How does workers’ compensation work?

What is workers’ compensation? 

When you experience a job-related injury, workers’ compensation is your safety net. Often referred to as “workers’ comp,” workers’ compensation is an insurance program that provides financial and medical support for your injury.  

While it may sound like a benefit for employees, its goal is to be mutually beneficial for employees and their employers. Workers’ compensation acts as a no-fault system, where injured workers receive help regardless of fault.  

You may be wondering how employers benefit from offering workers’ compensation. By offering workers’ compensation, companies mitigate the risk of an employee suing them for their job-related injury.  

This may sound like a win-win situation—but in most cases, it is not. Employers and their insurance companies continue to protect their best interests at the expense of the injured workers. 

What is workers’ compensation? 

When you experience a job-related injury, workers’ compensation is your safety net. Often referred to as “workers’ comp,” workers’ compensation is an insurance program that provides financial and medical support for your injury.  

While it may sound like a benefit for employees, its goal is to be mutually beneficial for employees and their employers. Workers’ compensation acts as a no-fault system, where injured workers receive help regardless of fault.  

You may be wondering how employers benefit from offering workers’ compensation. By offering workers’ compensation, companies mitigate the risk of an employee suing them for their job-related injury.  

This may sound like a win-win situation—but in most cases, it is not. Employers and their insurance companies continue to protect their best interests at the expense of the injured workers. 

What is included in workers’ compensation? 

In the best-case scenario, workers’ compensation offers well-rounded support. In Louisiana, workers’ compensation benefits include weekly payments and medical care.  

According to Louisiana Workers‘ Compensation Law, you are eligible for various benefits. These benefits include money for missed work, medical treatment, expense reimbursement, and payment for earning less. 

The job of this insurance package is to support your recovery, allowing you to get back on your feet. 

Medical Support

Workers’ compensation offers financial coverage of medical treatment and rehabilitation for job-related injuries or illnesses. It covers the following services. 

• Hospital stays 
• Doctor appointments 
• Prescription medications 
• Physical therapy 
• Medical equipment 

Replacement of Lost Wages

A job-related injury can render you unable to work and receive income. Luckily, workers’ compensation allows you to receive a portion of your lost wages. This compensation usually equates to a set percentage of your expected, regular income. 

Vocational Support

In some cases, a job-related injury or illness can prevent you from returning to your line of work. Workers’ compensation coverage may allow you to learn new skills or find alternative employment through vocational rehabilitation.  

Disability Coverage

Whether you suffer a temporary or permanent disability due to your work-related injury, workers’ compensation can help. Disability benefits can range from partial to total coverage. These options include the following: 

• Temporary Total Disability (TTD) 
• Supplemental Earnings Benefits (SEB) for partial disability  
• Permanent Total Disability (PTD) 
• Permanent Partial Disability (PPD) 

Death Benefits

There are devastating events that may lead to an employee’s death. In these instances, workers’ compensation can provide support to surviving dependents or beneficiaries. 

Legal Protection for Employers

Workers’ compensation provides many benefits for employees. However, it’s advantageous for employers to offer workers’ comp as it reduces the likelihood of an employee lawsuit.  

Workers’ compensation, however, does not completely protect the employer if intentional harm occurs. 

Requirements for Employers

Workers’ compensation is a form of coverage required by law. To stay compliant, employers must not only offer workers’ comp but also: 

• Report any injuries or illnesses that take place  
• Complete all required forms for claims 
• Adhere to the claims process if an injury or illness occurs

What is the process for a workers’ compensation claim?

When you experience a job-related injury, you must follow a series of steps to start your claim. Below we’ve outlined a typical process. 

Rest assured that you do not have to navigate these steps alone. A team experienced in workers’ compensation can help you along the way, weathering any difficulties for you.  

Prioritize Health and Safety

A job-related injury or illness can pose significant risk to your health and wellbeing. The first and most important step is to seek medical attention when an event occurs. When seeking medical attention, you must inform your healthcare team that the injury is job-related.  

After you report your injury to your employer, they may ask you to see a physician they recommend. You do not have to accept care by their physician. You have the right to maintain your doctor, and you should ensure that you protect your interests, not your employers. 

Contact a Workers’ Compensation Attorney

Before or immediately after you report your injury or illness to your employer and their insurance company, contact an attorney. The insurance company of your employer will pressure you to make a statement, which could be detrimental to your case.  

Don’t make a statement. Instead, contact an attorney first.  

Report the Injury or Illness to the Employer

You must report workplace injuries or illnesses as soon as possible. You typically have 30 days to report your injury. 

Be sure to get a copy of your accident report. The information provided in this report will be important when submitting your insurance claim.  

Note: It’s not enough to tell your employer about your injury or illness. Stay on top of your employer to ensure the workers’ compensation process has officially begun.  

Begin the Claims Process 

Your employer and their workers’ compensation carrier will have forms for your claim. You must accurately fill out these claims and submit them as soon as possible. 

