DO YOU NEED A LAWYER FOR YOUR
LOUISIANA WORKERS COMPENSATION CLAIM?
This section answers three common questions about hiring a Louisiana Workers Compensation lawyer to help you with your claim.
WHY DO YOU
NEED A LAWYER?
Though about 20,000 people are injured while working in
Louisiana each year, injured employees are often shocked
when they learn the truth about the Louisiana Workers
Compensation system:
- Your time limit for filing a claim with the
Louisiana Workers
Compensation Court expires in different years depending upon
the type of wage benefits you should be receiving. In fact,
your time limit for filing a claim for benefits can expire
even while you're still under medical care. It's important
to know the type of Louisiana Workers Compensation indemnity benefits
you're receiving and how that impacts time limitations in
your case.
- “Vocational Rehabilitation” rarely amounts to more than the
insurance company's Vocational Expert mailing you a letter
listing a few low-paying, dead-end jobs. It is an
exceptional and unusual case in which an injured employee is
actually retrained for a new job.
- Insurance companies can sometimes legally terminate people's
benefits even though the claimant's treating doctor reports
that they are unable to return to work. On the other hand,
the Louisiana Workers Compensation Court can award you
thousands of dollars in penalties if the insurance company
terminates your benefits without the appropriate medical
documentation. If you want to protect yourself, you need
understand why.
- Over the years, numerous Louisiana Workers Compensation Judges,
including a former Chief Judge and a former Deputy Chief
Judge, have quit, alleging that the system is biased against
injured workers. Enacting amendments to the Louisiana
Workers Compensation laws is a highly politicized process
with important changes introduced each year.
- The Louisiana Workers Compensation insurance market is
dominated by a single big company, the Louisiana Workers
Compensation Corporation (LWCC). According to the Greater
Baton Rouge Business Report (6/7/05): "Today, LWCC holds
fast to a market share larger than its next 10 competitors."
LWCC is well know for their widely advertised policies that
strictly limit settlements.
- Some injured employees may be legally fired. You
need to know whether your employer will hold your job
open for you and let you come back to work when you
recover from your injury. Even if you never want to go
back to work at the place where you were injured, this
is an important factor that impacts the settlement or
outcome of your claim. Congress recently strengthened
and expanded the protections provided by the Americans
with Disabilities Act. In some situations, injured
employees have more rights and options under the
Americans With Disabilities Act than they do under the
Louisiana Workers Compensation laws.
- Louisiana Workers Compensation law often excludes coverage for developmental or
repetitive motion injuries which, according to OSHA, are
among the most common work-related conditions. The main
factors that control whether your medical condition is
covered are: (1) how long you worked for your employer
before the disability arose, (2) your ability to pinpoint
the beginning of your symptoms, and (3) whether your medical
condition is one of the conditions that is specifically
included or excluded by Louisiana Workers Compensation law.
- Many people have a hard time finding an attorney who has the
knowledge and experience needed to successfully represent
them in a Louisiana Workers Compensation claim. As the
Judges of the Louisiana Third Circuit Court of Appeal
concluded, you're effectively not protected by the Workers
Compensation laws if you're not represented by a capable
attorney: “We do not exist in a vacuum, immune to the
realities of the real world and the inability of a worker's
compensation claimant to find effective or adequate counsel"
“The injured worker would effectively be denied the
protection offered by the workers' compensation statutes if
he or she was unable to find an attorney to represent his or
her interests." Charles v. Acadia.
- In a typical claim, you and your attorney will need to talk
with many people who work for your employer's Workers
Compensation insurance company, including their Adjuster,
their Medical Case Manager, their Vocational Rehabilitation
Expert, and eventually, the insurance company's Attorney.
Those are the people with whom you or your attorney will
have direct contact. There are other important individuals
operating behind the scenes, people that you will probably
never talk to, such as the Private Investigator that the
insurance has hired to conduct video surveillance of you and
your family, the doctor or nurse who reviews your medical
records to decide whether the insurance company will pay for
your medical treatment, or the Claims Manager, who is the person
who often makes many of the important
decisions about resolving your case through settlement.
Unfortunately, some folks people adopt a "wait and see"
attitude about their Workers' Compensation claim. They want
to "wait and see" how their claim develops before they
decide whether they need to call an attorney. Sadly, some
even mistakenly believe that the insurance company will
treat them better if they don't hire a lawyer.
But while the injured employee is waiting to decide if
they need to contact an attorney, the insurance company may
be quietly and legally stripping away the injured employee's
rights. The Louisiana Workers Compensation insurance company has one clear goal. They want
to minimize the amount of money they pay out on your case.
To do that, they target the primary benefits you receive:
- by limiting or denying your medical tests and surgery.
- by delay, delay, delay, making the process of getting your
medical treatment as difficult as possible.
- by limiting your right to select the doctors who will
treat you.
- by failing to include all of your income when calculating
your benefits rate.
- by sending you back to work
based on their doctor's opinion before your doctor releases
you to return to work.
