One of the most common questions about workers’ compensation is: when will my benefits start and how much will I receive? The answer depends on a number of factors, including when the benefits are approved and the extent of your injuries.
Below, the Baton Rouge workers’ compensation attorneys at Simien & Simien explain how these and other factors determine how your workers’ compensation benefits are paid.
If you were injured on the job, we may be able to help you file a workers’ compensation claim. We can evaluate your situation during a free initial consultation. We work on a contingency fee basis, so we only collect legal fees if you are compensated.
One of the main factors in determining how much compensation you receive and when you begin receiving it is the type of benefits you qualify for. There are several different types:
If your workers’ compensation claim is approved, your employer or its insurance company is responsible for paying all medical expenses that are approved as medically necessary, including travel to doctor’s visits and other locations to seek treatment.
If the provider uses electronic billing, the employer or its insurance company must pay these expenses within 30 days of receiving notice of them. If the provider uses paper billing, these expenses must be paid within 60 days. However, you must obtain pre-approval for medical services that will exceed $750 or include non-emergency hospitalization.
If there are opposing medical opinions regarding your injuries or ability to return to work, the Office of Workers’ Compensation Administration (OWCA) will schedule an independent medical examination. The independent medical examiner will examine you and review your medical records before rendering a decision. Your employer is required to pay the costs of this examination.
If you qualify for this benefit, the amount you receive will be equal to two-thirds of your average weekly wage, up to a maximum amount set by law. The average weekly wage is typically calculated based on your earnings in the month before the accident.
Workers who suffer a covered injury may be able to receive Supplemental Earnings Benefits if they can return to work but cannot earn a minimum of 90 percent of their previous wages. These benefits are equal to two-thirds of the difference between your average monthly wages before the injury and the average amount you are able to earn after the injury.
If the injury is considered catastrophic, the injured worker may be paid a one-time lump sum of $50,000. The following injuries are considered catastrophic under Louisiana workers’ compensation laws:
If an injured employee dies within two years of the last treatment of a job-related accident, his surviving spouse and dependent children may be able to receive weekly indemnity benefits. However, if there are no surviving children or spouse, a one-time death benefit of $75,000 may be paid to the worker’s parents. Additionally, the workers’ compensation policy should pay reasonable burial expenses up to $8,500.
The timing of the first benefit payment is based on the type of benefits you are eligible to receive. Temporary Total Disability, Permanent Total Disability and death benefits must be paid on the 14th day after the employer becomes aware of the injury or death.
Typically, the first week of the injury is not compensated unless a disability stems from the injury for two or more weeks after the date of the accident. Therefore, if you suffer an injury that causes you to miss eleven days of work, you will only be paid for the last four days of lost wages. However, if you suffer an injury that causes you to miss 16 days, you should be compensated for all 16 days.
Supplemental Earnings Benefits are paid on a monthly basis in most cases. These benefits are payable for a maximum of ten years.
Louisiana’s Workers’ Compensation Act prohibits employees from receiving workers’ compensation benefits at the same time that they receive unemployment benefits. Additionally, if a worker is approved for Social Security disability benefits, Social Security retirement or disability benefits through an employer-provided plan, his or her workers’ compensation benefits may be reduced. The rate of reduction is determined on a case-by-case basis.
If you were injured at work, you may be entitled to compensation to cover your accident-related medical expenses and a portion of your lost income.
However, the process for obtaining workers’ compensation can be complicated and tough to manage on your own. If your claim is denied, you could be in for a lengthy appeals process while you are dealing with your injury.
You should strongly consider working with an experienced lawyer throughout the process. For nearly 30 years, the attorneys at Simien & Simien have helped injury victims in Louisiana recover fair compensation.
We can review your claim for free to determine if workers’ compensation benefits may be available in your case. We work on a contingency fee basis and only get paid for our services if your claim is approved.