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Dealing with Insurance Companies

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Dealing with Insurance Companies

Work injuries are complex claims. Even when an initial injury seems minor, consulting with an experienced New Orleans workers’ compensation lawyer is the best thing you can do to protect your rights and the financial well-being of you and your family.

Workers’ compensation insurance provides benefits to most employees who are injured on the job, regardless of fault. In exchange, employees are generally prohibited from suing an employer for additional damages as a result of a work accident. The system is designed to provide timely benefits to injured employees for medical care and lost wages, while shielding employers from the expense of personal injury and wrongful death litigation.

However, it’s critical for injured employees and their families to understand that they are dealing with an insurance company and their defense lawyers. Whenever a claim is filed, it is assigned to a team. More complex and costly claims are assigned to more experienced staff. As a routine matter of business, their job is to limit the cost of your claim. Thus, from the outset, you are battling an experienced team of legal and medical professionals.

Louisiana Workers’ Compensation Claims

Workers’ compensation benefits can include medical care, a portion of lost wages, rehabilitation, vocational training, temporary or permanent partial or total disability benefits, and death benefits.

Most employees in Louisiana are covered from the day they start employment. Employees may be full-time, part-time, seasonal, or minors. However, some employers attempt to evade the law by categorizing employees as independent contractors or otherwise exempting them from workers’ compensation benefits. It’s important to note that in such cases an employer may be pursued through a personal injury or wrongful death lawsuit.

Within 10 days of actual knowledge of an on the job injury resulting in death or lost time in excess of one week, the employer must report the injury to their insurer. Covered injuries include:

  • Physical or mental injuries
  • Accidents
  • Occupational diseases
  • Sudden trauma
  • Repetitive stress

While most injured employees are entitled to these benefits, challenges and complications often arise. In many cases, employees do not seek legal advice from an experienced New Orleans workers’ compensation lawyer because they believe an injury to be minor. In other cases, the need for legal help does not become apparent until a claim is denied, an insurer denies recommended treatment, a return-to-work order is issued, an employee is determined to have reached maximum medical improvement, or disagreements arise over the extent of disability. Having an experienced work injury law firm handle your case from the beginning can provide peace of mind, help ensure you are getting all of the benefits to which you are entitled, and avoid delays in the payment of crucial benefits required for medical care, rehabilitation or support of an injured worker’s family.

Work Injury Benefits in Louisiana

An employee who suffers a covered injury is entitled to immediate medical care. He or she is eligible for wage benefits after 7 days. No compensation shall be paid for the first week after the injury occurs unless the disability from the injury continues for two weeks or longer after the date of the accident.

  • Medical benefits: An employee has a right to choose one doctor in each specialty field for treatment of an on-the-job injury. Non-emergency medical services over $750 are subject to pre approval and authorization. Such expenses may be challenged by the workers’ compensation insurer and are subject to legal review.
  • Temporary Total Disability (TTD): Two-thirds of an employee’s average wage, subject to statutory minimums and maximums.
  • Supplemental Earnings Benefits (SEB): Are available if an injured employee returns to work but is unable to earn at least 90 percent of the pre-injury wage. SEB benefits are calculated at two-thirds of the wage difference.
  • Death benefits: If the employee dies within two years of the last treatment as the result of any job-related accident, his or her surviving spouse and/or dependent child(ren) (or other dependents) may be entitled to weekly indemnity benefits pursuant to the Louisiana Workers’ Compensation Act. If there are no surviving dependents, the employee’s surviving parents or adult children are entitled to a one-time benefit of $75,000. The employer or its workers’ compensation insurer shall also pay, in addition to any other benefits, reasonable expenses of the burial of the employee, not to exceed $8,500.
  • Catastrophic injuries: An employee is entitled to one-time benefit of $50,000 for catastrophic injury, defined under the law as paralysis, and certain anatomical losses (amputation injuries).
  • Disability benefits: In addition to temporary total disability benefits, permanent total and permanent partial disability benefits are payable based on statute for the long-term consequences of a work injury.

It’s a complex system and without the help of an experienced work injury attorney in New Orleans, Covington, or Raceland, an injured worker faces a significant disadvantage when it comes to getting all of the benefits to which he or she is entitled. Common complications include:

  • Disputed medical care
  • Pre-existing conditions
  • Claim settlement offers
  • Termination of employment
  • Termination of benefits
  • Return-to-work orders
  • Contested disability ratings

At Wanko Law, we focus exclusively on the representation of injured workers and their families. Having an experienced law firm handle your work injury claim can allow you to focus on recovery and help ensure that the benefits you need and deserve will be there when you need them most.

If you have been injured, call day or night for a free and confidential consultation to discuss your rights. Call 985-202-9907.

Louisiana Workers' Compensation Claims

-20 Years of Professional Experience- 

Will My Injury Be Covered?

Workers’ compensation covers both mental and physical injuries and occupational diseases.
Under Louisiana law, an accident refers to anything that is unexpected, unforeseen and occurs suddenly or violently – producing an injury.
The injury:
  • may or may not produce a disabling condition
  • may allow you to still work
  • may take you out of work
Generally, your compensation will not be affected depending upon who was at fault for the accident.
An occupational disease or illness is covered if it is the direct result of exposure to hazardous or toxic materials in the workplace. If you work in Louisiana’s oil and gas or chemical and petrochemical industries, you are at a greater risk to develop serious health conditions.

Common injuries suffered on the job include, but are not limited to:

Louisiana Workers' Comp Benefits

Will My Injury Be Covered?

In Louisiana, most workers are covered under Workers’ Compensation Statutes on the first day that they begin employment. These benefits extend to all workers whether they are employed full-time, part-time or seasonally.
Additionally, employees who are minors are also covered to the same degree as if they were adults.
Primary Types of Benefits:

Indemnity/Lost Wages — weekly payments based upon your average weekly wage; you will receive 66% of your average weekly wage capped at a maximum rate

Medical and/or Death — covers all necessary and reasonable medical treatment, including doctors visits, diagnostic tests, hospital stays, surgery, physical therapy, etc.

Mileage Reimbursement — travel related expenses to and from health care provider, pharmacy, etc. Vocational Rehabilitation program designed to retrain you in an attempt to return you to work for your previous employer, or find new 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
406 West 3rd Street #105
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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