Tuesday, July 7, 2009
The law currently says:
"When the injury does not result at the time of or develop immediately after the accident, the [time] limitation [for filing a claim] shall not take effect until expiration of one year from the time the injury develops but in all such cases the claim for payment shall be forever barred unless the proceedings have been begun within two years from the date of the accident."
The new law would have changed the time limitation from two years to three years.
Governor Jindal's office announced today that he has vetoed the bill, because a group of Louisiana Workers Compensation insurance companies asked him to. As his letter issuing the veto states:
"I have received a request to veto this legislation from the Louisiana Workers’ Compensation Corporation, the Louisiana Association of Self-Insured Employers, the Property Casualty Insurers Association of America, the Louisiana Restaurant Association Self Insurer’s Fund, and LUBA Workers’ Compensation."
Read the full text of the letter here.
Wednesday, July 1, 2009
House Bill 729, which extends Louisiana Workers Compensation coverage to volunteer firefighters, and
Senate Bill 303, which creates a panel of doctors to compile a "medical treatment schedule" to be used by the Louisiana Workers Compensation Medical Services Division.
Tuesday, May 12, 2009
- David Buie is an attorney who represents individuals in Workers Compensation claims throughout Louisiana. For more information about Louisiana Workers Compensation claims, visit www.DavidBuie.com.
Saturday, May 2, 2009
Friday, May 1, 2009
House Bill 537 privatizes the handling of claims for less than $50,000 involving employees of the Louisiana state government.
House Bill 562 requires that health care providers receive notice when a Louisiana Workers Compensation claim is settled.
House Bill 658 changes the time limits for filing some types of Louisiana Workers Compensation claims.
House Bill 706 Changes the "Burden of Proof" in Louisiana Workers Compensation claims.
House Bill 729 extends Louisiana Workers Compensation coverage to volunteer firefighters.
House Bill 841 makes a a number of changes, including (1) expanding the circumstances for which an IME is appropriate, (2) requiring reporting of fraud, (3) allowing direct deposit and debits cards for benefits payments, and (4) extending time limits for reimbursement rates for the Louisiana Second Injury Fund.
Senate Bill 303 authorizes a group of doctors to create a "medical treatment schedule" to be used by the Louisiana Workers Compensation Medical Services Division.
David Buie is a Louisiana Workers Compensation Lawyer who represent individuals throughout all of Louisiana. For more information, visit DavidBuie.com
Friday, February 27, 2009
Louisiana Workers Compensation benefits and insurance rates decline while disputes and employer violations grow.
Louisiana Commissioner of Insurance Jim Donelon recently announced that workers compensation benefits, and the rates that Louisiana employers pay for workers’ compensation insurance, has declined for three consecutive years.
For 2009, the rates that Louisiana employer pay for workers compensation insurance will be adjusted to reflect that workers' compensation benefits paid in Louisiana declined by 17.4 percent over the last year.
In 2008, Louisiana workers compensation insurance rates fell 8.6 percent.
In 2007, Louisiana Workers' Compensation insurance rates fell 15.8 percent, the highest reduction of the 35 states NCCI analyzes.
The Times-Picayune notes that the impact of the lower rates could be especially important since Katrina because more people are working in higher-risk, higher-paying jobs.
In related news, LWCC recently announced a $7.5 million dividend (refund) to its policyholders.
On the other hand, according to the Louisiana Office of Workers' Compensation, in 2007, latest year for which complete information is currently available, both the number of disputed workers compensation claims and the number of workers compensation trials increased.
And as mentioned earlier this month, as many one of every five Louisiana businesses may be illegally failing to purchase workers compensation insurance or misleading their insurance agents.
Monday, February 23, 2009
If the medical treatment includes an overnight hospitalization or surgery, your doctor should fax the Workers Compensation insurance company the basic information about the type of treatment you need and the insurer should then contact the doctor’s office to request the specific information they need to review the treatment request. If the treatment includes surgery, the insurance company may schedule an examination with a different doctor for a second surgical opinion. If the insurance company doctor disagrees with the claimant’s treating doctor, then the claimant or the insurance company may request an Independent Medical Examination with a doctor appointed by the Office of Workers’ Compensation or a Workers’ Compensation Judge.
When all of the information is available, the Workers Compensation insurance company must indicate whether they will cover the cost of the hospitalization or surgery. If the hospitalization or surgery is denied, you may file a Disputed Claim for Compensation with the Louisiana Office of Workers' Compensation to ask a Judge to determine whether the treatment should be approved.
