• Many people have a hard time finding an attorney who has the knowledge and experience needed to successfully represent them in a Louisiana Workers’ Compensation claim. As the judges of the Louisiana Third Circuit Court of Appeal concluded: “We do not exist in a vacuum, immune to the realities of the real world and the inability of a worker's compensation claimant to find effective or adequate counsel. This is a factor that must be contemplated, considering the real world reluctance of counsel in today's legal environment to accept worker's compensation cases. The injured worker would effectively be denied the protection offered by the workers' compensation statutes if he or she was unable to find an attorney to represent his or her interests." Charles v. Acadia, 01-0129 (La.App. 3^rd Cir. 6/6/2001) 787 So. 2d 1206.
   

• Your time limit for filing a claim with the Workers’ Compensation Court expires in different years depending upon the type of indemnity benefits you're receiving. In fact, your time limit for filing a claim for benefits can expire even while you're still under medical care. It's important to know the type of Workers' Compensation indemnity benefits you're receiving. Insurance companies rarely volunteer this information.
   

 

• Some injured employees may be legally fired. You need to know whether your employer will hold your job open for you and let you come back to work when you recover from your injury. Even if you never want to go back to work at the place where you were injured, this is an important factor that impacts the outcome or settlement of your claim.
   

• In some claims, insurance companies get away with terminating people's benefits with no penalty even though the claimant's treating doctor was holding them out of work. On the other hand, the Louisiana Workers’ Compensation court can award you thousands of dollars in penalties if the insurance company terminates your benefits without the appropriate medical documentation. Sometimes they get away with it and sometimes they don't. If you want to protect yourself, you need understand why.  
   

• Louisiana law often excludes coverage for developmental or repetitive motion injuries which, according to OSHA, are among the most common work-related conditions. Some repetitive motion injures are covered. Others are not. The main factors that control whether your medical condition is covered are: (1) how long you worked for your employer before the disability arose, (2) your ability to pinpoint the beginning of your symptoms, and (3) whether your medical condition is one of the conditions that is specifically included or excluded by Louisiana Workers' Compensation law. 
   

• “Vocational Rehabilitation” rarely amounts to more than your ex-employer mailing you a letter listing a few low-paying, dead-end jobs. It is an exceptional and unusual case in which an injured employee is actually retrained for a new job.
   

• One of the most important laws relating to your claim is not even in the Louisiana Workers’ Compensation Act. In fact, it's not even a Louisiana state law, and it can impose larger penalties upon your employer than would any violation of the Louisiana Workers’ Compensation Act. 
   

• The Louisiana Supreme Court said: “The legislature has remained silent on the issue of a claimant's right to a medical case manager. Accordingly, neither Plaintiff nor the Workers' Compensation Hearing Officer can regulate medical case management services.” Martin v. Davison, 01-C-3143 (La. 2/22/2002) 810 So. 2d 1103. What should you do if you believe that the insurance company's Medical Case Manager is trying to take over your medical care or poison your relationships with your doctors? Do they go to your medical appointments with you so they can tell your doctors what to write in their reports? Solving this problem requires careful planning. But it's a problem that can be solved.
   

• Over the years, numerous Workers’ Compensation Judges, including a former Chief Judge and a former Deputy Chief Judge, have quit, alleging that the system is biased against injured workers. Enacting amendments to the Louisiana Workers’ Compensation laws is a highly politicized process with important changes introduced each year. 
   

• The Louisiana Workers' Compensation insurance market is dominated by a single big company, the Louisiana Workers' Compensation Corporation (LWCC). According to the Greater Baton Rouge Business Report (6/7/05): "Today, LWCC holds fast to a market share larger than its next 10 competitors." LWCC is well know for their widely advertised policies that strictly limit settlements.

• The insurance company wants to reduce the costs of your medical treatment:
  
  - by taking away your right to select the doctors who will treat you.
  
  - by limiting or denying your medical tests and surgery.
  
  - by delay, delay, delay, making the process of getting your medical treatment as difficult as possible.
   
• They want to reduce the amount they pay you in weekly or monthly wage  benefits:
  
  - by failing to include all of your income when calculating your benefits rate.
  
  - by sending you back to work before your doctor releases you to return to work.
  
  - by reducing or terminating your benefits based upon a defective Labor Market Survey.
   
