An introduction to Louisiana workers’ compensation benefits
Louisiana workers’ compensation law is complicated and not always worker friendly, so consulting an experienced lawyer is a good idea for any Louisianan injured or sickened because of work.
Workers’ compensation is the result of the so-called “grand bargain” between employers and employees. Namely, employers agree to pay employees benefits for work-related injury or illness regardless of whose fault the harm was and in exchange, employees cannot normally sue their employers for workplace injury or disease.
Louisiana passed its first workers’ compensation statutes in 1914 at a time when the idea of workers’ compensation was starting to take hold across the country. Today, almost all employees in the state (with a few exceptions) are covered through their employers, which either have workers’ compensation insurance or self-insure.
The Office of Workers’ Compensation Administration or OWCA, part of the Louisiana Department of Labor, is the state agency charged with administering the program, including resolution of disputed claims.
Eligibility and benefits
A primary requirement of eligibility for benefits is that the harm must have occurred in the course of and arising out of employment. Many legal disputes have been over whether the particular harm suffered met both requirements.
Louisiana employees may file claims for both physical and mental work-related harm, but eligibility based on mental injury is harder to prove in some cases. The mental injury must have been caused by a work-related physical injury or by a “sudden, unexpected and extraordinary stress related to the employment,” according to the Louisiana Workforce Commission’s website.
A compensable occupational disease must be related to the conditions the worker is exposed to in the particular occupation.
Workers’ compensation benefits may include:
- Medical care
- Indemnity wage benefits, consisting of periodic payments for temporary total disability or TTD, or permanent total disability or PTD, based on two-thirds of the person’s average weekly wage or AWW, with a minimum and maximum level under the law
- Supplemental earnings benefits, called SEB, paid if after returning to work the claimant cannot earn at least 90% of their previous wage level
- Catastrophic injury payment of $50,000
- Vocational rehabilitation services, including potential retraining
- Death benefits, including funeral and burial coverage capped at $8,500, and indemnity benefits to a surviving spouse, dependent children or other dependents; or if no surviving dependents, then $75,000 to each surviving parent
Normally, whether an injury is compensable does not depend on whose fault it was. However, the employee might lose coverage if the harm occurred when they were engaged in “horseplay,” if they tried to hurt themselves, if they were intoxicated (unless the employer provided the alcohol or other intoxicating substance) or if they intentionally started a fight.
Review and appeal
When a claimant disagrees with an aspect of awarded benefits or if benefits are denied, there are rights to workers’ compensation mediation and administrative appeal before a workers’ compensation judge. Next, either the employer or the employee may request review in state court. At any point in the process, the parties may reach a settlement through negotiation.
Deadlines for filing are complicated and vary by type of benefit, so anyone wanting to have a claim reviewed should act quickly and seek legal advice. An attorney can help at any stage of application or appeal.
The attorneys at The Townsley Law Firm in Lake Charles, Louisiana, represent injured workers In Calcasieu Parish and the surrounding area in workers’ compensation claims.