Clayton Law Firm is experienced with Workers' Compensation cases in Slidell, Louisiana.
If you are hurt on the job, filing a workers' compensation legal claim can seem daunting. Whether you are filing for the first time or you have already been denied, Clayton Law Firm can help. We have helped many people get the medical and compensatory damages they deserve. Sometimes workers' compensation and personal injury cases overlap.
Workers' compensation is a term for insurance that means benefits are provided for individuals hurt on the job. Louisiana has a no-fault system. You do not have to prove who was at fault; just that it arose out of and occurred within the course and scope of employment. Insurance companies try to settle early and pay as little as possible.
Understanding Your Workers' Compensation Legal Rights in Louisiana
In 1914 the state legislature in Louisiana enacted the Louisiana Workers’ Compensation Act, which is found at Louisiana Revised Statute 23:1021, et seq. That law provides various medical, disability and other benefits must be paid to or for injured workers covered by the Act.
Since 1914 our legislature has enacted many changes to the law and some have been beneficial to the injured worker, but some present challenges and difficulties.
To qualify for benefits under the Louisiana Workers’ Compensation Act, the injured worker must show that he or she:
- Was injured in Louisiana
- Or was hired in Louisiana by a Louisiana employer
- Had an accident arising out of and occurring within the “course and scope” of employment
- The accident resulted in injury or disability
There are many twists and turns in workers’ compensation law and in workers’ compensation claims. It is an area of the law that requires the attorney handling workers’ compensation claims to remain well-versed and well-informed. Not all lawyers are skilled and experienced in handling such claims. If you are injured at work and need an attorney to represent you, be sure that you hire one who has the necessary skills and experience to represent you well.
Certain features of our state’s workers’ compensation law should be noted:
Louisiana Office of Workers' Compensation (OWCA)
As a general rule, the claim must be filed with the Louisiana Office of Workers’ Compensation Administration (OWCA) on a form LDOL-WC-1008 within no more than one (1) year from the date of accident, although there are exceptions to that general rule. If your claim is not filed within the time required by law, then it has “prescribed,” and it is too late to pursue the claim, in which case you lose your rights to make a claim under the Act.
Medical Treatment After a Work Injury
All medical treatment, except for the first $750, must be pre-approved by the employer or its workers’ compensation insurer, except for “emergency treatment.” Currently the workers’ compensation law of our state requires your physician to make all requests for treatment to the claims adjuster by completing a form LWC-WC-1010. The claims adjuster has five (5) working days from the date of receiving that properly completed and documented form to respond in writing by either approving or rejecting the doctor’s request. If there is a denial of the request, then the doctor, injured worker or the attorney of the injured worker has fifteen (15) days to file a form LWC-WC-1009 with the Medical Director for the Louisiana Office of Workers’ Compensation Administration in Baton Rouge, Louisiana. The Medical Director then has thirty (30) days from the date of receiving the form to render his written decision, either approving of or rejecting the recommendation of the physician. There is a process for appealing the decision of the Medical Director.
Choosing a Doctor
The injured worker has the right to choose one (1) physician in any necessary health care specialty. The employer or its insurer must pay for the treatment by that physician. For instance, if the injured worker needs to be seen by an orthopaedist, then the injured worker can choose an orthoapaedist and by law the employer or its insurer must pay for treatment by that physician. WARNING: Your employer or the claims adjuster may try to get you to pick a particular doctor who will likely favor them, rather than being fair with you. Beware of signing a “Choice of Physician” form without first talking to an attorney and determining that you are choosing a competent physician who will be fair with you, rather than favoring the employer and its insurer.
Fraud in Support of or in Defense of a Workers Compensation Claim
La. R.S. 23:1208 provides for both civil and criminal penalties against anyone who either lies in order to support a claim or to try to defeat that claim. Civil penalties include forfeiture of benefits, repayment or “restitution” of benefits obtained by fraud or deceit, fines and paying the attorney’s fees and costs of the other parties. Criminal penalties can include prison sentences, with or without hard labor, of up to ten (10) years, plus fines of up to $10,000. La.R.S. 23:1208.1 is similar and provides for civil and criminal penalties in connection with employees who make false statements in job applications.
Intoxication, whether through alcohol or controlled substances, including, but not limited to marijuana, cocaine, heroin, amphetamines, other pills, etc., results in forfeiture of benefits.
Legal Representation in a Work Injury Claim
There are too many other features of the workers’ compensation law to discuss here, but a competent workers’ compensation attorney should be able to answer your questions. The Clayton Law Firm has many years of experience in handling workers’ compensation claims.