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All employers across all the States, with a few exceptions, are mandated by law to ensure that they have workers’ compensation insurance. It is a state-regulated insurance that entitles all employees, especially those that are in high risk jobs, to receive medical and lost income compensation in case they are injured while on the job.

Though there are a few exceptions, these exemptions are limited to small companies that do not meet the required number of employees or large companies that have self-insure instead. Failure to comply on the part of employers will result to a possible criminal liability. In New Orleans this is strictly implemented. Here are a few important things that employees have to be aware of.

  • All employers in Louisiana must provide their employees workers’ compensation insurance. They also need to provide proof that they have the financial capability to carry out Louisiana workers’ compensation insurance.
  • There are, however, exemptions to the rule. Employees of residential households are exempt from workers’ compensation insurance. Likewise with performers, artists, and musicians, and all the other workers whose works are related to performing arts.
  • Also included in the exemption are licensed real estate workers doing business in Louisiana.
  • Airline crews who belong to the spraying operations group are also exempted.
  • As an employee, it is not necessary to prove that your employer have done something wrong. Normally, when a person is hurt, it is imperative that the aggrieved party will have to prove that a certain individual caused the injury in one way or anther. However, the law benefits employees in this aspect since it is easy for workers to receive compensation without the need to prove any fault on the part of the employer. All the employee has to do is to prove that he is she has been injured at work.
  • Your employer chooses the medical provider to which you can go for check up, failure to comply would imply that you are forfeiting your compensation claim.
  • Employers are mandated by law to pay all of the employee’s medical bills.
  • Workers’ compensation lawyers are instructed by law to charge a flat-fee rate to the employees. These lawyers are required to work on a contingency fee. Meaning the lawyer will be paid a portion of the amount of the compensation to be received by the patient. This is also a risky business for lawyers. If it case an employee has no means to pay for their services, the lawyer goes unpaid.
  • The Workers Compensation Commission is mandated by law to regulate lawyer fees.

These are merely general information that you ought to be aware of in case you get injured while at work. Having the right information about these things will surely go a long way.

Are you in a position where you are at a loss for steps to take? John Fox Associates would be able to help you with your case. You can visit the website for more information, www.johnfoxassociates.com.

 

If you are in the work force, you should be aware that in case you get injured or ill on the job, you are protected by the worker’s compensation law. The law stipulates that all injured workers are entitled to workers’ compensation benefits should their claim is deemed valid. Thus, worker’s compensation laws in every State are significantly beneficial especially in high risk jobs.

However, before you can make a claim with your employee, you have to seek assistance from compensation lawyers. Check out the following tips to help you when you need to go through the process.

  1. Your medical records are one of the most important documents you need to have. Make sure you have at least three copies of your medical records duly signed by your attending physician. Include if there are any, your test results and your physician’s narrative. Ensure also that you keep your own copy of all the documents.
  2. For your claim to be approved, you’ll need to furnish a detailed medical abstract on how the injury or illness could be related to your job, and whether the incident has caused partial or permanent disability on your part. Include as well how long the treatment will be. Make sure that you attending physician includes all the important details in your medical document.
  3. Make sure that you know the contents of the documents that you are filing. Check them thoroughly to make sure that you have all the pertinent details and documents on hand.
  4. Fraud on the part of the employer or insurer is not a remote possibility. There have been recent cases in other States of fraud and it has been proven in court already. If you suspect that there is such a thing, make a report to the worker’s compensation board.
  5. If you suspect that there are irregularities or improper actions made by the insurer, immediately file a complaint with Louisiana’s Department of Insurance.
  6. Also, assess your working environment. If you have reason to believe that you are being subjected to an unsafe working environment, report immediately to the Occupational Safety and Health Administration.
  7. In the event that you are denied of the benefits that you rightfully deserve, you have the option to refer your case to the State Worker’s Compensation Board to have an administrative hearing.

You need to realize that injuries do happen at work, especially if you are exposed to a high risk job. You have to be aware that any injury or illness that can be traced back with the nature of your job or duties should be compensated. Some of the most common accidents at work are slipping due to poor facilities, system and/or machine malfunction, or injury and illness brought about by toxic wastes. Employers should ensure that their employees are provided with a safe working environment. Anything related to neglect by the employer should also have to be covered.

Employers are required by law to carry out the insurance for their workers in case disability claims are filed. The worker’s compensation law is in effect in all the 50 States. Some employers have taken this for granted, proof of which are the recent fraud cases in other States.

