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Workers’ Compensation

Is workers’ compensation mandatory under Louisiana law?

What is considered a compensable accident?

Does the Employee have to give written notice of an accident?

What benefits might become due and when?

What to expect with a claim?

Is mediation required?

What if a 3rd party is responsible for the work accident?

Settlement - Can the future medical benefits of a claim be settled in Louisiana?





Q: Is workers’ compensation mandatory under Louisiana law?

Yes.  An employer with one employee must still provide workers’ compensation insurance to protect that employee. However, a sole proprietor can waive her own coverage.


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Q: What is considered a compensable accident?

Louisiana law statutorily defines an accident as:

“an unexpected or unforeseen actual, identifiable, precipitous event happening suddenly or violently, with or without human fault, and directly producing at the time objective findings of an injury which is more than simply a gradual deterioration or progressive degeneration.” La R.S. 23:1021(1).

However, individual facts can make this very initial determination sometimes difficult and an experienced attorney can assist in analyzing the circumstances and case law to determine if an accident at work is compensable.


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Q: Does the Employee have to give written notice of an accident?

Written notice to the employer within 30 days of injury or death by any person claiming benefits should occur.  But, lack of notice is not a bar to benefits if employer had knowledge or is not prejudiced by the delay.

When the employer receives notice, it should submit the First Report of Injury/LA Form 1007 to OWC within 10 days.


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Q: What benefits might become due and when?

Benefits  are  due  on  the  14th  day  after  the  employer or insurer has  knowledge of  injury or death.  Computing the amount of benefits can be a tedious process - depending upon full-time, part-time, or unit basis pay and the pre-accident components of the employee's wages. 

Benefit payments can include Medical, Disability, and Death Benefits.  Medical benefits include all necessary medical, surgical, hospital services, medicines, and palliative treatment related to the accident and resulting injury.

On the other hand, disability benefits are due when the employee is treating and cannot work, or when the employee earns less than 90% of their pre-accident wages due to the injury.  The term of payments varies on the type of benefits due the employee.


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Q: What to expect with a claim?

Now, the claims process is largely a "1002 form" process.  An employer should:

1.  Complete a 1002 Form to provide notice of the type, frequency, and amount of benefits it computed to be due the employee. 

2. Send the 1002 Notice to the injured employee by certified mail at same address shown for benefit payments with the initial benefit payment;

3. Mail a copy of the notice to OWC within 10 days;

4. Send a copy of the Notice to claimant counsel, if retained.

**Same process required for any subsequent modification, including termination of benefits.

If a 1008 is filed, the Employer may be able to request a preliminary determination to streamline the claim administration.

Also, a 1008 may be premature, if the Employee has not submitted a Notice of disagreement.


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Q: Is mediation required?

The workers’ compensation courts prefer to settle disputes through mediation and it offers a mediation conference with every filed claim.  But, both parties must agree to participate.

With Louisiana workers' compensation courts, this is an informal proceeding where the mediator acts as an impartial party, gives each party an opportunity to state their side of the issues in dispute, and when possible, the mediator provides assistance in resolving the dispute. If a claim cannot be settled with OWC, or outside meditation, the claim may require litigation. 


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Q: What if a 3rd party is responsible for the work accident?

The employer can protect its statutory worker's compensation lien by filing suit against the third party within one year of the accident, or by filing an intervention in the suit that has been filed by the employee. 

The employee should not settle his claim against a third party without the approval of the employer/insurer, or he can risk forfeiture of benefits.


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Q: Settlement - Can the future medical benefits of a claim be settled in Louisiana?

The entire future obligation of the employer can be released through settlement.  However, a workers’ compensation judge must approve the settlement and the insured must also consent.  Settlements can also occur with unrepresented litigants after the claimant and attorney for the employer appear before the court and obtain judicial consent.


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