Louisiana Workers’ Compensation Misconceptions | Part 1: Claims

Common misinformation related to Louisiana Workers Compensation Claims

When it comes to Louisiana Workers’ Compensation, misconceptions about the laws are quite common. And since we get questions all the time, we decided to address the most common misconceptions to clarify any confusion. Follow along for the first in a multi-part series addressing these misunderstandings. In Part 1, we address common misconceptions related to workers’ comp claims.

MISCONCEPTION #1: I cannot sue my employer for workers’ compensation benefits in Louisiana because I was hurt outside of the State of Louisiana.

If your employment was principally localized in Louisiana or your contract of hire was made in Louisiana, you may be able to make a claim for workers’ compensation benefits under Louisiana Law.

MISCONCEPTION #2: Pain and suffering damages from my employer will be awarded because my accident was the fault of my employer.

While you can sue your employer for workers’ compensation benefits under Louisiana Law, those benefits do not include “pain and suffering” or any “damages” for that matter. Because an injured worker does not have to prove “fault” or “negligence” of its employer to receive workers’ compensation benefits, the law does not award damages in workers’ compensation.

MISCONCEPTION #3: I cannot make a workers’ compensation claim because I have a pre-existing injury.

Accidents that aggravate, accelerate, or cause your pre-existing condition to worsen are compensable, and you can make a workers’ compensation claim for such accidents. It should be expected, however, that the insurance company will fight back & attempt to make you prove that your accident did, in fact, aggravate or accelerate your pre-existing injury.

MISCONCEPTION #4: I already have an open workers’ compensation claim. I cannot make an additional claim if I have another accident.

Each time you have a new accident at work, it is a new claim, even if you already have an open claim with the same (or another) insurance company. While these claims can be very complex and denials can be expected, the claim itself may still be worth pursuing.

MISCONCEPTION #5: If the compensation carrier denies my treatment, I can use my health insurance to pay for my treatment.

Most health insurance companies, including those that administer Medicaid and Medicare benefits, will not pay for your medical treatment if you have an open claim and treatment is denied for not being necessary. However, if your claim is denied for compensability, your insurance should pay for your medical treatment. If your own health insurance company pays for your medical treatment and you settle your workers’ compensation claim down the road or receive a favorable judgment, the health insurance company will likely demand the money it paid out for your medical treatment back.

MISCONCEPTION #6: I have to file suit on my workers’ compensation claim within one year of the accident, or else there isn’t anything I can do.

This is partially true. Suppose you have not received any workers’ compensation benefits (indemnity or medical) from your employer or its workers’ compensation insurance company within one year of the accident. In that case, yes, you have to file a lawsuit with the workers’ compensation court to keep the claim alive, so to speak. However, if you have received an indemnity check, you have one year to file a lawsuit with the Court to dispute a claim for additional indemnity benefits (three years for Supplemental Earnings Benefits). If the employer or workers compensation insurer has paid a medical bill, you have three years to file a lawsuit with the Workers Compensation Court from the date the bill was paid to dispute a claim for more medical benefits.

Chase Villeret