To know more about worker’s compensation or disability claims, it is best to talk to a legal adviser. If you are in Louisiana, contact our attorneys by visiting http://www.johnfoxassociates.com/ or calling toll free number 1-866-994-1912 or 1-504-891-3303. You may also send us an email at johnfoxassociates@cox.net.

The new medical treatment guidelines indicate a significant change in the way the workers’ compensation system works. It has been stated that if the recommended treatment falls within these guidelines the employer or insurance company should automatically approve the claim.On the other hand, if it fails to meet the guidelines set forth by the commission, the employer or insurance firm has the prerogative to deny the claim. The employee can still appeal the denial along with his or her treating physician to the medical director of the Louisiana Workforce Commission.The director can then uphold the denial or approve the treatment procedure based on the facts presented and on his best medical judgment.This decision can still be appealed in court based on the discretion of either the employer or worker.

These set of guidelines have really made the claims process faster and help employees attain immediate and quality medical treatment. At the same time, it has basically made the entire process simpler. It draws a number of cases away from the court, enabling monetary savings for both parties.

According to data, before these medical treatment guidelines were implemented by the Louisiana Workforce Commission, most if not all medical disputes were litigated in court. Not only is this litigation process a lot more expensive, but it also takes a significant amount of time and effort.  On average, a single dispute takes 15 months to be resolved completely.

On contrary, the commission’s medical director has received 98 medical disputes as of September 30, 2011. On average, the disputes were resolved in just 5 days.Compared to appealing the dispute to courts, this is much more practical. As of today, none of the 98 medical disputes have been appealed and the door to appeal has already been closed.

On top of saving money on court litigation, this new set of guidelines has also eliminated other costly procedures such as independent medical exams, court reporters, and second medical opinions. In total, all of these processes would cost $25,000 on average per case and the new guidelines were successful in removing that huge amount.

The Louisiana Workforce Commission Executive Director Curt Eysink says that this new procedure is game-changing and revolutionary in the sense that it shows great results. According to the studies conducted by the commission, the savings and positive results will grow exponentially due to the increase in the number of employees being able to return to their jobs faster.

Even if you have personal health insurance, your employer is still obliged to provide you with decent health insurance benefits. Now, you have health insurances that you presume will cover all your medical expenses. However, if you get injured or ill, chances are neither would process your claim. Why? Because there is an overlapping sphere of responsibility to be addressed by state laws. As per the Louisiana law on workers compensation, your personal health insurance will only come into the scene after your employer’s health insurance denies your claims. This means that your own health insurance policy will only be secondary. It would have been this easy if only all employers would report work-related injuries honestly.

From an employer’s perspective, filing work-related injuries will go against their health insurance policies and these will ultimately affect their premium. An increase in premium means an increase in monthly expenses and therefore a decrease in net gain. As a result, the Louisiana Workers’ Compensation Act is oftentimes violated. Fortunately, advancements in technology have made it possible to verify whether your claim is compensable or non-compensable.  All you need is to make a direct verification through the website of the Louisiana Workforce Commissioner.

When are you considered a victim of unlawful denial of application for claims?
By law, you are entitled to benefits if you sustain any work-related injury. Such benefits come in the form of medical care, disability compensation, rehabilitation services and/or death benefits that are payable to your benefactors in case of your demise. There are also instances when you are given a lump sum settlement, granted that it has been included in your contract. A lump sum settlement means that the employer will pay for the value of the current claim and if you accept it, you will no longer be entitled to other future benefits.

In Louisiana, if you think you have been unlawfully denied of claims for work-related injuries, the Louisiana Workforce Commission can help you out. The commission is tasked to handle workers compensation cases by laying the rules for both the employers and the employees. However, let it be clarified that the commission cannot intervene in the case once it has reached court and it also does pay for the workers’ compensation benefits.

Aside from providing compensation, the system also protects you in case you are unjustly terminated for filing a dispute regarding the denial of your workers’ compensation claim. Employers are prohibited from discriminating or terminating employees who exercise their rights under the workers’ compensation system. However, do know that your employer is not entitled to keep the same job open for you once you get back to work. Hence, you might be given another job.

Ideally, any case on workers’ compensation would take six to nine months from the date that it has been filed. But the time frame could be longer if an appeal has been filed. In the event that everything goes well, you should be able to receive your first check fourteen days after you filed for the claim.

