WHAT TYPE OF INJURIES AND ILLNESSES
ARE COVERED BY WORKERS COMPENSATION INSURANCE IN LOUISIANA?
The Louisiana Workers Compensation Act
covers people who experience a work-related accident or
illness. Louisiana Revised Statute 23:1021(1) defines
"An unexpected or unforeseen
actual, identifiable, precipitous event happening
suddenly or violently, with or without human fault, and
directly producing at the time objective findings of an
injury which is more than simply a gradual deterioration
or progressive degeneration."
Though the Louisiana Courts initially
followed a very restrictive interpretation of what
constituted an “accident,” the term has gradually become
Currently, some injuries that are caused by
repetitive motion, such as an afternoon of lifting unusually
heavy boxes while working as a stocking or shipping clerk,
may be covered by Workers’ Compensation. Other injuries,
such as back pain that develops over a period of days or
weeks, may not be covered. In many claims, there is no
clear, easy answer. The determination will depend upon the
circumstances of the injury and your ability to pinpoint the
specific moment in which the accident occurred.
If you have more than one injury while
working for the same employer, the Louisiana Workers
Compensation Act provides that each accident should be
treated as a separate claim.
For example, let's assume you
experience a lower back injury on the job in January. An MRI
shows that you have a herniated disc, but you have only
relatively mild pain. You have a great job and your company
is willing to work with you on your schedule, so you miss
just a few day of work here and there. Then in December you
have a fall because your leg gives out (probably due to your
lower back injury) while you're on the job. Now you have
severe lower back pain and trouble walking.
In the second accident you strained your knee, but your
medical tests for your lower back show essentially
the same result as they did following your first accident in
January. The one-year anniversary of the first accident is
rapidly approaching. Or perhaps you receive Temporary Total
Disability benefits for a few weeks while your knee injury
heals. Now your doctor reports that your knee is fine.
Meanwhile your employer says they had to hire someone to do
your job, and by the way, you're past the one year
anniversary of your first accident.
You probably have more legal rights in
this situation than it initially appears, but the point is
to recognize that the time limit on a Louisiana Workers
Compensation may expire even while you're under treatment
and receiving benefits for another claim.
If you have more than one work-related
accident, your claim may be covered by the
Louisiana Workers Compensation Second Injury Fund. The
Louisiana Workers Compensation Second Injury Fund may cover
your later claim without regard to whether you were working
for the same, or a different, employer.
LOUISIANA WORKERS COMPENSATION WORK-RELATED
In addition to providing coverage for
work-related accidents, the Louisiana Workers Compensation
Act also provides coverage for some work-related illnesses
or diseases. The illness must be disabling, and must
result from causes and conditions that are "characteristic
of and peculiar to" the employee's job or work environment.
In most circumstances, if you develop an illness during
your first year on the job with your employer, the law
presumes that your medical condition is not work-related.
That presumption can be overcome and your claim can be
successful if you have convincing evidence which shows that
your medical condition was caused by your employment.
The Louisiana Workers Compensation Act specifically
provides coverage for some medical conditions, such as
carpal tunnel syndrome.
Other medical conditions, like
degenerative disc disease, arthritis, mental illness and
heart disease, are specifically excluded from coverage.
While these conditions are excluded from the Occupational
Illness statute, they may still impact the severity of
an injury caused by a work-related accident. They may also
limit your ability to return to work when you've reached
maximum medical improvement from another injury that is
covered by the Louisiana Workers' Compensation laws.
become disabled because of a work-related illness, your
Louisiana Workers Compensation benefits should based upon the wages
you were earning at the time you stopped working for your
employer, or the date of your last exposure to the condition
that caused the illness, whichever is later.
If your employer refuses to provide Louisiana Workers
Compensation income and medical benefits for an
occupational illness or disease, you must file a
Claim for Compensation with the
Louisiana Office of Workers Compensation within one year of
the date that:
- The disease manifested itself.
- You become disabled from working as a result of the
- You knew, or had reasonable grounds to believe, that the disease
or illness is related to your employment.
Next: Louisiana Office of Workers Compensation