Who Qualifies for a Workers’ Compensation Claim in Lafayette?

According to the Louisiana Workforce Commission (LWCC), most employees, regardless of employment status, qualify for workers’ compensation if they are injured on the job. Qualifying employees can be full-time, part-time, seasonal, adults, or minors. Subcontractors and some independent contractors may be eligible for benefits if their work furthered their employer’s pursuit of business or if they performed “substantial manual labor.” However, certain limitations exist regarding benefits for independent contractors. A workers’ compensation lawyer from our firm can confirm whether you qualify to recover benefits.

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What Injuries Are Covered by Workers’ Compensation?

Louisiana workers’ compensation insurance covers various illnesses and injuries that occur in the workplace. Covered workers’ compensation injuries include, but are not limited to:

  • Back and spinal cord injuries
  • Head and traumatic brain injuries (TBI)
  • Fractured and broken bones
  • Exacerbated pre-existing conditions, such as worsened back pain due to heavy lifting
  • Muscle tears and strains
  • Repetitive motion injuries like carpal tunnel, back strain, and tendinitis
  • Disfigurement, burn injuries, and amputation
  • Punctures, cuts, and lacerations
  • Nerve damage
  • Hearing and vision loss
  • Occupational diseases from exposure to harmful chemicals

Workers’ compensation may cover dog bite injuries in Louisiana under specific circumstances. If an employee is bitten by a dog while performing work-related duties, they may be eligible for workers’ compensation benefits. A Lafayette dog bite lawyer from our team will review your options for financial recovery if you were in this situation.

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Do I Need to Hire a Workers’ Comp Lawyer?

The insurance adjuster may tell you that you don’t need a lawyer, but keep in mind that they have defense attorneys reviewing all of their claims. Insurance companies are out for their best interests, which also means they’ll try to save money in any way possible. This could impact you by limiting your income benefits and access to paid medical care.

Furthermore, many workers’ comp cases are not as straightforward as imagined, so a lawyer may be essential. For example, if it is perceived that an injury occurred while an employee was engaged in personal business or performing certain tasks outside of their scope of work, an employer and their insurance company may try to escape responsibility.

Other parties may be involved, such as an equipment manufacturer or property owner, from whom you could potentially seek compensation.

Due to these and other factors, it is highly advised that you discuss your specific situation with our workers’ comp lawyers in Lafayette, LA.

Common Causes of Workplace Injuries & Fatalities

According to OSHA, the leading causes of workplace fatalities include falls, electrocutions, “caught-in/between” accidents when a person is crushed or stuck between objects, and “struck-by” accidents when a person is struck while positioned between fixed and moving objects.

Some of the most common workplace injuries are caused by trips and slip-and-falls, including slipping on wet or oily floors and falls from roofs or ladders. Other causes include vehicular accidents, falling objects, dangerous contact with equipment, and exposure to hazardous chemicals and environments. In addition, injuries from repetitive movements and heavy lifting are common.

How Do I Make a Claim?

All employers in Louisiana, except those under statutory exemptions, must have workers’ compensation insurance to cover medical expenses and lost wages if an employee gets injured while working, per RS § 1020.1. To claim benefits, you must alert your employer about your workplace injury.

You can also report your injury to the LWCC by completing a First Report of Injury form. Once you submit this form, the claims process will begin. An LWCC claims service agent will respond to your injury report.

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What Benefits Are Part of Workers’ Compensation?

Covering basic living expenses can be challenging when you cannot earn a living. Fortunately, you may find financial relief through your employer’s workers’ compensation coverage. As an injured worker, it’s normal to wonder what benefits you could receive if approved for workers’ compensation. The different types of workers’ compensation benefits you could be entitled to include:

Disability Benefits

Disability benefits describe the compensation you can receive for your lost income. The insurer won’t cover your lost wages entirely, but they will be expected to cover around two-thirds of your weekly pay.

You can often continue to collect disability benefits until you have reached maximum medical improvement (MMI) or can return to work. After that, however, the insurance company can stop your disability benefits at any time. If this happens, you may need a dedicated workers’ compensation attorney to help you get your benefits reinstated.

Medical Benefits

The insurance company should cover all medical expenses related to your work injury. This includes your medical care, along with other expenses.

You should also expect the insurance company to cover your ambulance bills, the cost of your mental health counseling, expenses associated with physical or occupational rehabilitation, co-pays, prescription medication fees, and all of your injury-related medical care in the future. For this reason, you should never accept a lump-sum workers’ compensation settlement offer from the insurance company without first discussing your options with a Lafayette workers’ compensation attorney.

