Shreveport Law Firm Explains the 5 Step Process
So, you’ve been injured on-the-job or became ill because of worksite conditions. Now what? In Louisiana, employees are protected by the Louisiana Workforce Commission’s Department of Labor through the Office of Workers’ Compensation’s (OWCA) no-fault system. Because of OWCA, you do not have to prove your injuries were caused carelessly or intentionally. Simply, you may be awarded workers’ compensation benefits if your injury occurred at work or was caused by job-related activities.
When your workers’ compensation claim is approved, workers’ compensation may provide the following benefits:
▪Reasonable and necessary medical care.
▪Temporary total disability replacement for lost wages.
▪Permanent disability benefits.
▪Catastrophic injury benefits.
▪Vocational assistance—job training and education.
▪Death benefits for surviving family when an employee was killed on the job.
To ensure your benefits’ rights when you’ve been injured or became ill because of your workplace, you must report your condition to your employer within 30 days of the incident or upon discovery of an illness. After you‘ve made the report, there are strict procedures and additional deadlines to follow. If you do not complete the claims process as required by established deadlines, you may permanently lose your right to workers’ compensation benefits.
Here are the steps to filing a workers’ compensation claim:
STEP #1 Report your injury or illness to your supervisor or an employer representative immediately. Although you have 30 days to make the report, the longer you wait, the more likely it will be denied by your company’s workers’ compensation insurance company. If you delay reporting your job-related condition, you may permanently lose your right to workers’ compensation benefits. Also, your employer or their insurance company may use the delay as an excuse to assert that your injury or illness must not have been serious enough to warrant benefits. In either case, waiting too long could cause you to lose the valuable, necessary benefits of workers’ compensation when you’ve been hurt on the job.
To properly report your injury, you must provide it to your employer in writing. The following information is required in your report:
▪Time and date of your injury.
▪Location where your injury occurred.
▪How the injury happened.
▪Body parts that were injured.
STEP #2 If your injuries or illness caused you to lose work time beyond your normal shift or you need medical treatment beyond first aid, it is imperative that you seek medical treatment and care if you haven’t already. To ensure your workers’ compensation benefits are approved, it’s important that your injury or illness, including psychological or psychiatric problems created by your work conditions, is medically documented.
#3 The next step is your employer’s responsibility. In Louisiana, unlike many other states that require you to take initial responsibility for completing the employee section of the workers’ compensation form, your employer is required by law to send a “First Report of Injury” claim form to its insurance company within ten days of your written injury or illness notice. If your employer has been approved by the state to self-insure, the company’s insurance administrator will handle your claim. At this point, your workers’ compensation injury claim enters the review process.
#4 When the employer’s insurance company or insurance administrator receives the claim regarding your injury or illness, they file it with OWCA.
#5 Once your employer’s insurance company has filed your claim with OWCA, their insurance company will conduct an investigation to determine your eligibility for benefits. Included in the insurance company’s investigation and preparation to determine your eligibility may be the following:
▪A review of any existing medical records pertaining to your claim.
▪An independent medical examination to assess your injury or illness.
▪An evaluation that sets work restrictions or “functional capacity.”
▪An analysis of your work experience, education, and wages to determine appropriate compensation if any.
After the insurance company’s investigation is complete, your claim will either be approved or denied. If it is approved, you should receive benefits soon thereafter. However, if your claim is denied, you will receive written notice from your employer’s insurance company. In this case, if you still want to pursue benefits, you’ll have to begin the complicated process of filing an appeal which almost always requires an attorney’s assistance.
Because the workers’ compensation claims’ process is complicated and deadlines strict, the system can be confusing and frustrating. The more you understand the process, the more effective your claim may be. The experienced employment law attorneys at Fischer and Manno Law intricately understand the Louisiana workers’ compensation claim system and have the knowledge and expertise to help you through it. Should we take your case, you’ll never pay us up-front—there’s no fee until we win your case.
It’s easy to begin the conversation with Fischer and Manno’s workers’ compensation attorney team. For a free, no-obligation assessment of your work-related injury or illness benefits, call us at (318) 869-0304 or simply fill out our free case review form.