To be eligible for workers’ compensation benefits (sometimes called workman’s comp), there are two basic requirements:
- You must be an employee of a company who has (or was supposed to have) workers’ comp insurance.
- You must have been injured at work or as a result of job-related duties.
The basic benefits that you are entitled to under workers’ compensation are:
- payment for your time off work, usually at two-thirds of your average weekly wage;
- payment of your medical bills that are related to your work injury; and
- You may be entitled to a settlement at the end of your case, which is based upon a number of factors – including your age, your occupation, the injury that you sustained and the residual effects of that injury, among other factors.
The Louisiana Workers’ Compensation Act provides four types of income benefits for people who have a work-related injury or illness:
- Temporary Total Disability Benefits
- Supplemental Earnings Benefits
- Permanent Partial Disability Benefits
- Permanent Total Disability Benefits
You can receive only one type of benefit at a time, but you may qualify for different types of benefits at different points in your claim.
How Much Are The Benefits That I’ll Receive Under Workers’ Compensation?
You’ll need to know your “average weekly wage” before you can determine how much your Louisiana Workers Compensation income benefits should be. For most people, their average weekly wage equals their average gross wages during the four full weeks before their accident. But the basic calculation is subject to many adjustments and variations.
You will usually need to answer at least two questions to determine your “average weekly wage”:
- How much were your “gross wages?”
- Which weeks were the “four full weeks before your accident”?
“Gross Wages” means the total amount of your pay, before deductions for taxes, social security, retirement plans, health insurance, etc. “Gross Wages” may also include taxable fringe benefits, such as the payment of a per diem (if you pay taxes on it).
Your average weekly wage is usually based upon your gross income in the “four full weeks” before your accident. If you were a full-time employee and usually worked at least 40 hours per week, the calculation may need to be adjusted if any of the following things happened in the four weeks immediately before your accident:
- You had a full or partial vacation week.
- You worked less than 40 hours during a week due to holidays.
- You were laid off for part or all of a week.
- Your employer required you to work a reduced schedule.
How Are Medical Benefits Paid?
An employee has the right to select one doctor of his or her choice in each specialty field for treatment of the job-related injury. The employer or its workers’ compensation insurer is required to pay all approved necessary expenses for medical treatment, plus mileage expenses to obtain treatment.
Medical benefits payable under the Louisiana Workers’ Compensation Act shall be paid within 30 days after the employer or its workers’ compensation insurer receives written notice thereof, or within 60 days if the provider of medical services is not utilizing the electronic billing rules and regulations provided for in R.S. 23:1203.2. An itemized list of out-of-pocket medical expenses and receipts paid by the employee should be sent to the employer or its workers’ compensation insurer for reimbursement.
Workers’ compensation insurance is not limited to just accidents. It also covers “occupational diseases” that are developed over a long period of time of doing the same activity. A good example of this is carpal tunnel syndrome from some sort of repetitious movement while on the job.
Get Help With Your Workers’ Compensation Claim
It can be difficult to navigate the law without professional guidance. We aim to provide accurate resources that can be used to educate yourself with, but most cases have unique circumstances, so it’s always important to lean on an expert in your time of need. Please contact our experienced workers’ compensation attorneys at Fischer & Manno Law to receive a free consultation on your workers compensation case.