If you’ve been hurt on the job, you have the right to seek workers’ compensation benefits, which provide for a variety of needs and expenses the worker may incur. However, employers and their workers’ comp insurers are often reluctant to pay for their sick and injured employees.
Have you been injured but aren’t sure what your legal rights are? Is your employer or its workers’ compensation insurance company refusing to cover you? Talk to the family at Inzina Law Firm Injury Attorneys.
Work Injury Claims
Workers’ compensation is required for most employers and provides benefits to sick and injured workers irrespective of fault. In exchange for these benefits, employees generally cannot file personal injury claims against their employers. Although fault is not a consideration, insurance companies often look for reasons to deny valid claims, such as arguing that an injury was pre-existing or was not work-related.
A skilled Lafayette workers’ compensation attorney can help your claim by:
- Investigating the circumstances surrounding your work injury
- Obtaining evidence to prove the injury was work-related and not pre-existing
- Determining who is liable to you for your injuries
- Calculating the full amount of compensation to which you are entitled
- Pursuing additional claims against third parties not subject to workers’ compensation
Who Is Eligible for Workers’ Compensation in Louisiana?
Most employees—full-time, part-time, and seasonal—are covered by Louisiana’s workers’ comp law. Certain workers are not covered, including:
- Domestic employees
- Most real estate salespersons
- Directors and officers of certain non-profit organizations
- Public officials
An employee can apply for benefits if the injury or disease arises during the scope of employment. Because workers’ compensation is a no-fault system, it doesn’t matter who was responsible for the accident. Making a mistake at work that causes you injury will not deprive you of coverage.
However, someone who intentionally hurts themselves or was intoxicated at the time of the accident will not receive benefits. This includes being the aggressor in a physical altercation or engaging in irresponsible conduct (“horseplay”) on the job.
If you are unsure whether you can claim benefits, talk to a workers’ compensation lawyer in Lafayette.
Common Types of Workers’ Compensation Claims in Lafayette
The bulk of workers’ comp claims occur in such industries as refinery and manufacturing.
However, any worker who suffers an injury has the right to pursue benefits. Some of the most common claims involve:
- Slips, trips, and falls
- Head injuries, including traumatic brain injury (TBI)
- Collisions with large or heavy objects
- Bone fractures
- Repetitive motion injuries
- Burns
- Compression injuries
- Facial and eye injuries
- Hearing loss
- Sprains and strains
- Amputations
- Car accidents that occur in the scope of work
- Neck, back, and spinal cord injuries
- Assaults and other violent acts
- Occupational diseases
Independent Contractors and Workers’ Compensation
As a general rule, independent contractors and subcontractors are not considered employees.
This means they are usually not entitled to workers’ compensation. However, there are many cases in which actual employees are deliberately misclassified as independent contractors.
Employers do this to evade their employment law duties, including providing workers’ comp coverage.
If a worker is substantially under the control or direction of a company, it is far less likely that the person is an independent contractor. Just because the employer calls the worker an independent contractor does not necessarily make it so. You owe it to yourself to discuss your case with a Lafayette workers’ compensation attorney.
What if I Am Injured Offsite?
A worker is usually not covered if he or she was injured while traveling to or from the job site or place of regular employment. However, if the individual was participating in a work-related activity, such as a business trip, workers’ comp may be available. It’s important to note that at the time of the accident, the worker must not have deviated from the business purpose of the trip.
A crucial test is what the purpose of the event or situation was that gave rise to the accident. For instance, if the worker was at a social, recreational, or other non-business function or acting solely for his or her pleasure, workers’ comp will almost certainly not apply. Conversely, workers’ compensation will likely apply if the worker was doing something in service to his or her employer. Ask a workers’ compensation lawyer in Lafayette if you are unsure.
Benefits Available for Injured Workers
Benefits provided to injured workers under Louisiana’s Workers’ Compensation Act include:
Medical benefits
The employer has to pay for all approved reasonable and necessary medical expenses to take care of a work-related injury or illness. Among these are:
- Emergency room visits
- Hospitalization
- Medical appointments
- Surgeries
- Prescription drugs
- Physical therapy
- Lab tests, MRIs, and X-rays
Indemnity benefits
A work-related injury will sideline you and keep you from earning an income, which is why indemnity benefits are available. The purpose of these benefits, also called disability benefits, is to make up for the worker’s lost wages. If you are unable to return to work for more than seven calendar days because of your injury, you could qualify for several types of indemnity benefits:
Temporary Total Disability (TTD)
TTD coverage is available for a worker who temporarily cannot work. If the claim is approved, TTD benefits are equal to 66 and two-thirds of the employee’s average weekly wage. There are minimum and maximum compensation rates that apply.
Supplemental Earnings Benefits (SEBs)
If you can return to work but your injury keeps you from earning at least 90% of your pre-injury income, you may be eligible for SEBs. These benefits are calculated at two-thirds of the difference between your earnings before and after the injury. SEBs are available for up to 520 weeks.
Catastrophic injuries
Certain injuries are considered catastrophic and allow the worker to receive a one-time payment of $50,000. Among these are:
- Paraplegia
- Quadriplegia
- Total anatomical loss of both arms, hands, legs, feet, or eyes
- Total anatomical loss of a single hand, foot, or a combination of any two
Death benefits
If a worker dies within two years from the last treatment for an injury or illness, the surviving spouse and/or dependent children might be able to claim weekly indemnity benefits. In the absence of any surviving dependents, surviving parents can receive a one-time payment of $75,000. Burial costs of up to $8,500 may also be available.
Vocational rehabilitation
Workers who cannot return to their previous jobs may qualify for vocational rehabilitation. The purpose of this benefit is to help the worker find job opportunities that match their work skills, education, and training. The objective is to have minimal retraining to get the worker back to gainful employment as soon as possible.
Reporting a Work-Related Injury
You have to report a work-related injury within 30 days, but the best practice is to report it immediately. This helps ensure minimal questions and potentially avoid a denial of your claim.
After you report the injury, your employer has 10 days to report it to its workers’ compensation insurer. In turn, the insurer will check with the Office of Workers’ Compensation Administration (OWCA) to determine eligibility before investigating the incident.
Claims for medical and indemnity benefits should be filed within a year of the accident. For occupational diseases, you should file within one year of the date you knew or had a reasonable belief that the illness was work-related.
Can I File a Dispute if My Claim Was Denied?
Yes, you can dispute your employer’s decision and request a hearing before a workers’ compensation judge. This may be necessary if the insurer:
- Denied your claim
- Paid you less money than you are entitled to
- Failed to pay you on time
- Refused to cover some or all your medical treatments
- Rejected payment of eligible expenses
Important Lafayette Workers’ Comp Regulations
Hiring a Lafayette workers’ comp lawyer is a great first step to protecting your rights. The workers’ compensation rules, especially concerning timing (30 days to report and one year to file the claim) can be confusing. So too can the regulations around disability and death benefits.
The rules are often harsh, complex, and unforgiving, and if you miss any deadlines or neglect any substantive requirements, you could miss out on the benefits you need.
Call a Lafayette Workers’ Compensation Lawyer Today
If you have questions about the workers’ compensation process or you’re ready to get started on your claim, count on the family at Inzina Law Firm Injury Attorneys. We can handle all aspects of your claim, including appeals and hearings, and fight for the benefits to which the law entitles you. Contact us today to begin.
