Louisiana Workers’ Compensation Benefits: How to Apply

The birthplace of jazz, Louisiana the only U.S. state that breaks its territory into parishes instead of counties. The Pelican State is also known for its flavorful Cajun food and Mardi Gras celebrations in the streets of New Orleans. Finally, as a Gulf state, LA is also famous for its offshore drilling, manufacturing, and agribusiness sectors. Sadly, these industries can also be quite dangerous for certain workers. So how hard is it to qualify for Louisiana workers’ compensation benefits? And how can you tell if you have insurance coverage through your employer?

Below, we’ll explain how to apply for workers’ comp in Louisiana, what types of benefits are available, which doctor to see, and more helpful info.

Getting Louisiana Workers’ Compensation Benefits: Key Takeaways

• Nearly every employer in this state must provide workers’ compensation insurance coverage to all their employees. But certain types of employees are also automatically exempt from filing a claim under current state law.
• As the injured employee, you have the right to see any doctor you choose to treat your workplace injuries. However, you must report it to your supervisor within 30 days to qualify for Louisiana workers’ comp benefits.
• Your employer’s workers’ comp policy also has the right to demand an Independent Medical Exam (IME) in certain cases. Refusing to attend or cooperate could make you lose your right to claim any Louisiana workers’ compensation benefits.
• Failing to report your work-related injury or illness to your employer in writing within 30 days could also put your claim at risk.
• Your first 7 days off after a work-related accident are usually unpaid unless you’re off the job for at least 2 weeks, minimum. After that, workers’ comp insurance covers your first unpaid week off. If the doctor clears you to return to work in less than a week, you’ll only qualify for medical benefits.

Which Louisiana Businesses Must Have Workers’ Compensation Insurance?

According to state law, all Louisiana businesses with at least one employee must carry workers’ compensation insurance. Employers must also pay the full workers’ compensation insurance cost, so employees pay nothing towards this coverage. And this coverage requirement applies equally to the following types of workers starting on day 1 of their employment:

• Full time employees
• Part time employees
• Seasonal employees
• Temporary workers

That said, there are also some workers who are automatically exempt from this type of coverage under Louisiana law.

Louisiana Workers’ Compensation Law Also Automatically Exempts Certain Types of Employees from Coverage

If one of the following describes your job or how you work, then you likely do not have coverage:

• Airplane crew workers employed in crop dusting or spraying operations
• Development, exploration, production, or mineral transportation services workers
• Domestic workers employed in a private home
• Federal employees
• Independent contractors
• Musicians and other performers hired to provide services under a temporary employment contract or on a per-performance basis
• Real estate brokers and sales agents licensed to do business in this state
• Sole proprietors and uncompensated corporate officers
• Private, unincorporated farm laborers
• Unpaid members serving on a board of directors
• Uncompensated officers for non-profit organizations
• Volunteers

How to File Your Louisiana Workers’ Compensation Insurance Claim for Benefits

1. Go to the closest hospital or clinic and seek medical treatment immediately after your accident.

You have the right to choose which doctor you see, at least for the first visit. But you will need authorization from your employer’s insurance company for any bill above $750 after that.

If you do not seek medical care after your job accident, then you cannot qualify for any Louisiana workers’ compensation benefits.

Important: Your job injury must happen while you’re at work and performing your required job duties. Workers’ comp insurance will not pay your medical bills for getting hurt outside of your workplace or on the way there.

2. Report your workplace injury to your supervisor or manager, preferably in writing, within 30 days of your accident.

Failing to give notice within that timeframe may make you ineligible for any LA workers’ comp benefits.

3. Your employer’s insurer must then notify the Louisiana Office of Workers’ Compensation Administration about your injury within 10 days.

The insurance company can use Form LWC-WC-1A-1 to complete this step. This also officially starts your Louisiana workers’ comp claim process.

4. The insurance company has 5 business days to review your claim before issuing an approval or denial for benefits.

If approved, your benefits should begin on the 15th business day after reporting your accident. Be sure to file any paperwork to get your claim going before the one-year anniversary of your injury date! Otherwise, the statute of limitations will run out and you are disqualified from receiving any benefits.

