With rare exceptions, if you are working and have an accident, or develop a medical condition due to the peculiar conditions of your employment, you are entitled to workers compensation benefits. Workers compensation is insurance your employer is required by law to carry. Just like a car wreck effects your insurance premium, too many claims from a particular employer can effect their premiums, and thus, their bottom line. For this reason, your employer may not be particularly helpful in advising you of your rights.
After an accident, the first right you have is to be seen by YOUR doctor. The employer has a right to have you evaluated by their doctor, but you have an absolute right to be seen and treated by the doctor you choose. Don’t let your employer force you to pick their doctor. There is usually a reason they want you to see a particular doctor, and that is because the doctor is looking out for the employer and not you as a patient.
If the doctor you see says you cannot work, then the second right you have is wage loss benefits. Wage loss, or indemnity, is usually two-thirds of the average of your earnings in the four full weeks before your accident. Calculating this amount has many variables, but indemnity benefits are owed after you have been off work for 7 days.
Many times the doctor will say you can work, but with certain restrictions. If your employer can accommodate those restrictions, then you can return to work. If the employer cannot or will not accommodate the restrictions and allow you to return to work then you must be paid indemnity.
The third right you have is medical treatment to treat your injury and return to work. Louisiana now operates under a medical guideline system and your doctor must follow certain procedures to get the medical treatment approved by the insurance carrier. Insurance carriers love to deny treatment, even if it means they end up paying more indemnity because you are not getting better and cannot return to work. If your medical treatment is consistently denied, then you will need to consult an experienced attorney to help you and/or your doctor weed through the medical treatment approval procedure.
You can’t go to court to force a settlement
Finally, at some point your claim may be in a position to settle. Many people are surprised to learn that settlements in workers compensation claims are completely voluntary. You cannot make the employer or insurance company settle with you and vica versa. You can’t go to court to force a settlement. A settlement typically involves only two things: future indemnity and future medical. Unfortunately, there is no pain and suffering or recovery for all the wages you have lost. You will need an experienced attorney to help you deal with the insurance company in settlement negotiations. They know the rules and the potential value. Without an attorney there is no way for you to have the same information.
Finally, when I meet with someone and they do not require representation at the time, I always tell them that if there is a little voice in the back of your mind questioning what is happening in your claim, you probably need to talk to an attorney. Don’t wait too late. It is possible for you to lose rights or the ability to collect certain benefits without even knowing it. Don’t let that happen to you.