Louisiana workers are covered, with very few exceptions, by the state’s workers’ compensation laws if they are injured while at work or become sick because of the nature of their job. It is also compulsory in most industries for employers to take out workers’ comp. insurance so that the insurer carries the burden if a worker has to take time off from work to recover from an injury or sickness that took place in the workplace. Unfortunately for the worker in some cases workers' compensation claims are rejected by the insurer. However, this doesn’t mean that getting compensation is impossible, as Louisiana’s workers’ compensation agency offers you the chance to appeal the decision. In order for the appeal to be a success a workers’ comp. attorney will be needed to help you through the process. Workers' Compensation Law in Louisiana The state agency dealing with workers’ compensation matters, including appeals in Louisiana is the Office of Workers’ Compensation. If you are injured or fall sick while at work Louisiana workers' compensation laws may well favor you. You must tell your employer of your injury no more than 30 days after it occurred but you have between 1 and 3 years to file a workers’ comp claim. It is preferable that your claim is filed within one year of you being injured. You are entitled to receive 66 2/3% of your average income before the injury took place. Louisiana offers cover for the cost of your medical care and wages compensation for the period you are unable to work. If your injury lasts no more than 2 weeks, your compensation will start in the 2nd week. Both physical and mental injuries are covered. However, mental injuries must be due to the impact of a physical injury or if a sudden stressful event occurred in the workplace resulting in severe mental injuries. Why Your Claim Could be Denied No one wants to let go of money unless they have to and this is the same with workers’ compensation claims. Your claim could be denied by the insurer who handles your employers workers’ comp insurance. It may claim that by the time your workers’ comp claim was filed it was passed the deadline date so you are no longer eligible to file an application for workers’ compensation. Also it’s common for insurer to try and prove your accident, injury or illness did not take place at work, though they cannot deny your claim because you had caused the accident. You will need firm evidence in order to counter this claim. Sometimes a claim is rejected because of clerical errors, such as a box not being filled or crossed on a form. Some of these excuses are quite easy to counter but there are some others that aren’t quite so simple such as: your injury was intentionally self inflicted; there is evidence available to suggest you weren’t using or wearing the supplied safety equipment at the time of the accident; being intoxicated caused you to have an accident and get injured. The Louisiana Workers' Comp Appeals Process If you have been denied access to workers’ comp or you are disputing the amount the insurer is currently paying in worker’s comp benefits you can ask for a formal hearing to take place with the Office of Workers’ Compensation before a workers’ compensation judge. You have to file a Disputed Claim for Compensation (Form 1008) which will need to be sent to both your employer (or insurer), as well as to the Office of Worker’s Compensation. You must file the claim within 12 months of the accident, or if you have been receiving disability benefits, within 12 months of the date of the last payment. As soon as the insurer receives the claim it will be given 14 days to reply using the legal document named an "Answer." The Office of Workers’ Compensation has its duty to assign the case to your closest district office and schedule a date for the hearing. The whole process can take up to 9 months. You can of course opt for voluntary mediation before or after completing Form 1008. You both have to agree on using mediation. If this doesn’t help a hearing is the next option. The hearing makes the final decision about your workers' comp case. Why a Workers' Comp attorney may be of Help If you have been denied a claim for workers’ compensation there are many things that need to be done if you wish to appeal. It’s often too difficult to win a claim against a powerful insurer who has all the answers so the best thing to do is to contact an experienced workers’ comp attorney who will discuss with you the best route to take.