- by providing you with "vocational rehabilitation" in which
their expert copies a few jobs off of the or out of the newspaper to try to show that
there are jobs available they claim you are able to perform.
- by making things difficult to motivate you to settle
whenever they're ready to start negotiating with you.
- by offering you a small lump-sum payment to resolve your
claim, refusing to tell your how they calculated their offer
and making you believe it's a take-it-or-leave-it deal.
The process shouldn't be so confusing and difficult,
but having
help from an experienced attorney can be invaluable if you
want to make sure you're treated fairly.
GOALS FOR YOUR CLAIM
I have four primary goals that I work hard to achieve for
every person that I represent in a Workers' Compensation
claim:
First, we need to do everything possible to obtain the correct
diagnosis and medical treatment for your injury. Our goal
should be to aggressively pursue your medical treatment
until you reach "maximum medical improvement." In other
words, we need to insist upon high quality medical care and
we need to help you get that care while you are still
covered by Workers' Compensation insurance.
Workers' Compensation Insurance companies often refuse to
pay for test, medical treatment and medication. In fact,
they often just ignore the requests and never reply, despite
your doctors' repeated calls and letters. Their refusal to
authorize medical treatment is the most frequent reason
people call us for help with their claim. It doesn't have to
be that way. Louisiana law contains a procedure that
requires Workers' Compensation insurance companies to
promptly respond to your doctor's request for testing and
treatment, often within less than a week.
Secondly, we want you to receive Workers' Compensation
income benefits, on time and in the correct amount, during
the entire time that you're unable to return to fulltime
work. Your Workers' Compensation benefits may be underpaid
without you ever realizing you've been shortchanged. Some
companies will aggressively reduce or terminate your
benefits with no explanation and only a tenuous legal basis.
Workers' Compensation cases are frequently hotly disputed.
Your employer may deny that your accident happened or they
may claim that your medical condition is not covered by the
Workers'' Compensation laws. In a highly contested case
where you're not receiving benefits, we need to prepare your
claim and bring it to trial as quickly as possible.
But in most cases, our goal is to obtain 100% of the
benefits that you should receive at the time that you should
receive them. And we want to keep those benefits coming in
on a regular schedule until you settle your claim or return
to work (or both).
Our next goal should be to help you qualify
for Social Security Disability as soon as possible if you
have a significant injury that will keep you out of work
for at least twelve months. While
it's true that qualifying for Social Security Disability can
make it more complex to negotiate the settlement of your
Louisiana Workers' Compensation claim, applying for Social
Security Disability while you are still receiving Workers'
Compensation can allow you to recover tens-of-thousands of
dollars in benefits that you wouldn't otherwise receive.
I frequently see people who have lost years of Social
Security Disability benefits simply because they failed to
file the right forms at the right time. In fact, your right
to apply for Social Security Disability completely expires
if you don't apply within the right time frame. While you're
out of work and receiving Workers' Compensation benefits,
your time for applying for Social Security Disability is
gradually slipping away.
It's a travesty to pay thousands of dollars of payroll taxes
into the Social Security system and then be denied
Disability benefits because you waited too long to apply.
While not everyone who receives Workers' Compensation
benefits will qualify for Social Security Disability, it's
usually a mistake to wait until your Workers' Compensation
claim is over before you file your Social Security
Disability application.
Finally, we want to obtain the largest settlement or
Judgment that the law allows. And there are many things that
we can do to make certain that you are fully compensated in
the settlement or Judgment of your claim.
We need to verify that your doctors understand the impact of
signing the insurance company's forms authorizing you to
return to work. Many people have told me that their doctor
signed the forms releasing them to work while telling them:
"You need to be retrained for a light duty job." That's a
great idea! But it hardly ever happens in a Louisiana
Workers' Compensation claim.
We need to be prepared to challenge the Labor Market Survey
prepared by the insurance company's Vocational Expert. We
often find that taking the depositions of the potential
employers shows that the particular claimant was not at all
suitable for the particular job, or that the employer was
merely “accepting applications to keep on file for when they
do need to hire somebody.” It's been my experience that
Labor Market Surveys often cannot withstand much scrutiny.
Most importantly, we need to formulate a plan that pays for
your future medical treatment, provides you with a fair and
just lump-sum settlement and allows you to receive the
maximum benefits you qualify for from other sources (such as
Social Security Disability) after you've settled your
Workers' Compensation claim.
FEES & COSTS
Attorney's fees in Workers' Compensation cases are set
by law at no more than 20% of any funds or benefits we help
you recover. I
always offer a free telephone or email consultation if you
want to ask questions so you can decide whether I would be
the right person to work with you on your claim.
My practice is limited to representing individuals in
Workers' Compensation and Social Security Disability claims.
If you or someone you know needs a free consultation about a
Louisiana Workers' Compensation or Social Security
Disability case, please call me at (800) 851-9405 or send me
a note using the form at the top of this page.
Next: Contact David Buie
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