What Is and Isn’t Covered by Workers’ Compensation?

Louisiana Revised Statutes (RS) § 1021 explains what is and isn’t covered by workers’ compensation. Injuries covered by workers’ compensation are those that occur on-the-job that cause the employee to stop working and recover. They may be a physical injury or illness brought on by some event or exposure as they performed their duties. They may debilitate the employee fully or partially. In more general terms, an injury may be covered if it occurs during the normal course of your work. Injuries may not be covered if they occurred because you were intoxicated, were the aggressor in a physical altercation, or were engaged in activities that were not part of your job and which caused your injuries.

A lawyer may assess the circumstances of your on-the-job injury and advise you as to whether you could be eligible for workers’ compensation benefits.

Conditions Which May Be Covered by Workers’ Compensation

The Louisiana Workforce Commission (LWC) details several of the general rules governing what is and isn’t covered by workers’ compensation. The LWC states that, in general, workers’ compensation covers any accidental injuries or illnesses that affect the mind or body. However, making such determinations may not be as straightforward as it may seem.

A workplace injury or illness may be covered by workers’ compensation if:

• The injury occurred during the normal course of your job.
• The injury occurred because of extraordinary work-related circumstances that were out of your control, such as an object falling on you.
• The illness was the result of conditions you experienced during the normal course of your employment, whether it occurred suddenly or over time.

Trauma that negatively affects your mental health could be covered, but you may have to prove that the mental injury you have experienced was the result of stress. Your lawyer will handle the process of gathering evidence and other elements that can prove your workplace injury is one that should be covered by workers’ compensation insurance.

What Is Not Covered by Workers’ Compensation

Just as important as the injuries and illnesses covered by workers’ compensation are the circumstances that may disqualify you from workers’ compensation benefits. Injuries that may not be covered by workers’ compensation include:

• Those that occurred while you were intoxicated or under the influence of one or more drugs
• Those that occurred during circumstances that were not directly part of your job
• Those that stem from a physical altercation in which you were the aggressor

It may be difficult for your employer or their insurance company to prove that your on-the-job injury was the result of some disqualifying circumstance, but they may attempt to do so, nonetheless. Hiring a lawyer could help protect you from claims that your on-the-job injury or illness is not covered by workers’ compensation.

The Nature of Your Injury Could Affect Your Benefits

Your lawyer will collect and review all the information available regarding your injury and the circumstances that led to your injury. They may then determine the nature of your injury as it pertains to workers’ compensation benefits.

The LWC explains the specific disability categories which may be relevant to your workers’ compensation claim. They include:

• Temporary Total Disability (TTD), which includes conditions that prevent you from working completely, but that you are expected to recover from in time
• Permanent Total Disability (PTD), which includes conditions that prevent you from working on a permanent basis
• Permanent Partial Disability (PPD), which may cause you to work in a reduced capacity on a permanent basis

The specific designation that your injury or illness receives may have some effect on your benefit amount. Your lawyer will fight to ensure that your injury or illness is designated accurately.

Your Lawyer Will Be Your Advocate

You may hire a lawyer as soon as possible after your workplace injury occurs, as certain aspects of your workers’ compensation claim may be time-sensitive. Your employer will need to report your injury to their insurance company within ten days, and a lawyer can work so that you have done everything possible to maintain eligibility for benefits.

Some general services of a lawyer include:

• Helping you report your injuries to appropriate parties
• Monitoring the progress of any workers’ compensation claim that your employer files
• Filing a Form LWC-WC-1008 in case your employer or their insurance company disputes any aspect of your claim
• Gathering evidence of your injury-causing circumstances and documentation of your injuries
• Determining how much workers’ compensation you should be entitled to
• Filing any necessary appeals

A lawyer will defend your rights and fight for the benefits that you deserve.

Call Us Today

A workers’ compensation lawyer will handle your claim while you focus on recovery. Call Laborde Earles Injury Lawyers today at (337) 777-7777 for more details about how we will fight for the compensation that you deserve.