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Covington Workers’ Compensation Medical Benefit Attorney

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Workers' Compensation Medical Benefits

Access to timely, high-quality medical care is the first concern for anyone who suffers an on-the-job injury.

The Louisiana workers’ compensation system provides benefits to most injured workers, regardless of fault. These benefits include medical care, rehabilitation and vocational services, lost wages and disability benefits. In exchange, employees are generally prohibited from suing an employer for personal injury or wrongful death. While the program’s aim is to provide timely, cost-effective benefits to injured workers and their families, while protecting employers from the cost of lawsuits, it’s an imperfect system that pits unrepresented injured workers and their families against experienced teams of professionals working at large insurance companies. Those injured on the job are always best served by early consultation with an experienced Louisiana workers’ compensation law firm, which can handle your claim with no up-front costs while allowing you and your family to focus on recovery.

Work injury medical benefits
 

Work Injury Medical Benefits

Workers’ compensation medical benefits in Louisiana include:
  • Emergency medical care
  • Doctor visits
  • Specialty services
  • Diagnostic services, including x-rays, MRIs, etc.
  • Medical supplies
  • Prescription drug coverage
  • Hospital stays
  • Surgeries
  • Bloodwork and lab tests
  • Physical therapy
  • Home Care
  • Rehabilitative services
  • Vocational services
  • Travel expenses
  • Prosthetic devices
  • Mental health services
Injured employees have an absolute right under Louisiana workers’ compensation law to choose their own treatment provider, as well as one specialist from each required medical specialty. However, many common issues arise, ranging from workers’ compensation insurers challenging injury as a pre-existing condition, to the right of insurers to challenge any non-emergency medical care over $750. Additionally, while employees are entitled to copies of all paperwork, so are employers, their workers’ compensation insurance companies, and any health care provider, rehabilitation service or vocational service involved in an employee’s care. Understanding what information is being gathered about your injury, and how it will likely be used to determine benefits, including maximum medical improvement and impairment ratings, is critical to getting all of the benefits to which you are entitled and is always best left to an experienced New Orleans work injury law firm. Since the employee’s chosen treating physician will likely determine an employee’s ability to work, as well as his or her disability, such choices are critical. The insurance company may also force an employee to attend a Second Medical Opinion (SMO) exam. If disagreements arise, either side may then request an Independent Medical Exam with a physician from the Louisiana Office of Workers Compensation Medical Services Division or a physician chosen by the court. Without guidance from an experienced workers’ compensation lawyer in News Orleans, Covington or Raceland, the end result is often injured workers submitting to multiple medical exams with very little understanding of the long-term impact on his or her care and/or ability to continue to receive benefits. In fact, your choice of a law firm and your choice of a treating physician are among the two most important decisions you will make throughout your workers’ compensation claim. Claimants who do not carefully choose both at the outset of their case can face significant disadvantages. Insurance companies know this and often use it to their advantage by being cooperative and responsive when it comes to medical care at the start of a claim. Your chosen doctor will:
  • Decide what medical treatments and rehabilitative services you receive.
  • What home-care you require.
  • What ongoing medical issues you will have.
  • Whether you will be left with impairment or disability.
  • Whether your injury or medical condition was work related.
Your chosen workers’ compensation law firm can:
  • Help you choose a physician experienced in handling workers’ compensation claims.
  • Choose a doctor with a history of fighting for the rights of injured patients.
  • Help you determine which doctors have the experience and reputation to provide you with the best care.
  • Help protect you from common tactics used by workers’ compensation insurers to reduce or eliminate benefits or other necessary costs of your care or claim.
Injured employees also have a right to be reimbursed for out-of-pocket medical expenses and insurers are required to pay medical bills within 30-60 days, depending on whether a medical provider bills electronically or by paper. Don’t wait until care issues or significant disagreements arise before reaching out for help from an experienced Louisiana work injury law firm. At Wanko Law, we believe injured workers and their families deserve the same access to knowledgeable and experienced advocacy that will be deployed by their workers’ compensation insurance company and their attorneys. If you have been injured, call day or night for a free and confidential consultation to discuss your rights. Call 985-202-9907.

