Filing Your Louisiana Workers’ Compensation Claim
Filing your Louisiana workers’ compensation claim involves several steps aimed at establishing and verifying your claim, and if necessary, resolving any disagreements between the employer/insurer and the injured worker. Here’s a general outline of the process:
- Inform the Employer: Notify your employer about the injury as soon as possible. This should be done within 30 days of the injury to ensure eligibility for benefits, although immediate notification is ideal.
- Seek Medical Treatment: Receive necessary medical treatment for your injury as soon as possible from a licensed healthcare provider. In Louisiana, the employee has the right to choose the treating physician in any area or specialty of medicine. That right does not generally include physical therapists, diagnostic facilities, etc. because they are not “physicians.”
- File a Claim: If your injury requires more than basic first aid, your employer should provide you with a Workers’ Compensation First Report of Injury form (LWC-WC-1008). You must fill this out and return it to your employer. This form starts the process of your claim.
- Claim Evaluation: The employer or its insurer will evaluate your claim. They may accept or deny the claim based on their assessment of the facts and circumstances.
- Dispute Resolution: If your claim is denied or if there is a dispute regarding your entitlement to benefits, you have the right to dispute the decision. The steps involved in disputing a workers’ compensation claim in Louisiana typically include:
- Formal Dispute: File a Disputed Claim for Compensation form (LWC-WC-1008) with the Louisiana Workforce Commission’s Office of Workers’ Compensation Administration (OWCA).
- Mediation: The OWCA may schedule mediation between you (the employee) and the employer/insurer to try to resolve the dispute informally. You are not obligated to participate however.
- Formal Hearing: If mediation does not resolve the dispute, a formal hearing may be scheduled before a workers’ compensation judge. Both parties present evidence and witnesses, and the judge will issue a decision.
- Appeal: If either party disagrees with the judge’s decision, they can appeal to the Louisiana Court of Appeal within certain time limits.
Pursuing a Louisiana Workers Compensation claim is typically a lengthy and stressful process. Throughout the process, it’s advisable to keep detailed records of all communications, medical treatment, and documents related to your injury and the claim. Consulting with an experienced workers’ compensation attorney can provide valuable guidance and representation, especially if your claim becomes complex or contentious, and particularly when the insurance adjuster proposes the possibility of settling your claim.