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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 "accident" as:

"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 more inclusive.

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 ILLNESSES
  
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.

If you 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 Disputed 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 disease.
  • You knew, or had reasonable grounds to believe, that the disease or illness is related to your employment.

Next: Louisiana Office of Workers Compensation 

 

David Buie, Louisiana Workers Compensation Attorney and Social Security Disability Attorney, 650 Poydras Street, Suite 1400, New Orleans, LA 70131, (800) 851-9405 / Fax: (866) 702-5297 Representing claimants in:
Alexandria Baton Rouge Bossier City Covington Gretna
Hammond Harahan Harvey Houma Kenner Lafayette Lake Charles
Laplace Marrero Metairie Monroe New Iberia New Orleans
Opelousas Ruston Shreveport Slidell Terrytown

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