Louisiana is at the forefront on the battle for better workers’ compensation laws. Aside from the presence of the Louisiana Workforce Commission, the local businesses are also aware of what they can do for a better  workplace for all employees. In addition, the possibility of obtaining legal advice and relevant information online has greatly benefited the drive for better knowledge on workers’ compensation benefits.

 

 

There are a number of different ways to commit worker’s compensation fraud in Louisiana but the major issue here is that the person is withholding or falsifying information in order to manipulate the system in such a way that favors him or her. One such example is being able to go to work while still receiving worker’s comp benefits. This is already a fraud because the main reason for this benefit is to allow an injured person to still earn while unable to perform his or her duties at work. By being able to do both, it violates the entire purpose of the law.

If indeed injured but are able to perform light duty at work, this should immediately be reported to the employer or the insurer. The failure to report earnings from the light work duty while receiving worker’s compensation benefits is subject to civil and even criminal prosecution. So, intentional or not, the issue should be reported.

Another question that comes to mind regarding worker’s compensation is that, can you receive this benefit and at the same time receive unemployment benefits? In the state of Louisiana, a person is not allowed to get both benefits at the same time unless the person is permanently disabled and is receiving partial disability payments. In the case wherein the person is not at all permanently disabled or is simply injured for the time being but receives both, this again is subject to prosecution.

Although there are several ways to commit this fraud in the state of Louisiana, it’s not easy to get away with it. Most cases are discovered within a short period of time and the offenders face hefty fines and even possible jail sentence if a criminal case is brought against them. This is why there hasn’t been much reports regarding worker’s compensation fraud in the state. This is also the reason why not much studies and research has been done on the topic as well. Despite this however, experts suggest that only 1 to 2% has committed this fraud, knowingly and unknowingly.

The main problem for a regular citizen of Louisiana is that there is a chance they’ll get slammed with a worker’s compensation case if they are not careful. As noted earlier, simply forgetting to report earnings from light work duty can already lead to a criminal case. This is why it is really important to be cautious and know the law. After all, you wouldn’t want to be tagged as a perpetrator of worker’s compensation fraud.

 

Employers are actually required to adhere to the workers’ compensation laws in their state. Generally, employers are obliged to purchase an insurance coverage from a workers’ insurance company to protect employees by ensuring that they will receive sufficient support in case an accident occurs at the workplace or if an employee is unable to return to work immediately due to medical problems.

The set of rules governing the workers’ compensation law varies from state to state, and the only state that allows businesses not to subscribe to this policy is Texas. In Louisiana, it is mandatory for employers to secure workers compensation insurance coverage for their employees. Employers who fail to comply with this policy will be subject to lawsuits from employees whose rights have been violated.  With that being said, here is a list of information that employees in Louisiana should review to obtain detailed guidance on workers’ compensation issues.

The Right to Complain
The Worker’s Compensation Act was adopted in 1912. The main objective of this policy is to provide assurance to workers that if they have been injured in work-related accidents they will receive financial compensation for wage losses and medical expenses, regardless of who is at fault. Filing a workers’ compensation claim is different from any other personal injury lawsuits. The employee does not have to prove any fault on the part of the employer to be covered by a workers’ compensation policy. Employers who do not conform to the workers’ compensation law are subject to criminal prosecution, civil liability, and monetary penalties.  Hence, if the employer violates this law, the employee has the option to file a lawsuit.

Scope of Benefits
An injured worker or employee will only be compensated if the injury is considered work-related. To be recognized as work-related, the condition must arise during the course of employment. Any absence from work must be supported by records prepared by the employee’s treating physician. Once the claim has been approved, the employee will be able to receive benefits based on the extent of the injury.  If the injury is severe enough to prevent the employee from being able to return to his  work after the accident, he or she may be eligible for vocational rehabilitation to overcome an employment disability.

Fraud and Scams
In any type of system, fraud and scams are always a major concern. Workers’ compensation fraud refers to the act of intentionally concealing information in order to receive the compensation amount or prevent an individual from obtaining the benefits. In order to prevent these fraudulent manipulations, the state of Louisiana has initiated anti-fraud schemes such as fraud hotlines and fraud awareness programs.

Need legal advice on your rights as a worker or employers? Visit: http://www.johnfoxassociates.com/ or talk to a legal adviser by calling toll free number 1-866-994-1912 or 1-504-891-3303, or email johnfoxassociates@cox.net.

Every employee should be educated about this. A worker’s compensation is much like an insurance policy. Like just any other kind of insurance, this allows an employee to file a claim should there be a need for it. He will have to be reimbursed for any expenses he may have incurred while undergoing treatment.