5. You must miss 7 calendar days of work before you qualify for any temporary benefits to cover your lost wages.

Under Louisiana workers’ compensation law, your first week out of work after a job accident is always unpaid time off. However, if the doctor says you cannot work for at least 15 days, then workers’ compensation insurance covers that first week off. The state calls these payments “indemnity benefits,” and we will explain how those work in the section below.

If you can go back to work in less than a week, then workers’ compensation only covers your medical bills.

6. If the insurer denies your claim, you have 15 days (and two different ways) to appeal that decision.

The two ways to appeal disputed claims in LA are:

1. Mediation. Contact your employer’s insurance provider to start, and see if that helps resolve anything. If that fails, you can then request mediation services from the Office of Workers’ Compensation Administration. Learn more about OWCA mediation services.
2. Appeal. If you plan to work with an attorney or mediation doesn’t work, this is your final option to appeal your denial. To do this, file Form LWC-WC 1008 within 15 calendar days.

Types of Louisiana Workers’ Compensation Benefits Available to Injured Workers

Medical Benefits

Medical benefits can start right away and cover all medical expenses related to your claim, including:

• Doctor’s visits
• Physical therapy
• Labs, X-rays, MRIs, CT scans, and other tests you may need to diagnose or treat your work-related injury or illness
• Travel expenses (such as mileage reimbursement) required to receive needed medical treatment

You can receive medical benefits until you reach Maximum Medical Improvement (MMI) or go back to your old job at full pay.

Temporary Total Disability Benefits

If you cannot work for a period of time after your job accident, you may qualify for temporary total disability (TTD) payments. These equal 66 2/3% of your gross average weekly wage, subject to LA’s maximum and minimum benefit amounts.

TTD benefits can last until you return back to your old job at your usual pay rate or reach MMI, whichever comes first.

Permanent Total Disability Benefits

PTD benefits are available if you cannot work at all in any similar job once you reach MMI. Permanent total disability benefits equal the same pay rate as weekly TTD payments.

Permanent Partial Disability Benefits

If you can go back to work but only part-time or at a lower pay rate, you may qualify for permanent partial disability. These payments equal 2/3 of the difference between your pre-injury and post-injury job wages. You can receive PPD payments until you reach MMI, but for no more than 520 weeks total.

Supplemental Earnings Benefits

If you can keep working once you reach MMI, but cannot earn at least 90% of your pre-injury work wage, you may qualify for supplemental earnings benefits. These are functionally the same thing as temporary partial disability benefits. You can receive SEB payments monthly for up to 520 weeks total, but no longer. The state calculates SEBs at the same rate as PPD benefits.

For a catastrophic injury, you may also qualify for an additional $50,000 workers’ compensation settlement payment. This one-time payment from Louisiana workers’ compensation benefits only applies for the following injuries:

• Total loss of both your hands, arms, feet, legs, eyes, or any two of those limbs or organs at once. This means they are each fully missing from your body, not just losing the use of these body parts.
• Paraplegia (i.e., you cannot move any part of your body from the waist down for life)
• Quadriplegia (i.e., you cannot move any part of your body from the neck down for life)

Death Benefits if an Employee Dies on the Job

Louisiana workers’ compensation benefits are also available for eligible family members of deceased employees killed at work:

• Up to $8,500 for burial and funeral expenses
• Weekly payments equal to 65% of the deceased worker’s AWW

Eligible survivors include a current or former spouse and any dependent children until the youngest turn 18 years old. When the surviving spouse remarries, he or she may become eligible for a single settlement payment equal to two years of weekly benefits.

Family members have two years from the date of the injured worker’s last medical treatment date to file a claim for death benefits.

How to Get Your Free Consultation from a Louisiana Workers’ Comp Attorney

Not sure if you qualify for Louisiana workers’ compensation benefits? Or already had a claim denied? We can connect you with a workman’s comp attorney for a free, no-obligation case evaluation today.

All workers’ comp lawyers from Baton Rouge to New Orleans work on contingency. That means if your case isn’t successful, then you owe $0 in legal fees to the attorney representing your case.

And if you do win benefits, then you only owe one small fee afterwards. Louisiana law says your attorney cannot charge more than 20% of your total award in legal fees.

Ready to get started? Click the button below to request a free consultation now: