your gross wages will be determined based on your annual salary and the four full weeks you worked before the accident. If you are an hourly employee, your gross wages will be determined based on the wages you earned for the hours you worked in those four full weeks before the injury.
Filing For Indemnity Benefits
Filing a workers’ compensation claim to receive indemnity benefits can sometimes be difficult. Though the process is initially fairly straightforward, if any mistakes are made, it can lead to a denial and the need for an appeal which can complicate matters. The steps below can help keep you on track to ensure your claim is properly filed:
1. Report the Incident to Your Employer
The first step you should take following the accident is to report what happened to your employer. If you require emergency medical care, seek treatment first and then notify your employer 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. The Claim Gets Filed
After the incident is reported, it is your employer’s responsibility to file a First Report of Injury with their insurance provider. Once your employer files this report, 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. 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.
An Experienced Louisiana Workers’ Compensation Attorney Can Help
Dealing with a disability due to a workplace injury can be traumatic and distressing. The physical and emotional pain and suffering coupled with the financial burden of medical expenses and loss of wages can make the whole experience seem overwhelming.
Our compassionate and dedicated legal 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 indemnity benefits promptly and fully paid, including appealing claim denials if necessary.