The worker’s compensation program differs from an insurance policy in terms of who is paying for the insurance premiums. The employer is the one paying for the employee’s premiums. The worker’s compensation act, by which all States in the US should abide, should be covering for the employee’s work-related injuries and accidents. Since the employers are paying for the premiums, employees have no say or inputs as to what the policy should encompass. The worker’s compensation act is regulated by the State.

The overall system works well, in case you are injured while on the job or gets sick because of the hazards of your duties and responsibilities; you can easily file a worker’s compensation claim with your employer.

How do you file a claim if you are living in Louisiana? If there comes a time for you to claim from your employer, you just need to submit a medical examination form. It is important that you notify your employer if there be changes in your condition. Your employer is required to submit a report to their insurance policy carrier about your illness or injury in 10 days.

In case the employee is found to have faked his condition or intentionally hurt himself for them to be eligible to make claims, their eligibility for worker’s compensation will be forfeited. There are cases also where employees were intoxicated at the time of the accident or injury. The employee will also forfeit should the investigation show that they were injured due to their own doing.

The medical reports will be evaluated for approval or denial. In case the appeal is denied, the employee has the option to appeal the decision. When this happens, most employee lose interest in their claims – the process of filing a claim is already slow, appealing the decision will further cause the employee and their family more stress. Consequently, the employee will continue to be without an income due to the injury plus creating tension between the employee and the employer.

If you are in the work force, you need to be aware of the different laws that protect your rights at work. Make sure to carefully examine and understand the policy by talking to an expert in this matter. If you are in Louisiana, one of the best firms to go to is John Fox and Associates. Call 1-866-994-1912 or 1-504-891-3303, or email johnfoxassociates@cox.net.

Any worker in the New Orleans area in Louisiana ought to learn about the specific clauses that go along with obtaining the workers compensation benefits. If you want to fully enjoy the workers compensation benefits that you deserve, make sure that you understand the grounds for the termination.

First off, it is possible to terminate your benefits even if you have an existing and active medical care. The employer is also not required to seek approval from the Louisiana Office of Workers Compensation prior to terminating your benefits. Hence, it is part of the employees’ responsibility to ensure that all of the requirements to the insurance are met to keep receiving these benefits and prevent the account from being terminated. One of the most basic requirements to ensuring that you can enjoy your workers compensation benefit is to attend regular medical appointments.

All employees should educate themselves about their rights as governed by the Louisiana workers compensation laws. One instance that you should take cognizance of is the possibility of your benefits being terminated solely by judging the result of your medical examination obtained for second medical opinion. In case the result from the doctor’s report indicates that you are fit enough to go back to work, they have the means to access that report so that they can decline to give you the benefits, even if your primary physician recommends that you not report for work yet.

Hence, an employee would normally ask one question: how do you respond in this situation, or prevent it from happening in the first place? There are several options available for you during such instances. You can begin by negotiating the reinstatement of your benefits, in case the insurance company threatens to terminate it. Or, you can request that another independent medical examination be conducted to assess the legitimate status of your health condition.

Filing a claim directly to the Louisiana Office of Workers Compensation is also a good measure. Make sure that when you do this, you should obtain additional medical evidence before you file the claim to further support the claim you have made. If nothing else works, and in case you were forced to return to work, demonstrate your restricted capacity to make them see about your limitations.

All employees are advised to pay heed to one very important rule to prevent termination of employment benefits, even though your employer might not be forced to seek the approval of the Louisiana Office of Workers Compensation prior to removing all of your benefits due to an injury or illness acquired from work. There is judicial approval that must be fulfilled by the insurance company before they can officially and legally terminate your benefits. The judicial approval is needed in cases wherein you failed to submit a medical examination report performed by a physician that was selected for you by the insurance company or your employer. Failing to attend a medical appointment with the said physician is not enough grounds for terminating your benefits. In case that happens, it is best that you speak to a legal adviser to help you deal with the situation in the proper legal manner. If you are in Louisiana, you can seek legal advice from experienced attorneys of John Fox and Associates. To talk to  1-866-994-1912 or 1-504-891-3303, or email johnfoxassociates@cox.net.

The two sectors that are affected by workers’ compensation laws in Louisiana are on a heated debate. Employers argue that Louisiana currently has in effect the longest disability duration rate of 9 months. However, from the business perspective, that’s akin to loss of thousands of possible revenue with a full workforce. But the Louisiana Workforce Commission argues that instead of complaining about the current guidelines, private companies should work on bettering their workers’ compensation benefits.