• They want to minimize the amount that you receive in settlement:
  
  - by reducing or eliminating your indemnity benefits to motivate you to settle whenever they're ready to start negotiating with you.
  
  - by providing you with "vocational rehabilitation" in which their expert copies a few jobs off of the Department of Labor's Website or out of the newspaper to show that there are jobs available that you can perform.
   
  - by offering you a quick settlement before you even know the extent of your medical condition or the type of treatment you will need.

1. We need to do everything possible to obtain the correct diagnosis and medical treatment for your injury. Our goal should be to aggressively pursue your medical treatment until you reach "maximum medical improvement." In other words, we need to insist upon high quality medical care and we need to help you get that care while you are still covered by Workers' Compensation insurance.
   
   Workers' Compensation Insurance companies often refuse to pay for test, medical treatment and medication. In fact, they often just ignore the requests and never reply, despite your doctors' repeated calls and letters. Their refusal to authorize medical treatment is the most frequent reason people call us for help with their claim. It doesn't have to be that way. Louisiana law contains a procedure that requires Workers' Compensation insurance companies to promptly respond to your doctor's request for testing and treatment, often within less than a week.
    

2. Secondly, we want you to receive Workers' Compensation income benefits, on time and in the correct amount, during the entire time that you're unable to return to fulltime work. Your Workers' Compensation benefits may be underpaid without you ever realizing you've been shortchanged. Some companies will aggressively reduce or terminate your benefits with no explanation and only a tenuous legal basis. 
   
   Workers' Compensation cases are frequently hotly disputed. Your employer may deny that your accident occurred or they may claim that your medical condition is not covered by the Workers'' Compensation laws. In a highly contested case where you're not receiving benefits, we need to prepare your claim and bring it to trial as quickly as possible.
   
   But in most cases, our goal is to obtain 100% of the benefits that you should receive at the time that you should receive them. And we want to keep those benefits coming in on a regular schedule until you settle your claim or return to work (or both).
    

3. If you have a significant injury that will keep you out of work for at least twelve months, we want to help you qualify for Social Security Disability as soon as possible. While it's true that qualifying for Social Security Disability can make it more complex to negotiate the settlement of your Louisiana Workers' Compensation claim, applying for Social Security Disability while you are still receiving Workers' Compensation can allow you to recover tens-of-thousands of dollars in benefits that you wouldn't otherwise receive.
   
   I frequently see people who have lost years of Social Security Disability benefits simply because they failed to file the right forms at the right time. In fact, your right to apply for Social Security Disability completely expires if you don't apply within the right time frame. While you're out of work and receiving Workers' Compensation benefits, your time for applying for Social Security Disability is gradually slipping away.
   
   It's a travesty to pay thousands of dollars of payroll taxes into the Social Security system and then be denied Disability benefits because you waited too long to apply. While not everyone who receives Workers' Compensation benefits will qualify for Social Security Disability, it's usually a mistake to wait until your Workers' Compensation claim is over before you file your Social Security Disability application.
    

4. Finally, we want to obtain the largest settlement or Judgment that the law allows. And there are many things that we can do to make certain that you are fully compensated in the settlement or Judgment of your claim.
   
   We need to verify that your doctors understand the impact of signing the insurance company's forms authorizing you to return to work. Many people have told me that their doctor signed the forms releasing them to work while telling them: "You need to be retrained for a light duty job." That's a great idea! But it hardly ever happens in a Louisiana Workers' Compensation claim.
   
   We need to be prepared to challenge the Labor Market Survey prepared by the insurance company's Vocational Expert. We often find that taking the depositions of the potential employers shows that the particular claimant was not at all suitable for the particular job, or that the employer was merely “accepting applications to keep on file for when they do need to hire somebody.” It's been my experience that Labor Market Surveys often cannot withstand much scrutiny.
   
   Most importantly, we need to formulate a plan that maximizes and includes all of the benefits you qualify for, pays for your medical treatment without requiring you to rely upon the state hospital system and allows you to get back to at least the standard of living you had before your accident happened. 

My practice is limited to representing individuals in Workers' Compensation and Social Security Disability matters. If you or someone you know needs a free consultation about a Louisiana Workers' Compensation or Social Security Disability case, you can reach us at (800) 851-9405 or by email.