The Challenges of Navigating Louisiana’s Workers’ Comp System

Navigating Louisiana’s workers’ compensation system can be challenging. From the start, it can be difficult to know if you qualify for benefits. Furthermore, obtaining the benefits themselves can be difficult, even if you qualify.

Workers’ compensation insurance companies are typically reluctant to pay out on claims. They even use their own specially chosen doctors to determine who is entitled to benefits. It is important to reach out to a workers’ compensation attorney as soon as possible to assist you in getting what you deserve.

A Brief Overview of Workers’ Compensation Benefits in Louisiana

Workers’ compensation is a no-fault insurance system that protects both employees and their employers in the event of a workplace injury. The types of workers’ compensation benefits that exist in Louisiana and are governed by law include:

• Medical Benefits – reasonable medical expenses needed to treat a work-related injury or illness, including any medical or nonmedical treatment recognized by the state of Louisiana, prescription drug medications, physical therapy, and reasonable travel expenses to and from treatment.
• Temporary Total Disability Benefits (TTD) – benefits that cover a portion of an injured worker’s wages while they recover from an injury, and that end when a doctor releases the worker to return to work. 
• Permanent Total Disability Benefits (PTD) – benefits paid to workers who are injured so severely that they can never return to work.
• Vocational Rehabilitation Benefits – assistance with restoring an injured worker, as much as possible, to the earning capacity they enjoyed before their workplace injury.
• Death Benefits – financial support paid to the surviving family members of a worker who lost their life due to a work-related injury or illness.

Navigating Louisiana’s Workers’ Comp System

Various challenges can impact an injured worker’s ability to receive the benefits to which they are entitled under Louisiana’s workers’ compensation system. What follows is a discussion of what we consider the biggest challenges with navigating a Louisiana workers’ compensation claim, based on our years of experience.

Calculating The Correct Workers’ Compensation Rate

An injured worker is entitled to weekly payments to compensate for lost wages while they are unable to work. The weekly compensation rate is a percentage of the worker’s average weekly wages prior to their injury. 

Some workers’ compensation insurance companies will base an injured worker’s average weekly wages on a 40-hour work week, then set the compensation rate at two-thirds of that figure. However, this fails to consider other factors, such as overtime wages paid to the worker and whether they worked more than one job before being injured. 

The compensation rate must be calculated by adding wages earned from all the injured worker’s sources of income, including self-employment. If the worker had more than one job, wages from all their employers, as well as overtime pay, bonuses, and paid vacation time should all be included in calculating their weekly compensation rate. 

Impairment Ratings

An impairment rating is a medical evaluation that establishes the degree to which a worker has been permanently impaired by a workplace injury. Impairment ratings are used to determine if an injured worker is entitled to any permanent disability benefits.

Essentially, a doctor will assign an impairment rating to a worker’s injury on a scale of 0 to 100—the more severe the impairment, the higher the rating. The higher the rating, the more likely the insurance company will offer the injured worker a settlement for permanent disability benefits.

Some doctors give very conservative impairment ratings to please the insurance companies who send them steady business. An experienced lawyer may be needed to carefully examine the impairment rating assigned by the insurance company’s doctor. 

A good worker’s compensation attorney will review the impairment rating assigned by the authorized doctor to determine if it is overly conservative under the American Medical Association guidelines. If so, the attorney can assist the injured worker with seeking a second opinion with another doctor who does not have ties to the insurance company.

Workers’ Compensation Benefits & Public Benefits

An injured worker may be entitled to both workers’ compensation as well as public benefits, such as Social Security Disability Insurance (SSDI). However, this can be problematic since the amount of workers’ compensation the worker receives can reduce their SSDI and other public benefits, and vice versa.

If a worker is injured on the job, and they are considering applying for SSDI, it is crucial that they hire an experienced workers’ compensation lawyer. If they don’t, they may lose tens of thousands of dollars in benefits. 

The same thing is true for Medicare coverage. If an injured worker does not settle their workers’ compensation case correctly, they can end up voiding any Medicare coverage they might otherwise have been entitled to receive. 

A skilled New Orleans workers’ compensation attorney may be able to address this issue by adding special language to a workers’ compensation settlement agreement that will allow the injured worker to protect their entitlement to SSDI, Medicare, and other public benefits to the greatest extent possible. 

Let Dudley DeBosier’s Workers’ Comp Lawyers Help You

Our law firm has been helping injured employees in New Orleans for many years, and we can also help you. If you are having trouble receiving workers’ compensation benefits, contact the workers’ compensations attorneys at Dudley DeBosier.

We love to help people protect their future and get what they deserve. Contact our New Orleans office today to schedule your free consultation. We are available 24/7 and your call is completely confidential.

Related Posts