FILING A CLAIM FOR LOUISIANA WORKERS' COMPENSATION
BENEFITS
If you have an accident at work, you must
report your accident or injury to your employer within 30 days
of the day that it occurs or your right to recover Workers'
Compensation disability and medial benefits may expire. Because the
law does recognize a very few exceptions to the limitation of
the time period for reporting your accident, you should
contact an attorney for assistance with your claim even if
more than 30 days have passed to determine if one of the
exceptions may apply.
Don't forget
to ask your employer for a copy of your accident report
because the report can provide proof to establish the date
that your accident was reported.
FILING A CLAIM WITH THE LOUISIANA OFFICE OF WORKERS'
COMPENSATION
If your employer
is underpaying, or not paying, your Workers' Compensation wage or medical
benefits, you or your attorney may file a
with the
Office of Workers' Compensation. Filing this form starts the
process that can ultimately result in a trial before a
Workers' Compensation Judge.
If you have a
disagreement with your employer about your Workers'
Compensation benefits and would like for the dispute to be
submitted to the Workers' Compensation Court, you must file
your claim with the Court within the following time periods:
A claim for
Workers' Compensation wage benefits must be filed within one year of the
date of the accident or the date through which you were last
paid Worker’s Compensation disability benefits, whichever is
later. The time limit for filing a claim for Workers'
Compensation benefits is not extended because you received
another type of disability benefits, such as Social Security
Disability or benefits from a private short term disability
policy.
If Workers’ Compensation wage benefits
have been paid, a claim for Supplemental Earnings Benefits
must usually be filed within three years of the date
through which you were last paid indemnity benefits.
Conversely, a claim for any other type of
indemnity benefits (such as Temporary Total
Disability benefits) must be filed with the Louisiana Office of
Workers' Compensation within one year of the date through which you were last paid
disability benefits.
A claim for
medical benefits must be filed within one year of the date of
the accident or three years from the date that Workers’
Compensation medical benefits were last paid, whichever is
later.
A claim
for Workers' Compensation benefits that is not based upon a
specific accident but is instead based upon a work-related
illness or disease must be filed with the
Louisiana Office of Workers' Compensation within one year of
the date that:
-
The disease
manifested itself.
-
The
employee is disabled from working as a result of the
disease.
The
employee knows or has reasonable grounds to believe that the
disease is occupationally related.
Louisiana
Courts have decided that your right to file claims for
Workers' Compensation medical benefits and Workers'
Compensation indemnity benefits are separate legal rights.
Thus, the Courts have held that your time limit for filing a
claim for indemnity benefits can expire even though the
Workers' Compensation insurance company is still paying for
all of your medical treatment. This is an area of the law that
can appear confusing and unfair and its impact can depend
heavily upon the specific circumstances of your case.
TERMINATION OF EMPLOYMENT
The Louisiana Workers' Compensation Act prohibits an employer from firing an employee in retaliation
for the employee filing a Louisiana Workers' Compensation
claim. Nonetheless, if a doctor withholds an injured employee
from work, that person usually will be classified as Temporarily
Totally Disabled from performing their job. If their injury
prevents them from returning to work, they may in some
circumstances be fired because, at least temporarily, they can
no longer perform the duties of their employment.
It is
important to realize the distinction between the two
situations.
In most
circumstances, the Louisiana Workers' Compensation Act allows
your employer to terminate your employment if you are
medically unable to perform the work. Additionally,
Louisiana law does not require employers to allow injured
employees to return to their job when they have recovered from
their injury. Federal laws, such as the Family & Medical Leave
Act or the Americans with Disabilities Act, extend greater protection to some
injured Louisiana employees.
On the other hand, your employer is prohibited from terminating
your job in retaliation for the fact that you filed a
Louisiana Workers'
Compensation claim. You may have a significant cause of action
against your employer if you are able to prove that you were
subjected to "retaliatory discharge" or a "wrongful termination."
TERMINATION OF
DISABILITY BENEFITS
Contrary
to what many people believe:
-
Your
Workers' Compensation benefits often can be terminated while
you are still under active medical care.
-
Your
employer usually is not required to obtain the approval of the
Louisiana Office of Workers' Compensation before terminating
your benefits.
One of our
primary goals is to have your Workers' Compensation disability
benefits continue without interruption until you either return
to work or settle your claim. There are many things that you
can do to improve your chances of receiving benefits on a
regular basis, including attending all of your medical
appointments.
Unfortunately, employers will sometimes terminate disability
benefits based solely upon the results of a limited
examination performed by a doctor of their selection. If they
are able to obtain a report from their doctor that says you
can go back to work, they may terminate
your benefits even though your treating physician continues to
withhold you from work.
You have
many options in such a situation, including:
-
Negotiate
reinstatement of your benefits.
