Louisiana's system of workers' compensation is compulsory, meaning that employers are required to provide workers' compensation insurance to their employees. Workers' compensation insurance may be provided through private insurance carriers or self-insurance. Waivers may be permitted to exclude certain employees from coverage, including corporate officers and sole proprietors.
Exemptions from coverage may apply to certain employees, including certain low-earning workers, domestic employees working in private homes, and employees of private, unincorporated farms.
Medical Benefits are provided to employees entitled to workers' compensation benefits, with medical care subject to review for medical necessity and utilization.
The employee makes the initial choice of treating physician, with any change of physician subject to approval of the employer or workers' compensation insurance company.
Indemnity benefits are payable to injured workers to help make up for lost income. There is a waiting period of 7 days before a worker is eligible for indemnity benefits, but if the worker's disability lasts more than six weeks indemnity benefits become retroactive to the date of the injury.
Benefits available to injured workers include the following:
Temporary Total Disability (TTD)
Temporary total disability (TTD) benefits are paid to workers who are unable to work due to injury, but who are expected to make full or partial recovery such that they may return to work. Benefits are based upon 2/3 of the worker's average pre-injury weekly wage, subject to a cap, and continue for the duration of the temporary disability. Offsets may apply for Social Security or disability insurance benefits.
Permanent Total Disability (PTD)
When a worker is not expected to recover from a total disability caused by a work-related injury, and as a result suffers a total loss of earning capacity, the worker becomes eligible for permanent total disability (PTD) benefits. In Louisiana PTD benefits are calculated based upon 2/3 of the injured worker's pre-injury weekly wage, and may continue indefinitely. Offsets may apply for Social Security benefits, and for employer-funded retirement or disability benefits.
Permanent Partial Disability (PPD)
Once an injured worker has recovered to the maximum possible extent, the worker may be able to return to employment but nonetheless remain partially disabled, and may potentially qualify for permanent partial disability (PPD) benefits. In Louisiana PPD benefits are determined based on a statutory schedule, utilizing 2/3 of the difference between the injured worker's pre- and post-injury average weekly wage, subject to a cap. Injuries that are not scheduled may be compensable based upon the worker's injury ratings and income differential, and are normally limited to 100 weeks.
Temporary Partial Disability (TPD)
When a worker suffers an injury that limits his ability to return to work, resulting in a reduction of income as a result of reduced hours or wages, the injured worker may be eligible to receive a benefit based on the difference between the worker's pre-injury earnings and their reduced, post-injury earnings. In Lousiana, TPD benefits are paid based upon 2/3 of the difference between the injured worker's pre-injury and post-injury wage, subject to a cap. TPD benefits may be paid for up to 520 weeks.
For some, more serious injuries, workers' compensation indemnity benefits may be paid according to a statutory schedule, instead of following the standard model of the weekly benefit based on the duration of the disability. Scheduled injuries include such injuries as the amputation of an arm, the loss of a dominant hand, the loss of a leg, the loss of a foot, the loss of an eye, or loss of hearing in an ear.
Coverage may be available for cumulative trauma, disfigurement, mental stress and occupational hearing loss.
When a worker dies as the result of a work-related injury, workers' compensation pays additional benefits, including a burial allowance, and benefits for a surviving spouse and dependents. Survivor benefits are calculated based on 46.25% of the worker's average weekly wage, subject to a cap in amount. Benefits may continue for minors until the age of 18, the age of 23 if the dependent is a student, or indefinitely in the event of disability, subject to the benefits cap. Spousal benefits end upon remarriage, with the spouse receiving a two-year lump sum benefit.
Attorney fees are limited by statute to 20% of the award, and are subject to review by the Office of Workers' Compensation.
This article provides a quick overview of the benefits available to injured workers, but the full formulas used for assessment of benefits, coordination of different types of benefits, and assessment of injuries and disability ratings can quickly complicate the determination of benefits. Also, states frequently revise their workers' compensation laws. Most workers who suffer a significant injury or wage loss as the result of a workplace injury will benefit from consulting a workers' compensation lawyer.
The state agency responsible for workers' compensation is:
&exitTitle=Louisiana_Workforce_Commision">Louisiana Workforce Commission
Office of Workers' Compensation
1001 North 23rd Street
P.O. Box 94040
Baton Rouge, LA 70804-9040