For other types of medical treatment, including prescription medication, physical therapy, medical devices, medical tests (MRI, EMG, CT Scans, etc.) or other treatment that doesn't require an overnight hospital stay, the doctors should send the insurance company a report that contains the following information:
- the patient’s history and physical examination results, including a clinical summary.
- the diagnosis.
- the type of service or treatment the doctor is requesting.
- the plan of care, including the expected length and frequency of treatment.
- the patient’s prognosis, including the expected outcome of the treatment or test.
- any test results and interpretations that support medical necessity of the treatment requested.
A nurse working for the Workers’ Compensation insurance company should review the request and approve or deny coverage for the treatment within seven calendar days of the date of that the doctor’s office provided the required information. If the Workers’ Compensation insurance company does not respond within seven days, the claimant may assume the treatment was denied and file a Disputed Claim for Compensation with the Office of Workers’ Compensation. A Workers’ Compensation Judge may then assess penalties against the insurance company for failing to follow the Louisiana Utilization Review Procedures.
If the insurance company’s nurse decides the treatment is not medically necessary, the insurer should have the request reviewed by a doctor of the same medical specialty as the doctor who ordered the test or treatment. If the insurance company doctor agrees that the treatment is not medically necessary, the insurer must notify the treating physician and claimant in writing immediately. The insurer must also fax the information they based their decision upon to the Louisiana Office of Workers’ Compensation Medical Services Division.
The Medical Services Division will review the information and may either:
- Schedule an Independent Medical Examination to obtain additional advice.
- Agree with the insurance company’s decision to deny the treatment.
- Disagree with the insurer and recommend that the treatment be covered.
If the Judge decides that the Workers Compensation insurance company failed to review the request within seven days of receiving the information from the doctor’s office, the Judge may impose a penalty. If the Court finds that the insurer or employer “arbitrarily and capriciously” refused to approve the claimant’s medical care, the Court may order an award of attorney fees as an additional penalty. It’s necessary for the claimant to prove that their doctor submitted all of the required information and the insurance company acted irresponsibly in failing to follow the Louisiana Utilization Review Procedures in order for the Court to conclude that the insurer handled the claim in way that was “arbitrary and capricious.”
- David Buie is a Louisiana Workers Compensation Lawyer who represent individuals throughout all of Louisiana. For more information, visit DavidBuie.com
Thursday, February 19, 2009
A recent Associated Press report concludes that as many as one in five Louisiana businesses may be breaking the Workers Compensation law. The report is based upon a new fraud detection program recently announced by the Louisiana Workforce Commission and the Louisiana Attorney General's Office.
"A big part of our goal is to attract and retain businesses," said Tim Barfield, executive director of the commission. "We want to make sure we have an environment that's conducive to business and that there's a level playing field for all of our businesses. Right now, there's a number of companies who aren't playing by the rules."
Chris Broadwater, head of the commission's Office of Workers Compensation Administration, said violators will face penalties of $250 per employee, per incident. Repeat offenders could face criminal penalties and have the businesses shut down.
Broadwater said a spot check of 20 companies, using auditor and hotline tips, found seven of the 10 which responded out of compliance. The other 10 didn't respond, he said.
Read the rest of the article in the New Orleans Times Picyune.
Thursday, February 12, 2009
If you have not received any income benefits (indemnity benefits) as a result of your current injury, you must file a claim for Louisiana Workers' Compensation indemnity benefits with the Office of Workers’ Compensation Court within one year of the date of your accident. If you have a “developmental injury" where your medical condition was not immediately apparent, the time limit for filing a claim may be extended up to a total of two years, as long as that is still not more than one year from the date that you knew that your disabling medical condition was related to your job. “Developmental injuries” are comparatively uncommon, so in the vast majority of claims, the one-year limit applies.
If you have been paid Louisiana Workers' Compensation indemnity benefits due to your current injury, your right to file a claim for Temporary Total Disability, Permanent Partial Disability or Permanent Total Disability benefits will expire if your claim is not filed with the Louisiana Office of Workers' Compensation within one year of the date through which you were last paid indemnity benefits.
Additionally, if you have received any type of Louisiana Workers’ Compensation income benefit as a result of your current injury, a claim for Supplemental Earnings Benefits must usually be filed within three years of the date through which you were last paid indemnity benefits.
The time limit for filing a claim for Workers' Compensation benefits is not extended because you received another type of disability benefits, such as Social Security Disability or benefits from a private short term disability policy.
A claim for medical benefits must be filed within one year of the date of the accident or three years from the date that Workers’ Compensation medical benefits were last paid, whichever is later.
