Being injured on the job and losing your ability to earn a living, even temporarily, can be a life-altering event. In Louisiana, the Workers’ Compensation laws are there to protect injured workers. In general, if you are hurt at work, your employer, or its workers’ compensation insurance carrier, is obligated to pay medical benefits and disability benefits, also known as indemnity benefits.
To preserve your rights under the Workers’ Compensation law, you must take certain steps if you are injured at work. First, you must report the injury to your supervisor, and, if there is one, your employer’s human resources manager. Make sure an injury report is completed and, if possible, request a copy. Even if you do not think your injury is serious and will require medical attention or lost time from work, you should still report it. This way, if your initial assessment of your injury turns out to be wrong, you will have saved yourself a lot of trouble trying to document an injury after the fact.
An injured worker is entitled to have all reasonable and medically necessary medical treatment paid for by his or her employer or its workers’ compensation insurance carrier. An injured worker is not required to pay co-pays or deductibles. A word of caution: medical treatment which costs more than $750.00 (such as ongoing physical therapy, MRIs, etc.) may require prior approval from the insurance carrier.
You, as an injured worker, are entitled to choose one physician in a particular specialty. For example, if you selected a primary care physician to treat your injury and later it becomes necessary for you to be treated by an orthopedist, you are entitled to choose one orthopedist also. The insurance carrier also has the right to choose a doctor for you. Sometimes the insurance company will choose a doctor for you and later send you a form asking you to agree that that doctor is your choice. Before signing such a form, it is a good idea to consult with an attorney.
Prescriptions are also covered by workers’ compensation insurance. Injured workers are also entitled to mileage reimbursement for traveling to and from doctors’ appointment, physical therapy appointments, etc. Ask your claims adjuster for a medical mileage log. If you are unsure of the exact mileage to and from the appointments, use an on-line map service, such as Google Maps Map Quest or Yahoo Maps.
Lost Wages/Indemnity Benefits
Temporary Total Disability Benefits (TTD)
Generally speaking, if an injury prevents you from returning to work, and a doctor certifies that you cannot return to work, you are entitled to 2/3 of your average weekly wages, subject to a maximum compensation rate, which changes periodically. Before you are entitled to lost wage benefits, your injury must prevent you from returning to work for seven days. If your injury keeps you out of work for 42 days or more, you are entitled to be paid for the first seven days of missed work. In other words, if your injury keeps you out of work six days or less, you are not entitled to lost wages from the workers’ compensation insurance carrier.
Supplemental Earnings Benefits (SEBs)
If you are able to return to work, but your injury prevents you from being able to earn as much as you did before you were injured, you may be entitled to Supplemental Earnings Benefits. If you return to work and are earning less than 90% of your pre-injury wages, you are entitled to receive 2/3 of the difference between your post and pre-injury wages. These benefits are paid monthly and continue until you are released by your doctor to return to full duty, or you have received 520 weeks of benefits.
Permanent Partial Disability (PPD)
These benefits are payable in addition to TTD and SEB payments. If your doctor determines that you have suffered a permanent disability to a certain body part (e.g., thumb, finger, toe, eye, hand, arm, leg or foot) you may be entitled to a scheduled benefit.
Permanent Total Disability (PTD)
If your injury prevents you from being able to perform any and all work, even with vocational rehabilitation, you may be entitled to PTD benefits. The standard for proving entitlement to PTD benefits is much more stringent than proving entitlement to Social Security Disability benefits. Therefore, just because you qualify for SSDI as a result of your on-the-job injury does not necessarily mean you will be entitled to permanent total disability benefits.
If you believe you are entitled to Workers’ Compensation, contact Attorney Frank A. Bruno.