You’ve likely heard the term “workers’ compensation” but many people don’t understand what this program is or how to receive benefits until they need it.
For this reason, our workers’ comp lawyers at The Law Offices of Blaine Barrilleaux have outlined what you need to know about workers’ compensation.
Workers’ Compensation Defined
Suffering an injury or illness as a result of your job can be incredibly devastating to your health, career, finances, and mental state. A state-mandated insurance program, the Louisiana workers’ compensation system is designed to provide financial benefits for some of your losses.
These benefits are often paid by a private insurance company. Most employers are required to carry workers’ comp insurance to cover their employees in the event of an accident.
Do You Qualify for Workers’ Comp?
If you’re wondering if you qualify for workers’ comp benefits, there are typically four eligibility requirements you must meet:
- You’re an employee.
- Your employer carries workers’ comp insurance.
- Your injury or illness is work related.
- You met your state’s deadlines for reporting your injury and filing a claim.
While these are the basic requirements for coverage, there are some exceptions and gray areas. Our workers’ comp lawyers can review your claim and determine if you’re entitled to benefits.
Breaking Down Workers’ Comp Benefits
If you’re eligible for workers’ comp benefits, you may be wondering what you can receive. While the details can get complicated, below are the main types of benefits you may be entitled to under your employer’s workers’ compensation insurance:
Workers’ comp covers all approved hospital and other medical expenses that are required to diagnose and treat your work-related injury or illness. This can include doctor’s appointments, surgeries, medications, and more.
You have the right to choose one doctor in each specialty field of treatment required for your job-related injury/illness.
If your injury or illness makes it impossible to work, workers’ comp may also provide disability payments to help supplement some of your lost wages during your recovery. Disability benefits are separated into four categories, depending on the severity of your condition:
- Temporary Total Disability – These benefits may be available if your injury/illness prevents you from working while you recover. In Louisiana, temporary total disability benefits are paid to workers who have to miss more than seven days from work due to their injury/illness. These benefits are two-thirds of your average weekly wages and stop once you’re able to return to work or it’s decided that you have reached maximum medical improvement.
- Supplemental Earnings Benefits – If you’re able to return to work but your injuries cause you to earn less than 90 percent of your normal wages, you may be entitled to Supplemental Earnings Benefits (SEB). These benefits provide two-thirds of the difference between your normal wages and the amount you’re capable of earning now. You can receive this benefit type for no more than 520 weeks.
- Permanent Total Disability – After treatment, your doctor will determine whether you have a permanent disability. If your condition is found to be permanently and totally disabling, you can receive weekly payments for the duration of your disability. To qualify for these benefits in Louisiana, you must be unable to perform any type of gainful employment.
- Permanent Partial Disability – This type of benefits may be available if you’ve suffered some permanent damage from a workplace injury/illness that partially hinders your abilities in the workplace. For example, Louisiana compensates workers for amputation or the physical loss of certain body parts. You can receive two-thirds of your average weekly wages for a period of time determined by the state schedule. Louisiana workers may also be able to receive a one-time award of $50,000 for catastrophic injuries, such as paraplegia or quadriplegia.
A workers’ spouse, children, or other financial dependents may be able to receive weekly death benefits if their loved one passed away as a result of a work-related injury or illness.
Filing a Workers’ Comp Claim
Before receiving these important benefits, Louisiana’s procedures for filing a workers’ comp claim must be followed:
Report Your Injury or Illness
The first step is to report your injury or occupational illness to your employer. While you have up to 30 days to do so, it’s important to notify your employer as soon as possible. Any delays can cause your employer or its insurance company to question the validity of your claim.
Your Employer Files a “First Report of Injury or Illness” Form
Within 10 days of your employer’s knowledge of your injury/illness, it’s their legal responsibility to complete a form known as the “First Report of Injury or Illness” and file it with their insurer. The insurer should then submit the form to the Louisiana Workforce Commission.
Investigation of Your Claim
After receiving the appropriate form, your employer’s workers’ comp insurance carrier will likely conduct an investigation to decide whether to approve or deny your claim. Typically, the insurer should inform you of its decision within two to four weeks.
If your claim is approved, you should start receiving your benefits. If your claim is denied, don’t lose hope. You may still be able to receive benefits through the appeals process. However, appealing a denied claim is complex and involves many strict deadlines. At this stage, it’s important to speak with a knowledgeable workers’ comp lawyer who is familiar with the Louisiana workers’ compensation system.
How Can You Get Help?
If, for any reason, your employer or the insurance company claims you aren’t eligible for benefits, please contact our workers’ comp lawyers at The Law Offices of Blaine Barrilleaux.
Employers and insurance companies regularly deny workers with valid claims in order to escape liability and pay as little as possible.
Our experienced legal team knows the laws in Louisiana and fights hard to help injured workers get what they deserve. You should never have to worry about how you’re going to pay your medical bills and support your family when you were just doing your job. After a workplace injury or illness, you have rights. Let us help uphold those rights.
Call us today at (337) 221-4299 or fill out our contact form to schedule a free case evaluation.