A claim for Workers' Compensation benefits that is not based upon a specific accident but is instead based upon a work-related illness or disease must be filed with the Louisiana Office of Workers' Compensation within one year of the date that:
- The disease manifested itself.
- The employee is disabled from working as a result of the disease.
- The employee knows or has reasonable grounds to believe that the disease is occupationally related.
You should consult with an attorney even if you think your time limit for filing a claim has expired. The calculation of legal time limits can be subject to many surprising exceptions. Additionally, in a Workers' Compensation claim, you may need to request information from the insurance company before you can determine when your time limitations began or expired.
David Buie is a Louisiana Workers Compensation Lawyer who represent individuals throughout all of Louisiana. For more information, visit www.DavidBuie.com
Tuesday, February 10, 2009
- They received incorrect or incomplete income information from the employer.
- They used the wrong calculation method.
- They made a calculation error that was never corrected.
- They failed to include taxable fringe benefits.
- what is a "full week"?
- when should a payroll week begin and end?
- what if you were on vacation?
- what if you were a subcontractor?
- what if you just started working at a new job?
- what if you had more than one job?
- what if your income is irregular, seasonal or based upon a commission?
- what if you just got a raise or were about to get a raise?
Sept 1, 1998-Aug 31, 1999 ..... Max. $367.00 .... Min. $ 98.00
Sept 1, 1999-Aug 31, 2000 .... Max. $384.00 .... Min. $102.00
Sept 1, 2000-Aug 31, 2001 .... Max. $388.00 .... Min. $104.00
Sept 1, 2001-Aug 31, 2002 .... Max. $398.00 .... Min. $106.00
Sept 1, 2002-Aug 31, 2003 .... Max. $416.00 .... Min. $111.00
Sept 1, 2003-Aug 31, 2004 .... Max. $429.00 .... Min. $114.00
Sept 1, 2004-Aug 31, 2005 .... Max. $438.00 .... Min. $117.00
Sept 1, 2005-Aug 31, 2006 .... Max. $454.00 .... Min. $121.00
Sept 1, 2006-Aug 31, 2007 .... Max. $478.00 .... Min. $127.00
Sept.1, 2007-Aug 31, 2008 .... Max. $522.00 .... Min. $139.00
Sept.1, 2008-Aug 31, 2009 .... Max. $546.00 .... Min. $146.00
who represents individuals throughout Louisiana.
For more information, visit DavidBuie.com
Tuesday, January 27, 2009
Louisiana Revised Statute 23:1121 of the “The Louisiana Workers' Compensation Act” says:
The employee shall have the right to select one treating physician in any field or specialty. The employee shall have a right to the type of summary proceeding provided for in R.S. 23:1124(B), when denied his right to an initial physician of choice. After his initial choice the employee shall obtain prior consent from the employer or his workers' compensation carrier for a change of treating physician within that same field or specialty. The employee, however, is not required to obtain approval for change to a treating physician in another field or specialty.But the law is very strict and you can easily forfeit your right to pick your own doctors.
Louisiana Revised Statute La.R.S. 23:1121 goes on to say:
If the employee is treated by any physician to whom he is not specifically directed by the employer or insurer, that physician shall be regarded as his choice of treating physician.Should you pick one of the insurance company’s doctors to be your primary treating physician?
When the employee is specifically directed to a physician by the employer or insurer, that physician may also be deemed as the employee's choice of physician, if the employee has received written notice of his right to select one treating physician in any field or specialty, and then chooses to select the employer's referral as his treating specialist after the initial medical examination as signified by his signature on a choice of physician form. The notice required by this Subparagraph shall be on a choice of physician form promulgated by the director of the office of workers' compensation and shall contain the notice of the employee's rights provided under R.S. 23:1121(B)(1). Such form shall be provided to the employee either in person or by certified mail.
* * *
If the employee fails or refuses to sign the form . . . the employer or his insurer shall be entitled to seek an expedited hearing to be held within ten days, and upon order of the court, may suspend medical benefits until such time as the employee complies with Subparagraph (2)(b) and Paragraph (3) of this Subsection.
Nothing in this Section shall be construed so as to provide that a physician who, regarding the work-related injury, administered emergency treatment only shall be the physician of choice of either the employee or the employer.
Doctors have deep and genuine philosophical differences about how to treat people who are involved in Workers’ Compensation claims. They have strongly differing opinions about what type of injuries require surgery, what types of medications to prescribe and the types of work that injured people are able to perform. They seem to disagree about practically every aspect of treating people who are involved in Workers’ Compensation claims. Some doctors even seem suspicious of patients who were injured at work and filed a Workers’ Compensation claim. The most important thing is that you select a doctor that you have confidence in and feel comfortable talking to. Your ability to communicate openly with your doctor can have a huge impact upon your recovery and the type of treatment you receive.
