The aim of workers’ compensation benefits in the immediate aftermath of a work injury is to provide medical benefits and temporary total disability benefits, including lost wages, to covered employees who are injured on the job.
In most cases, permanent total disability settlement benefits are available after 7 days for work injuries lasting longer than two weeks. However, other benefits are meant to compensate injured employees for the long-term consequences of injury, including supplemental income benefits and permanent disability benefits.
Such benefits are determined through a complex process and are often challenged by workers’ compensation insurers and their attorneys, all of whom are focused on reducing the cost of a claim. Consulting a workers compensation lawyer in New Orleans, Covington or Raceland early in the process is the best thing you can do to protect your rights and the financial well-being of you and your family.
Disability and Impairment Ratings - Permanent Disability Claims
For longer-term consequences of a work injury, a workers’ compensation insurer will generally seek a medical evaluation to determine an impairment rating as a first step to making a settlement offer. Impairments generally affect an employee’s ability to perform his or her job, and can have a major impact on a claim.
Impairment ratings in Louisiana are based on the 6th American Medical Association Guides to the Evaluation of Permanent Impairment. Impairment, under Louisiana workers’ compensation law, means abnormality or loss following maximum rehabilitation. As such, an impairment rating is generally determined following a determination of maximum medical improvement (MMI). Each of these determinations can have significant long-term impacts on your ability to collect benefits, or obtain a fair settlement offer, and are always best handled with the help of an experienced Louisiana workers’ compensation law firm.
An impairment rating is provided as a percentage - from 0 to 100. Impairment ratings may be different for each affected body part, and combined to provide a “whole person” impairment rating. While legal framework is provided, medical opinion and subjective determinations play a significant role and disagreements among providers, including medical professionals who work for the workers’ compensation insurance company, are commonplace.
Impairment ratings are usually determined during a Functional Capacity Evaluation (FCE). This rating is often used by the insurance company to determine a monetary award. However, under Louisiana law, an impairment rating is not used to determine Supplemental Earnings Benefits, Temporary Total Disability benefits or Permanent Total Disability benefits. Rather, this impairment rating percentage is used to determine a monetary award under LA R.S. 23:1221 for Permanent Partial Disability (PPD) benefits, which concerns cases of amputation or loss of use of parts of an injured employee’s body.
For these reasons, it is somewhat rare that an impairment rating will be required for a Louisiana workers’ compensation claim. However, the fact that workers’ compensation insurance companies frequently insist injured workers undergo an examination to determine such ratings, and then use these ratings in settlement negotiations, leaves injured workers exposed and confused. This is another example of why consulting with an experienced Louisiana workers’ compensation law firm at the outset of your case is often vital to obtaining all of the benefits to which you are entitled.
Social Security Disability Benefits
Further complicating matters is the fact that an injured worker may also be entitled to Social Security disability benefits. This is true even if a workers’ compensation disability claim has been rejected or not yet decided.
While disability payments from private sources, such as pension or insurance benefits, will not impact Social Security benefits, workers’ compensation and other public disability benefits may reduce benefits available to you through Social Security. Your workers’ compensation benefits and Social Security disability benefits may not exceed 80 percent of your average current earnings before you became disabled. When an excess exists, it will be deducted from your Social Security disability benefits.
Exemptions exist for Veterans Administration benefits, state and local government benefits if you paid into Social Security, and benefits through Supplemental Security Income for low-income individuals and families.
Coordinating these benefits in a way that maximizes income for an injured worker and his family is a complex process. How average income is determined, and whether you receive a lump-sum settlement, may also impact the benefits to which you are entitled. Seeking the advice and guidance of an experienced work injury lawyer in New Orleans, Covington or Raceland can help ensure you maximize the present and future benefits available to you and your family.
A lump-sum settlement may not impact disability benefits, since income history is used in the calculation, and not financial assets. However, of equal importance in accepting such awards is ensuring you are getting maximum benefits. Insurers will push for a discount rate in exchange for such settlements, when in reality, locking in costs, eliminating unknown future medical costs, and alleviating the time and expense of administering your case are all of significant benefit to an insurer, even absent a discounted award.
At Wanko Law, we focus exclusively on fighting the the rights of injured workers and their families and work to win all of the benefits to which you are entitled.
If you have been injured, call day or night for a free and confidential consultation to discuss your rights. Call 985-202-9907.