For instance, there should be more firms offering modified employment for injured workers. This means that a worker who is on temporary disability following a work-related injury must be moved to work at a temporary workplace that suits his or her medical condition. If he or she has been previously working out on the field, assigning him or her office tasks would still help the company in achieving its goals. If the principles behind a modified workplace are put in effect, employers could reduce indemnity by up to 70%.

Another aspect of the workers’ compensation worthy of mentioning is the fact that some employers are pushing for reforms in the medical field by limiting the employee’s choice of healthcare provider. Number one, this idea tramples on the patient’s right to choose his or her doctor; and number two, this can be treated as a way of manipulating clinic results and therefore, cheating the employee of workers compensation benefits.

The correctness of medical findings is essential in determining the length of time the employee needs to rest, the nature of treatment to be done and the amount of medical bills that the employer would have to pay. Thus, it is obvious why private companies want to control results by collaborating with select medical practitioners. In order to serve the interests of all employees, the Louisiana government has previously implemented a new treatment guideline.

Under the new guideline, automatic approval of claims should be given to medical care that falls within the insurance guidelines. Automatic approval helps reduce the number of disputes that are filed and pending court decisions. Over time, this new process would benefit both the claimant and the insurance company because they will be saved about 15 months of their time that would otherwise be spent waiting on a court decision.

Further, this new system will save more medical costs because there will be no need for independent medical tests, depositions, and second opinions. Other savings would extend to court reporters’ and attorneys’ fees. However, bear in mind that the automatic approval of claims will only take place after the cause of injury has been undoubtedly linked to the patient’s fulfillment of his or her duties.

And speaking of seeking a direct link, the process of finding the cause should not end with a written answer. There should also be actions involved. If employers were to use the information to create a better and safer workplace, there will be fewer injuries filed and better workflow. If that is the case, Louisiana companies would not have to pay one of the highest premiums in the US.

Any worker in the New Orleans area in Louisiana ought to learn about the specific clauses that go along with obtaining the workers compensation benefits. If you want to fully enjoy the workers compensation benefits that you deserve, make sure that you understand the grounds for the termination.

First off, it is possible to terminate your benefits even if you have an existing and active medical care. The employer is also not required to seek approval from the Louisiana Office of Workers Compensation prior to terminating your benefits. Hence, it is part of the employees’ responsibility to ensure that all of the requirements to the insurance are met to keep receiving these benefits and prevent the account from being terminated. One of the most basic requirements to ensuring that you can enjoy your workers compensation benefit is to attend regular medical appointments.

All employees should educate themselves about their rights as governed by the Louisiana workers compensation laws. One instance that you should take cognizance of is the possibility of your benefits being terminated solely by judging the result of your medical examination obtained for second medical opinion. In case the result from the doctor’s report indicates that you are fit enough to go back to work, they have the means to access that report so that they can decline to give you the benefits, even if your primary physician recommends that you not report for work yet.

Hence, an employee would normally ask one question: how do you respond in this situation, or prevent it from happening in the first place? There are several options available for you during such instances. You can begin by negotiating the reinstatement of your benefits, in case the insurance company threatens to terminate it. Or, you can request that another independent medical examination be conducted to assess the legitimate status of your health condition.

Filing a claim directly to the Louisiana Office of Workers Compensation is also a good measure. Make sure that when you do this, you should obtain additional medical evidence before you file the claim to further support the claim you have made. If nothing else works, and in case you were forced to return to work, demonstrate your restricted capacity to make them see about your limitations.

All employees are advised to pay heed to one very important rule to prevent termination of employment benefits, even though your employer might not be forced to seek the approval of the Louisiana Office of Workers Compensation prior to removing all of your benefits due to an injury or illness acquired from work. There is judicial approval that must be fulfilled by the insurance company before they can officially and legally terminate your benefits.

The judicial approval is needed in cases wherein you failed to submit a medical examination report performed by a physician that was selected for you by the insurance company or your employer. Failing to attend a medical appointment with the said physician is not enough grounds for terminating your benefits. In case that happens, it is best that you speak to a legal adviser to help you deal with the situation in the proper legal manner.

If you are in Louisiana, one of the best firms that specialize in worker’s compensation is John Fox and Associates. To talk to  1-866-994-1912 or 1-504-891-3303, or Email us at johnfoxassociates@cox.net.