The insurance company also has the right to set up occasional appointments with doctors that they have selected. In most cases, these appointments will be only examinations and the doctor will not provide you with any actual medical treatment. You are required to attend these appointments and the Workers' Compensation Court may suspend your benefits if you don't go. The insurance company isn’t allowed to send you to more than one doctor in each medical specialty without your consent. You should consult an attorney before agreeing to an examination with a second doctor of the same medical specialty.
David Buie is a Louisiana Workers Compensation Lawyer
representing individuals throughout Louisiana.
Monday, August 6, 2007
- David Buie is a Louisiana Workers Compensation Lawyer representing individuals throughout Louisiana. www.DavidBuie.com
Tuesday, June 12, 2007
Chief Judge Sheral Kellar
Judy Franklin, Mediator
Post Office Box 94040
Baton Rouge, LA 70804-9040
Phone: (225) 342-7970
Toll-free: (800) 201-2499
Fax: (225) 342-4790
Judge Brenza Irving
Tikisha Smith, Mediator
Camelia Antie, DRS
Monroe, LA 71201
Phone: (318) 362-3078
Toll-free: (800) 209-7321
Fax: (318) 362-3083
Judge Phillip Hendry
Rosa Whitlock, Mediator
Bridget Powell, DRS
Shreveport LA 71106
Phone: (318) 676-5331
Toll-Free: (800) 209-7173
Fax: (318) 676-5332
Judge James Braddock
Mayme Holt-Brown, Mediator
Jeanette Dodge, DRS
3724 Government Street, Suite 114
Alexandria, LA 71302
Phone: (318) 487-5966
Toll-Free: (800) 209-7329
Fax: (318) 487-5967
Lake Charles Office
Judge Charlotte Bushnell
Judge Sam Lowery
Chantell Smith, Mediator
Deborah Garriet, DRS
4250 Fifth Ave., Suite 3
Lake Charles, LA 70607
Phone: (337) 475-4882
Toll-free: (888) 768-8745
Fax: (337) 475-4884
Judge Sharon Morrow
Raven Pillette, Mediator
Norene Fusilier, DRS
556 Jefferson Street, First Floor
Lafayette, LA 70501-6947
Phone: (337) 262-1057
Toll-free: (800) 209-7174
Baton Rouge Office
Judge Pam Moses-Laramore
Judge Jason Ourso
Adam Johnson, Mediator
Audrey Scott, DRS
224 Florida St., Suite 100
Baton Rouge, LA 70801
Phone: (225) 219-4378
Toll-free: (800) 209-7175
Fax: (225) 219-4377
Judge Robert Varnado
Judge Elizabeth Warren
Valerie Marcules, Mediator
Mikal Pippins, DRS
19374 North Third Street
Covington, LA 70433-8813
Phone: (985) 871-1258
Toll-Free: (888) 575-6149
Fax: (985) 871-1264
Judge Sylvia Steib
Judge John Grout
Shannon Bruno, Mediator
Ken Dupre, DRS
2150 Westbank Expressway, Suite 403
Harvey, LA 70058-4902
Phone: (504) 361-6831
Toll-Free: (800) 209-7162
Fax: (504) 361-6834
New Orleans Office
Judge Gwendolyn Thompson
Judge Diane Lundeen
Rene Paysse, Mediator
Christine Melford, DRS
1340 Poydras Street, Suite 1450
New Orleans, LA 70112-2001
Phone: (504) 568-6952
Toll-Free: (800) 209-7232
Fax: (504) 568-8706
Judge Elizabeth Lanier
Debra Duplantis, DRS
8026 Main Street, Suite 404
Houma, LA 70360-3407
Phone: (985) 857-3775
Toll-free: (800) 262-1497
Fax: (985) 857-3781
David Buie is a Louisiana Workers Compensation Lawyer representing individuals throughout all of Louisiana. www.DavidBuie.com
Friday, June 8, 2007
Louisiana Senate Insurance Committee refuses to exempt PPOs from penalties for underpaying Workers' Compensation claims.
Chairman James David Cain, R-Dry Creek, said after the hearing that he was forced to put witnesses under penalty of perjury because of “a bunch of nasty lies” spread in radio ads and prerecorded telephone messages aimed at constituents in the districts of four members of the committee. The messages supported SB220.
“It’s about AIG and some insurance companies that got their hand caught in the cookie jar,” said Clark R. Cossé III, general counsel of the Louisiana Hospital Association. “The sky is not falling.”