Frequently Asked Questions

The Wanko Workers' Comp Lawyers page on Workers' Compensation Medical Benefits in Louisiana provides an extensive outline of what is covered under these benefits. It covers emergency care, doctor visits, specialty services, surgeries, hospital stays, and more, ensuring comprehensive medical care for injured workers. It also emphasizes the worker's right to choose their medical provider, which is crucial for ensuring personalized and effective medical care. This guide is valuable for anyone with a neck injury at work, as it helps them understand their rights and the benefits available to manage their treatment and recovery.
To ensure your medical treatments are covered by workers' compensation in Louisiana, you should first report your injury to your employer as soon as possible to initiate the claim process. Follow all required procedures and ensure that your medical provider is informed that the treatment is for a work-related injury. Keep detailed records of all treatments received and any communication with your employer or their insurance company regarding your injury. It's also beneficial to consult a workers' compensation attorney to help navigate any potential challenges in the claim process.
If your workers' compensation medical benefits are denied in Louisiana, you should file an appeal with the Office of Workers' Compensation Administration. It's important to gather all relevant medical records and any documentation that supports your claim. Consulting with a workers' compensation attorney can also be beneficial, as they can provide legal advice, help prepare your appeal, and represent you in hearings. Additionally, ensure that all communications and submissions are timely to meet any deadlines set by the workers' compensation laws.
Yes — Louisiana law gives injured workers the right to choose their treatment provider for their work injury. In addition, the injured worker can often select one specialist in each required medical specialty. However, insurers may require independent medical examinations (IMEs) or second medical opinions at their expense if there are disputes. Choosing a physician aligned with your injury type and who is familiar with workers’ compensation cases can improve outcomes and ensure appropriate documentation. The treating physician’s reports are pivotal in securing benefits, and delays or gaps in choosing a provider can complicate reimbursements. Legal advice helps ensure you exercise this right properly and avoid insurer pushback.
Treatments must generally be “medically necessary” and related to the workplace injury. Experimental or unproven treatments are often scrutinized or denied if the medical evidence for effectiveness is weak. Alternative medicine (e.g. acupuncture, holistic therapies) may be covered if a treating physician prescribes them and if they are accepted in the medical community and tied to your injury’s recovery. Even so, insurers sometimes deny or limit coverage for such treatments citing cost, lack of precedent, or efficacy. You have the right to question denials, submit additional medical evidence, or request independent medical experts to support the necessity. If the insurer refuses necessary treatment without good reason, you may have grounds for appeal through OWCA or via legal representation.
If the insurer claims your injury is due to a pre-existing condition, they may try to deny or reduce your medical and compensation benefits. The law allows for exacerbations of pre-existing conditions if the work activity aggravated or accelerated the condition. Your medical records, doctor's reports, and testimony will be crucial in showing that your work injury substantially contributed. Experts may need to differentiate between the pre-injury baseline and post-injury worsening. It’s important to continue treatment, keep records, and seek opinions that explicitly address causation. Legal help can assist in gathering evidence to counter arguments that the injury is not compensable due to pre-existing health.
To get legal assistance for your work injury medical benefits in Louisiana, consider hiring a workers' compensation attorney who specializes in such cases. An attorney can help ensure your medical claims are properly filed, represent you in disputes, and navigate the appeals process if your benefits are denied. You can start by contacting local law firms that specialize in workers' compensation, such as Wanko Workers' Comp Lawyers, and scheduling a consultation. Please contact us to schedule a consultation and discuss your case in detail.

Additional Information in Louisiana

Louisiana Workforce Commission - Rights and Responsibilities for Employees and Employers: Outlines essential guidelines and procedural information for both employers and employees under the Louisiana Workers' Compensation Act. It details who is covered, the types of injuries that qualify, how and when to report injuries, and the specific benefits available, such as medical and indemnity benefits. The document also explains how disputes are handled, including the role of the Office of Workers' Compensation Administration in resolving these disputes. This document is crucial for anyone dealing with a work injury medical benefit claim in Louisiana as it provides a comprehensive overview of the process, including how to file a claim, the types of benefits available, and the steps to take if there is a disagreement or a denial of benefits. Understanding this information can help ensure that your rights are protected and that you receive the appropriate medical benefits for your injury.
National Library of Medicine - Workers' Compensation: It covers the basic benefits like income replacement, dependent support, and medical benefits under state systems and highlights the differences in how states administer these benefits. It also discusses the importance of accurately identifying work-related injuries and illnesses, the role of healthcare providers in assessing work-relatedness, and the legal aspects of workers' compensation claims. This resource can be extremely helpful in a work injury medical benefit claim by providing detailed insights into the legal framework and medical considerations, aiding in understanding entitlements and the process for claiming benefits.
Louisiana Workers' Compensation Corporation (LWCC): Comprehensive resource for employers, workers, and medical providers involved in workers' compensation cases in Louisiana. It provides detailed information on claims management, policyholder resources, safety services, and legal assistance. The site also includes sections dedicated to injured workers, offering guidance on the claims process and access to medical care networks. For workers dealing with a work injury medical benefit claim, this site offers direct tools for reporting claims, finding medical providers, and accessing safety and health resources to support recovery and return to work.

Contact Louisiana Workers' Comp

Whether you have suffered an immediate injury or have endured a long-term disability or chronic illness, you deserve to have the support you need to recover. Our work injury attorneys will provide you with nothing less than compassionate understanding and exceptional legal counsel.
We’re eager to start advocating on your behalf.
CALL US (985) 893-6530
Wanko Workers' Comp Lawyers provides its service in New Orleans, Covington, Houma, Thibodaux, Mandeville and all across Louisiana
Covington Location
19295 N 3rd St #1 
Covington, Louisiana 70433
New Orleans Location
1140 St. Charles Street
New Orleans, Louisiana 70130
Thibodaux Location
407 West Third St
Thibodaux, Louisiana 70301

Disclaimer: The hiring of an attorney is an important decision that should not be based solely on advertisements. Before you decide, ask us to send you free written information about our qualifications and experience. The information on this website is for general information purposes only. This information on this website is not intended to create, and receipt or viewing of this information does not constitute an attorney client relationship. We are workers compensation attorneys serving the entire New Orleans area including Larose, Golden, Meadow, Thibodaux, Houma, Covington, Mandeville, Abita Springs, Metairie, Belle Chasse, Elmwood, Boutte, Harahan, Destrehan, River Ridge, Raceland, Slidell, Kenner and all of Louisiana. We serve St. Tammany Parish, Livingston Parish, Orleans Parish, and Jefferson Parish.
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