DO YOU NEED A LAWYER FOR YOUR LOUISIANA WORKERS COMPENSATION CLAIM?

	For Quick Answers: Why Do You Need A Lawyer? How Can A Lawyer Help? How Much Does It Cost?

WHY DO YOU NEED A LAWYER?

Though about 20,000 people are injured while working in Louisiana each year, injured employees are often shocked when they learn the truth about the Louisiana Workers Compensation system:

• Your time limit for filing a claim with the Louisiana Workers Compensation Court expires in different years depending upon the type of wage benefits you should be 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 Louisiana Workers Compensation indemnity benefits you're receiving and how that impacts time limitations in your case.
    
• “Vocational Rehabilitation” rarely amounts to more than the insurance company's Vocational Expert 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.
    
• Insurance companies can sometimes legally terminate people's benefits even though the claimant's treating doctor reports that they are unable to return to 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. If you want to protect yourself, you need understand why.
    
• Over the years, numerous Louisiana 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.
    
• 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 settlement or outcome of your claim. Congress recently strengthened and expanded the protections provided by the Americans with Disabilities Act. In some situations, injured employees have more rights and options under the Americans With Disabilities Act than they do under the Louisiana Workers Compensation laws.
    
• Louisiana Workers Compensation law often excludes coverage for developmental or repetitive motion injuries which, according to OSHA, are among the most common work-related conditions. 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.
     
  
• 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, you're effectively not protected by the Workers Compensation laws if you're not represented by a capable attorney: “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" “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.
   
• In a typical claim, you and your attorney will need to talk with many people who work for your employer's Workers Compensation insurance company, including their Adjuster, their Medical Case Manager, their Vocational Rehabilitation Expert, and eventually, the insurance company's Attorney. Those are the people with whom you or your attorney will have direct contact. There are other important individuals operating behind the scenes, people that you will probably never talk to, such as the Private Investigator that the insurance has hired to conduct video surveillance of you and your family, the doctor or nurse who reviews your medical records to decide whether the insurance company will pay for your medical treatment, or the Claims Manager, who is the person who often makes many of the important decisions about resolving your case through settlement.

Unfortunately, some folks people adopt a "wait and see" attitude about their Workers' Compensation claim. They want to "wait and see" how their claim develops before they decide whether they need to call an attorney. Sadly, some even mistakenly believe that the insurance company will treat them better if they don't hire a lawyer.

But while the injured employee is waiting to decide if they need to contact an attorney, the insurance company may be quietly and legally stripping away the injured employee's rights. The Louisiana Workers Compensation insurance company has one clear goal. They want to minimize the amount of money they pay out on your case. To do that, they target the primary benefits you receive:

• 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.
   
• by limiting your right to select the doctors who will treat you.
   
• by failing to include all of your income when calculating your benefits rate.
    
• by sending you back to work based on their doctor's opinion before your doctor releases you to return to work.
   
• by providing you with "vocational rehabilitation" in which their expert copies a few jobs off of the or out of the newspaper to try to show that there are jobs available they claim you are able to perform.
   
• by making things difficult to motivate you to settle whenever they're ready to start negotiating with you.
    
• by offering you a small lump-sum payment to resolve your claim, refusing to tell your how they calculated their offer and making you believe it's a take-it-or-leave-it deal.

The process shouldn't be so confusing and difficult, but having help from an experienced attorney can be invaluable if you want to make sure you're treated fairly.

GOALS FOR YOUR CLAIM

I have four primary goals that I work hard to achieve for every person that I represent in a Workers' Compensation claim:

First, 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.

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 happened 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).

Our next goal should be to help you qualify for Social Security Disability as soon as possible if you have a significant injury that will keep you out of work for at least twelve months. 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.

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 pays for your future medical treatment, provides you with a fair and just lump-sum settlement and allows you to receive the maximum benefits you qualify for from other sources (such as Social Security Disability) after you've settled your Workers' Compensation claim.

FEES & COSTS

Attorney's fees in Workers' Compensation cases are set by law at no more than 20% of any funds or benefits we help you recover. People are sometimes hesitant to hire a lawyer to represent them in their Workers' Compensation claim because they're worried that their lawyer will withhold 20% of each weekly or monthly benefit check. They know a lawyer would be able to help them and they realize that if they don't get legal advice, they will always be concerned that they got inadequate medical treatment or less benefits in the long run. But they just don't feel they could survive financially if they had to pay someone 20% of their already-reduced income.

I agree. It's a difficult situation.

So, in most cases, I do not withhold fees from my clients' weekly or monthly benefit payments. Attorneys fees are paid only from the final settlement of the claim. You do not have to pay anything "out of pocket" while your claim is going on. You should be able to have an attorney represent you in your Workers' Compensation claim without it making a difficult financial burden even worse. And remember, I always offer a free telephone or email consultation if you want to ask questions so you can decide whether I would be the right person to work with you on your claim.

Because of the way the laws are set up, I have to make two exceptions to my general rules that I do not withhold fees from my clients' periodic benefits and that fees are paid only from final settlements. First, if you've been represented by another attorney in your claim, you may owe that attorney for the services they performed. You will probably not have your fees reduced simply by switching lawyers, but your total fee will never be more than 20% of the benefits you receive. Secondly, if your claim has been denied by the insurance company, you're not receiving benefits and we file a proceeding with the Court that eventually results in you being paid benefits on a weekly or monthly basis, a fee may be payable on those benefits.

Finally, some people have already negotiated a settlement directly with the Workers' Compensation insurance company, but would like to have a lawyer look over the documents and answer some questions before the parties sign the documents and submit them to the Judge for approval. For example, do the documents really say what you meant for them to say? Do they accurately reflect your agreement with the insurance company? What impact will your settlement have upon any Social Security, Medicare, Long-Term Disability, Retirement Pension, health care or other benefits you may receive?

If you've already negotiated a settlement that has not yet been approved by the Court, I will review the documents with you, help you work with the insurance company's representatives to make any changes that you believe the documents need and represent you in the settlement approval process before the Court. Having an attorney assist you with your settlement can have many obvious benefits, including simple things such as the fact that you don't have to go to Court and appear personally before the Judge to have your settlement approved if you are represented by an attorney. The fee for representing you in the final steps of your claim after you've already negotiated a settlement on your own is based on the number of hours that I work on your claim. The fee usually works out to be only a small fraction of the 20% attorneys fee typically paid in a Louisiana Workers' Compensation claim. The fee must be reviewed and approved by the Workers' Compensation Court. I strongly suggest that you don't try to negotiate your own settlement. But if you've already done it and you would like for a lawyer to go over the documents with you, we can help.

My practice is limited to representing individuals in Workers' Compensation and Social Security Disability claims. If you or someone you know needs a free consultation about a Louisiana Workers' Compensation or Social Security Disability case, please call me at (800) 851-9405 or send me a note using the form at the top of this page.

Next: Contact David Buie