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SUPPLEMENTAL EARNING BENEFITS
If you are no longer temporarily totally disabled, but
your injury or illness prevents you from earning at least
90% of the income you were earning before your
accident, you should receive Supplemental Earnings Benefits
(often called "SEB").
Your Supplemental Earnings Benefits should equal
two-thirds of the difference between your
average weekly wage before you accident and the amount that you are
currently earning (or are capable of earning).
For example, if you were earning $500 per week prior to
your injury and you have returned to work, but are only
earning $300 per week in your new position, you should
receive Supplemental Earnings Benefits of $133.33 per week.
Because Supplemental Earning Benefits are paid monthly, you
would actually receive a monthly payment of $577.76 ($133.33
per week, times 52 weeks per year, divided by 12 months),
rather than receiving a payment each week.
You are usually required
you to file a
Louisiana Department of Labor Form
1020
at the end of each month in order to receive your
Supplemental Earnings Benefits. The completed form should be
mailed directly to your employers' designated representative
or their Workers' Compensation insurance
company. Generally, if you do not file the form, the
insurer will not pay the benefits.
Important points about Supplemental Earnings Benefits:
- If you are currently receiving Louisiana Workers
Compensation Supplemental Earnings Benefits, that means
that the Workers Compensation insurance company believes
you are currently able to return to some type of work. In most situations, it probably
also means either:
- The Workers Compensation insurance company agrees that you are medically
currently
unable to return to the job you were performing at the
time of your accident, or
- In the Workers Compensation adjusters opinion,
you may be able
to perform your old job, but your medical condition
prevents you from returning to unrestricted work and your employer no longer has
your old job available for you. Though they may believe
there is other work you are able to perform, they have
not yet been able to develop evidence through "Vocational
Rehabilitation" to establish that you are able
to earn at least 90% of the income you were earning at the time of your injury.
Therefore, they are paying you Supplemental Earnings
Benefits until they feel confident that they can
convince the Louisiana Office of Workers
Compensation that you are able to earn at least 90%
of the average weekly wage you were earning before
you were injured.
- The rules that control your
time period for filing a claim for Supplemental
Earnings Benefits
are somewhat convoluted and your
rights expire at different times depending upon the
types of benefits you have already received during
your claim.
- The total time period during which you can receive
Louisiana Workers Compensation Supplemental Earnings
Benefits is 520 weeks. The employer-insurer receives a
week-for-week credit off of those 520 weeks for any week
in which you have already received any other type of
Louisiana Workers Compensation income benefits. For example, if you received
Temporary Total Disability benefits for two years
(104 weeks) while undergoing medical treatment until you
reached "maximum medical improvement," you have a
maximum of eight years (416 weeks) remaining during
which you may receive Supplemental Earnings Benefits SEB.
- One area that is often disputed when calculating
your Louisiana Workers Compensation Supplemental
Earnings Benefits is how much you are actually capable
of earning. If a doctor has released you to return to
work, the Workers Compensation insurance company may
treat you as if you are earning income even though you
are not actually working. They will then reduce your
benefits based upon the amount they claim you are able
to earn. To determine how much they believe you can
earn, they will have their Vocational Expert obtain a
Labor Market Survey. The Vocational Expert will
submit the Labor Market Survey to your treating doctor,
their examining doctor, or to both, and ask the doctors
to check off any jobs they think you are capable to
trying. As the Louisiana Supreme Court has
succinctly stated:
"All
of this can be proven without the cooperation or
participation of the employee."
- Therefore, it is important that you stay involved in
the process. You should have a direct discussion with
your doctor about your doctor's point of view of your
capabilities and limitations. You should also discuss
your employment and benefit options with your attorney,
including whether the
Vocational Rehabilitation
process is being fairly and legally conducted. You
should also discuss the type of work you believe you are
able to perform, the nature of any medical treatment you
may need in the
future, the possibility of resolving
your claim through a lump-sum settlement, your correct
Supplemental Earnings Benefit rate, and any other issues
that affect the outcome of your claim.
Next: Permanent Partial Disability Benefits
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David Buie, Louisiana Workers
Compensation Attorney and Social Security Disability
Attorney, 650 Poydras Street, Suite 1400, New Orleans, LA
70131, (800) 851-9405 / Fax: (866) 702-5297 Representing
claimants in:
Alexandria
Baton Rouge
Bossier City
Covington
Gretna
Hammond
Harahan
Harvey
Houma
Kenner
Lafayette
Lake Charles
Laplace
Marrero
Metairie
Monroe
New Iberia
New Orleans
Opelousas
Ruston
Shreveport
Slidell
Terrytown
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