Vocational Rehabilitation Benefits

Vocational rehabilitation benefits may be available if you have permanent injuries. To qualify, your injuries must be so severe that you can no longer continue in the same line of work.

To recover vocational rehabilitation benefits, your comp attorney must show that you must take classes or obtain further job training to re-enter the workforce. The insurance company is supposed to cover these expenses in full.

Other Benefits

In addition to the benefits mentioned above, other benefits may be available depending on your case’s circumstances. For example, you may be entitled to catastrophic injury, death, or other workers’ compensation benefits on a case-by-case basis.

Death benefits, in particular, could cover a loved one’s funeral and burial expenses and provide surviving family members with disability benefits amounting to around two-thirds of the decedent’s average weekly wages.
By discussing your case with a Lafayette workers’ compensation attorney, you can determine which benefits are available to you.

How Can a Lafayette Workers’ Compensation Attorney Help Build Your Claim?

The workers’ compensation process can get confusing, especially if this is your first time filing a claim. This puts you at risk of having your claim denied on a technicality or due to a lack of information.

That’s why our workers’ compensation lawyers are here to help build a strong claim. Our legal team serves clients in Lafayette and other parts of Louisiana, so we understand the state laws that may pertain to your workers’ comp case.

Some of our services for workers’ compensation cases include:

  • Retrieving evidence proving your accident occurred at the workplace or during the course of your duties and verifying the claims in your report.
  • Filling out paperwork and submitting your claim before the applicable deadlines.
  • Communicating with your employer’s workers’ compensation insurer on your behalf.
  • Providing further information to prove the severity of your injury.
  • Attending hearings to petition for your right to receive benefits.
  • Appealing denials of your claim if necessary.

We can also help with other issues that may arise during your case. Our legal team is available for counsel if you have questions about the claims process.

Common Mistakes To Avoid When Filing For Workers’ Compensation

You could make many mistakes that would make it more difficult to get workers’ compensation benefits. Understanding these common pitfalls can help protect your right to benefits.

1

Delayed Reporting Of Injuries

One of the most critical mistakes you can make is waiting too long to report your workplace injury. Louisiana law requires you to notify your employer within 30 days of the accident or injury diagnosis.

Delaying your injury report can give your employer’s insurance company reasons to question the validity of your claim. They may argue that your injury occurred outside of work or that it isn’t as severe as you claim.

2

Poor Documentation Of The Incident

Many workers make the mistake of not keeping detailed records of their workplace accidents and subsequent medical treatment. Take photos of the accident scene and your injuries if possible. Keep copies of all accident reports, medical records, and correspondence related to your claim. Document any witnesses who saw the incident occur.

Make notes about conversations with supervisors, insurance adjusters, and medical providers, including dates, times, and what was discussed. This documentation can become vital if your claim faces challenges.

3

Social Media Missteps

Social media activity can seriously impact your workers’ compensation claim. Insurance companies often monitor claimants’ social media accounts looking for evidence to dispute injuries.

Avoid posting about your accident or injuries on social media platforms. Even innocent posts about daily activities could be taken out of context to suggest your injuries aren’t as severe as claimed. Be cautious about accepting new friend requests during your claim period, as insurance investigators may try to gain access to your private posts.

4

Missing Medical Appointments

Failing to attend scheduled medical appointments or following prescribed treatment plans can jeopardize your workers’ compensation benefits. Insurance companies may interpret missed appointments as evidence that your injuries aren’t serious or that you’re not committed to recovery. They might use this as grounds to terminate or reduce your benefits.

Keep all medical appointments and follow your healthcare provider’s instructions carefully. If you can’t make an appointment, notify the provider immediately and reschedule.

5

Not Understanding Your Rights

Many workers don’t fully understand their rights under Louisiana workers’ compensation law, leading to missed opportunities for benefits. You have the right to:

  • Choose your own physician.
  • Get a second medical opinion.
  • Receive necessary medical treatment.
  • Return to work when medically cleared.
  • Appeal denied claims.

Understanding these rights is crucial for protecting your interests throughout the claims process.

6

Handling Complex Claims Alone

Perhaps the biggest mistake is trying to handle a complex workers’ compensation claim without legal representation. Insurance companies have teams of adjusters and lawyers protecting their interests. Having an experienced Lafayette workers’ compensation attorney on your side can make a significant difference in the outcome of your claim when you’re dealing with:

  • Serious injuries
  • Disputed claims
  • Multiple responsible parties
  • Permanent disability
  • Vocational rehabilitation needs

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When Is Filing a Lawsuit Necessary in a Work Accident Case?

