A workplace injury can leave you with more questions than answers. How do you report the accident? Who chooses your doctor? What happens if the insurance company disputes your claim?
In Louisiana, workers’ compensation covers medical care and partial wage replacement for employees injured on the job. Because it is a no-fault system, you do not need to prove your employer caused the accident. You only need to show that the injury happened during and because of your employment.
Knowing what happens at each stage of the Louisiana workers’ compensation process can help you protect your rights and avoid unnecessary setbacks. A New Orleans workers’ compensation lawyer can provide guidance from the outset, helping you navigate the process and advocate for the benefits you may be entitled to receive. Contact us to schedule a free consultation.
First: Determine Whether You’re Covered
Most Louisiana employees are covered by workers’ compensation from the day they start employment. This includes full-time, part-time, seasonal, and minor employees, although certain limited exceptions apply.
To receive benefits, your injury must occur within the course and scope of your employment. Covered conditions may include workplace accidents, occupational illnesses, and repetitive stress injuries.
Next: Report the Injury to Your Employer
After a workplace injury, notifying your employer should be one of your priorities. Louisiana law requires injured employees to report a work-related injury within 30 days of the accident. Reporting the injury as soon as possible can help avoid disputes and preserve your right to benefits.
After you notify your employer of the injury, the next step takes place behind the scenes. Under Louisiana law, employers must report workplace injuries that result in death or more than one week of lost work time to their workers’ compensation insurer within 10 days of learning about the injury.
The insurer then reviews the claim and decides whether to begin benefits or dispute the claim.
Then: Get Medical Treatment
Seeking prompt medical attention is important not only for your health but also for documenting your injuries.
Louisiana law gives injured workers the right to choose their own treating physician. Employees may select one treating physician in any medical specialty. Because medical records often become key evidence in a claim, following treatment recommendations and attending appointments can strengthen your case.
In most cases, injured workers should not have to pay deductibles or copayments for authorized medical treatment related to their workplace injury. Louisiana workers’ compensation may also reimburse mileage expenses incurred while traveling to and from medical appointments related to the injury.
Keeping records of your travel and expenses can help ensure you receive reimbursement.
If Problems Arise: The OWCA Process Begins
Not every claim proceeds smoothly. Sometimes benefits are delayed, treatment requests are denied, or the insurance company disputes whether the injury is work-related.
When that happens, filing a workers’ comp claim may require assistance from the Office of Workers’ Compensation Administration (OWCA).
The formal dispute process includes the following steps:
- File the Disputed Claim for Compensation
- Participate in mandatory mediation
- Proceed to a hearing before a Workers’ Compensation Judge if mediation is unsuccessful
- Appeal the decision, if necessary
Many disputes are resolved during mediation without the need for a formal hearing.
Throughout the Process: Benefits May Be Available
Depending on the circumstances of your injury, Louisiana workers’ compensation may provide several types of benefits.
Medical Benefits
Coverage may include reasonable and necessary treatment related to the injury, such as doctor visits, surgery, hospitalization, physical therapy, prescriptions, and medical equipment.
Wage Replacement Benefits
If you cannot work while recovering, temporary total disability benefits may replace a portion of your lost wages. These benefits equal two-thirds of your average weekly wage, subject to state maximums.
In Louisiana, wage replacement benefits begin after a seven-day waiting period. However, if your disability lasts longer than 14 days, compensation for that initial waiting period may also become payable.
Supplemental Earnings Benefits
If you return to work but earn less than 90% of your pre-injury wages, Supplemental Earnings Benefits may help bridge the gap. Eligible workers receive benefits equal to about two-thirds of their lost earning capacity, up to the maximum amounts allowed by Louisiana law.
Permanent Disability Benefits
Workers with lasting impairments may qualify for permanent partial or permanent total disability benefits. Louisiana also provides a separate one-time $50,000 payment for certain catastrophic injuries, including paraplegia, quadriplegia, and the actual anatomical loss of specified limbs or eyes.
Vocational Rehabilitation
Some employees may receive assistance in finding suitable employment or retraining for a new position.
Death Benefits
If a workplace injury results in death, certain surviving dependents may qualify for weekly death benefits. Louisiana workers’ compensation may also reimburse eligible funeral expenses.
One Important Exception for New Orleans Workers
For some employees in and around New Orleans, Louisiana’s workers’ compensation system may not apply at all.
Dock workers, shipbuilders, harbor employees, and certain workers near navigable waters may instead be covered by the federal Longshore and Harbor Workers’ Compensation Act (LHWCA).
Because the LHWCA follows different rules and filing requirements, determining which system applies early in the process is critical.
Finally: A Claim Denial Is Not Necessarily the End
Claims are sometimes denied because insurers question whether the injury occurred at work, attribute symptoms to pre-existing conditions, dispute medical treatment, or argue that deadlines were missed.
A denial does not automatically mean you lose your right to benefits. The OWCA process allows injured workers to challenge adverse decisions and present evidence supporting their claims.
How a New Orleans Workers’ Compensation Lawyer Can Help
The Louisiana workers’ compensation process can be complicated, especially when disputes arise or when federal maritime laws may apply. If you have been injured at work, getting answers early in the process may help you avoid costly mistakes and focus your energy where it belongs: on your recovery.
A New Orleans workers’ compensation lawyer can help you understand your rights, navigate the OWCA process, gather supporting evidence, and help you understand the coverage available to workers under Louisiana law or the Longshore Act.
At Douglas & London, our team can explain your options and help you pursue the benefits available to you. You pay no fee unless we win your case. Contact us today for a free, no-obligation case review.