For the full text and status of Senate Bill 220, visit the Louisiana Legislature's website.
Tuesday, June 5, 2007
SB 220: Exempts preferred provider organizations from some laws that provide penalties for the underpayment of Workers' Compensation benefits.
HCR 105: Requests the Department of Labor and Office of Risk Management to review and reconsider the amount and term of benefits paid to employees who experience a catastrophic injury.
HB 651: Provides for the liabilities of the workers' compensation Second Injury Fund.
HB 156: Changes La.RS. 37:2175.2 to provide that proof of Workers' Compensation insurance is not required to get a contractors license if the applicant is an independent contactor who is a sole proprietor with no employees and has elected not to be covered by Workers' Compensation insurance as provided by law.
From the Times Picayune
June 1, 2007
Rates for workers' compensation insurance are decreasing, thanks to a large drop in loss costs for insurers, according to Louisiana Insurance Commissioner Jim Donelon.
Most workers' comp carriers in Louisiana use the National Council on Compensation Insurance annual loss cost filing report to help formulate their insurance rates. As a result of a recent NCCI filing showing Louisiana has the nation's largest percentage decrease in loss costs, at 15.8 percent, several companies have filed for a rate decrease with the Department of Insurance.
"This is positive news for our state's workers' compensation market," Donelon said. "Our market is healthy and viable."
Unfortunately, Louisiana also had the "largest percentage decrease" in population and employees.
David Buie is a Louisiana Workers Compensation Lawyer representing individuals throughout all of Louisiana. www.DavidBuie.com
Monday, June 4, 2007
In fact, it's especially important to get legal advice if you plan to settle your Workers' Compensation claim or if you believe you should qualify for both Workers' Compensation and Social Security Disability. The terms of your Workers' Compensation settlement can have a huge impact upon the amount of Social Security benefits you receive and the degree to which Medicare will cover your future medical expenses.
You can receive Workers' Compensation and Social Security Disability at the same time, up to a combined benefit of 80% of the income you were earning before you became disabled. Unlike most Workers' Compensation benefits, Social Security includes annual "cost of living" increases and may pay additional benefits for your spouse and children.
But the Workers' Compensation and Social Security laws determine the amount of income you were earning before you became disabled in very different ways.
Your Social Security Disability benefits are usually based upon your "average current wages" before you became disabled, which is the larger of:
- your average annual lifetime earnings
- your average earnings during the five years before you became disabled, or
- your earnings during the year before you became disabled.
Meanwhile, your Workers' Compensation benefits are usually based upon your "average weekly wage," which is the average weekly income you earned in the few weeks just before your injury. In Louisiana, your Workers' Compensation benefits are generally based upon your wages in the four full weeks just before your accident or the beginning of your illness.
While you're receiving Workers' Compensation benefits, your Social Security benefits may be reduced so that the combined benefits don't go over 80% of your "average current wage" as determined by the Social Security Administration. The exception to this rule in Louisiana is that the claimant's employer may request that the offset be reversed if the Louisiana Workers' Compensation Court determines that the claimant is permanently totally disabled.
The Social Security offset can become a very important issue when a Workers' Compensation claim is settled because the Social Security Administration may treat the lump-sum settlement as a replacement for periodic benefits. They may pro rate the amount of the settlement at the same rate that the claimant was receiving Workers' Compensation wage benefits before the settlement. The Social Security Administration applies either
- the rate specified in the lump-sum award
- the periodic rate paid prior to the lump sum settlement, or
- your state's Workers' Compensation maximum in effect for your year of injury. This figure can be used if no rate is specified in the award or there were no periodic benefits paid before the settlement.
The net effect is that a claimant's Social Security benefits will continue at same rate they were being paid before the Workers' Compensation settlement though the claimant is no longer receiving Workers' Compensation indemnity benefits. This can be particularly painful where the claimant has used their Workers' Compensation settlement to pay debts that they incurred while their claim was pending.
To address this problem, the Social Security Administration allows you and your employer to stipulate in your Settlement Agreement that the amount paid in the lump-sum settlement of your Workers' Compensation claim is intended to compensate you for your lost wages (or loss of earning capacity) over your entire remaining work-life. The settlement documents should explicitly state the term and imputed periodic rate of the lump-sum settlement.
In the typical settlement of a disputed Louisiana Workers' Compensation claim, the appropriate stipulation in the Joint Settlement Petition should substantially reduce or eliminate the Social Security offset.
David Buie is a Louisiana Workers Compensation Lawyer representing individuals throughout all of Louisiana. www.DavidBuie.com