The reality is that most disagreements with workers’ compensation insurance companies do not occur in the immediate aftermath of a workplace accident. Under Louisiana law, most employees are covered by workers’ compensation, regardless of fault, and so are entitled to medical care and temporary total disability benefits if they are not able to return to work in a timely manner.
Injured workers and their families are focused on medical care, and are understandably grateful that those bills are being covered. Temporary wage replacement is another benefit, and while it generally only covers two-thirds of an employee’s average wage, it is usually enough to keep the bill collectors away from the door over the short term.
However, it’s important to understand that workers’ compensation insurers are focused on reducing costs at each stage of the process. Your case has already been assigned to adjusters, investigators, and financial, legal and medical experts with significant resources and experience. The more serious your injury, the more senior the team arrayed against you. That’s why we always encourage injured workers and their families to seek out the early advice and representation of an experienced workers’ compensation lawyer in New Orleans, Raceland and Covington.
After initial emergency medical care, the workers’ compensation insurer must approve, and may challenge, medical expenses over $750. While you are allowed to choose your own treating physician, as well as one medical specialist in each necessary field of care, the insurer may also request its own medical evaluations and push for an independent medical evaluation when disagreements arise.
Your chosen physician will ultimately make many critical decisions impacting your care and eligibility for benefits and is best chosen in consultation with an experienced Louisiana work injury law firm. Choosing a physician with a track record of fighting for the rights of injured workers is a critical first step in the process, and one often missed by injured workers who are focused on recovery and satisfied with the initial responsiveness and benefits provided by a workers’ compensation insurer.
Your employer may insist you return to work sooner than you are able. Your same job may not be available. A workers’ compensation insurer may also move for a finding of Maximum Medical Improvement (MMI), Functional Capacity Evaluation (FCE) and an Impairment Rating (IR) to help bolster its case and/or make a discounted settlement offer to close your claim. Each stage of this process can impact current and future benefits.
Vocational rehabilitation benefits are among the most misunderstood benefits available to injured workers, particularly those who cannot return to their previous occupation. Examples are unfortunately common of workers forced back into positions before they are medically able, forced to work jobs they cannot handle, or forced to take substantially reduced positions, and then being eliminated for poor performance or other issues.
In most cases, employees without experienced legal help are pushed through the process with a single unanswered question: “Does my employer really need to put me back to work yet?”
When properly utilized, vocational rehabilitation can offer valuable assistance to injured workers who cannot return to their previous positions. However, it is most often utilized by workers’ compensation insurers to prove an injured worker is capable of re-entering the workforce, thereby allowing the insurer to terminate benefits.
The Louisiana Workforce Commission for the Department of Labor has outlined worker rights throughout the vocational rehabilitation process, including:
Returning to work has a major impact on many costly aspects of your work-injury claim, including medical care and rehabilitation, wage benefits and disability determinations. Insurers are anxious to prove you can return to the workforce in any available position in your community - if you are not successful in that position, that is not their problem.
Thus, workers’ compensation insurers use the system to reduce or eliminate lost wage benefits and other coverages provided to employees. It’s important to understand that Louisiana law does not even require insurers to show you have obtained employment, only that a job exists that your are capable of doing, and that such employment openings are available in your geographical area.
Proper navigation of the vocational rehabilitation system can be of significant benefit to injured workers and their families. Done properly, it can amount to paid occupational retraining and can leave workers better off than before an injury occurred. But entering the system without experienced legal help puts the insurance company in the driver’s seat, and the destination is pushing you back into the workforce, one way or another.
If you have been injured, call day or night for a free and confidential consultation to discuss your rights. Call 985-893-6530.
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.