Although workers’ compensation is designed to provide injured employees with the compensation necessary to recover, it also protects employers from personal injury lawsuits. However, in certain situations, filing a lawsuit might be necessary. For instance, if an employer fails to carry coverage, an employee may be eligible to collect compensation through civil action with the help of a personal injury lawyer.

Employees Can Sue Employers for Gross Negligence in Severe Cases

Generally speaking, you cannot sue your employer when you get into a work-related accident, as you are meant to rely on the workers’ compensation system.

However, you can sue your employer in Louisiana if they force you to work in unsafe conditions.

If this situation applies, you can hold your employer liable for injuries and damages you suffer.

You May Be Able to Sue Third Parties Who Contributed to the Accident

If another party contributed to your work-related accident, you could file a personal injury lawsuit against them. These parties can include:

  • Another employee who contributed to causing the accident.
  • A manufacturer of faulty equipment or machinery.
  • A maintenance company that failed to repair equipment or machinery.
  • A government entity.
  • A third party, such as another vehicle driver in a car accident.

If multiple liable parties exist in your case, you could file a personal injury lawsuit while pursuing workers’ compensation through your employer’s insurer. To find out if you can, speak with our workers’ compensation attorneys in Lafayette.

The Statute of Limitations Applies to Personal Injury Cases

After being injured at work, you must file a personal injury lawsuit against a liable party within one year of the injury date. Failure to meet this deadline can result in your case being dismissed. Other factors may affect or extend the statutory deadline attached to your case, such as whether your work-related accident involves a government entity. Our personal injury attorneys can review your claim and tell you exactly how long you have to file your lawsuit.

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How Do Compensatory Damages Differ in Lawsuits Compared to Workers’ Compensation?

Workers’ compensation generally covers your medical bills and a portion of your wages. However, with a personal injury lawsuit, compensation laws allow you to recover additional restitution for the following types of damages:

  • Property damage
  • Permanent disability, including loss of bodily function, vision, or hearing
  • Mental anguish and emotional distress
  • Current and future income loss, including full wages and benefits
  • Reduced earning potential
  • Diminished quality of life
  • Psychological trauma
  • Pain and suffering
  • Inconvenience
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What About Wrongful Death Claims?

Other damages not listed here might also pertain to your case. For example, families filing wrongful death actions may qualify to receive compensation for funeral expenses, loss of consortium, medical debts, and other losses related to losing their loved one.

Our Lafayette wrongful death lawyers will be sensitive to your situation and estimate a fair value for your case. During a free consultation, we can discuss other compensatory damages you may pursue.

There Are Limits on What Employees Can Collect

If you’re planning on filing a claim with or without a workers’ compensation attorney, remember a few things:

No-Fault Compensation

Unlike a personal injury lawsuit, a workers’ comp claim does not require an injured employee to prove fault when pursuing benefits. However, workers who accept workers’ compensation insurance cannot file a lawsuit against their employer.

Compensation Amount

Periodic payments or lump-sum settlements may be insufficient to cover all current and future recovery costs. For example, workers’ compensation typically reimburses an injured employee with only two-thirds of their weekly pay, which may not be enough to cover day-to-day expenses and medical bills.

Disputed or Denied Claims

Workers’ compensation claims can be disputed or denied for several reasons. For instance, an employer could argue that an injury did not occur on the job. In addition, the LWCC requires injured employees to adhere to strict requirements and filing deadlines. Failure to do so could result in denied claims or delayed payments. Expressly, a workers’ comp claim in Lafayette may be denied if the injury was a result of:

  • Willful intent to harm oneself or others
  • Intoxication
  • Unprovoked physical altercation
  • Horseplay

Employees dealing with a denied claim are not without options for legal recourse. However, the appeals process for having your workers’ compensation case reviewed again could take six to nine months.

Contact a Workers’ Compensation Attorney in Lafayette, LA

Workers’ compensation insurance could help you provide for your loved ones as you recover from work-related injuries. However, employees who enter the workers’ comp process without a legal advocate could be susceptible to delays, denials, and disputes.

Whether you need assistance navigating the complexity of filing a claim, have questions about an existing claim, or want to hear about your rights to a lawsuit, we are here to help. One of our workers’ compensation lawyers in Lafayette, LA, has the resources to explore all your options. Contact our legal office at Laborde Earles today to schedule a free consultation.

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