It’s important to be thorough, providing details including: 

• Type of injury or illness 
• Date and time of injury or illness 
• Witnesses present for the injury or illness 

It’s important to consult with an attorney when you start your claims process. You shouldn’t have to track down information on your own. At Workers’ Compensation, LLC, we can take this off your plate for more positive outcomes. 

Submit the Workers’ Compensation Claim

Once you complete the form, you must save copies for your records. Then, you must follow instructions for submitting all paperwork. You do not have to navigate claim submissions on your own. An experienced attorney can ensure you take the required steps.  

Keep in mind that insurance companies don’t view employees as people. They view you as a risk. Although an adjuster may seem friendly, their goal is to spend as little on you as possible. 

Seek Thorough Medical Evaluations

It’s important that you continue to seek medical treatment as prescribed by your doctor. Remember that you do not have to accept evaluations or treatment by the doctor recommended by the insurance company. 

Wait for Claim Approval

The insurance company will review the claim after the customer submits it and will determine how to proceed. They may approve or require additional investigation.  

Begin Receiving Workers’ Comp Benefits

The best-case scenario is that the claim will be approved and you will begin receiving your benefits. However, disputes often arise.  

Recover and Return to Work

If the injury or illness is properly treated, you may receive clearance to return to work. You may need accommodations or restrictions, and you should discuss them with your employer before returning to work. 

However, if the injury renders you unable to return to your previous work, vocational rehabilitation may be offered. This program can help you develop new skills for a different line of work. 

Resolve Claim Disputes or Disagreements

The previous steps outline the best-case scenario. However, there are instances where claim disputes arise. You and your attorney must then engage in a resolution process. 

These disagreements are best resolved with a legal team in your corner. 

Appeal Claim Denials

If your claim is denied, you have the right to appeal. A workers’ compensation attorney can help you navigate local laws and fight for adequate compensation. 

When do workers’ compensation payments start? 

Once a claim is approved, payments typically start soon after. However, there is often a waiting period required by laws set by the state or local jurisdiction.  

Timing of payments are dependent on these waiting period laws. The date of first payment can also be impacted by the following factors. 

• Severity of injury or illness 
• Efficiency of the insurance company  
• Local workers’ compensation laws  

Once payment begins, workers may receive retroactive payments covering the waiting period. You can better understand when you can expect to receive your workers’ comp payments by consulting with an attorney. 

For example, you should begin receiving your benefits quickly, including medical care coverage. Reimbursement for lost wages shouldn’t take longer than two weeks.  

How will Workers Compensation, LLC help with my claim? 

If you are unhappy with the support you are receiving after your injury, Workers Compensation, LLC can help. Your employer, insurance company, and medical team may not provide enough to get you back on your feet.  

With our team in your corner, you can expect to be treated like a human being. We provide peace of mind through personalized attention and care. We support Louisiana workers when they are injured on the job, helping them focus on recovery. We’ll help you with the following. 

Reviewing Your Claim

The first step towards getting your life back on track is a free consultation with our team. We’ll review your claim, assess its validity, and provide you with options.  

Submitting a More Thorough Claim

With thousands of cases handled, we know what insurance companies require. We ensure that we submit your claim on time, providing all necessary information and details regarding your injury. 

Furthermore, our team closely collaborates with your medical team to ensure we provide all documentation and evidence. This ensures that you substantiate your claim. 

Handling the Insurance Company

We believe your focus should remain on recovery. Our team will handle all discussions with the insurance company, acting as their point of contact and your protector of rights. Negotiations will be taken off of your shoulders.  

Identifying Your Ideal Compensation Package

Specializing in workers’ compensation allows us to maintain a deep understanding of workers’ comp laws. We can use our knowledge to calculate the maximum compensation you are able to receive. We’ll use this figure to then advocate for the right coverage. 

Negotiating on Your Behalf

Once we have your maximum compensation in mind, we’ll relentlessly advocate for it. The insurance company may attempt to settle, but we will negotiate until we reach a fair deal. We’ve supported clients when the following events occur. 

• Some but not all benefits are granted 
• Weekly payments are sent late 
• Benefits are halted before you’re ready to return to work 
• Pressure from your employer to return to work 
• Medical treatment is being delayed or denied 

Our team can handle all of these situations and more.  

Submitting Claim Appeals

If your claim is denied, we’ll handle the appeals process for you. We won’t stop until you receive what you deserve, submitting all necessary paperwork for the appeals process. We’ll represent your interests in hearings and present evidence to substantiate your claim. 

Protecting Your Rights

We’ll watch out for any circumstances that interfere with your rights. In some cases, we may recommend a third-party personal injury lawsuit if your injury or illness was caused by someone else’s negligence. 

Expediting a Resolution

In a workers’ compensation claim, time is of the essence. We quickly work to ensure we cover medical expenses and lost wages sooner rather than later. 

Litigating for Better Outcomes

Unfortunately, there are cases where negotiation and appeals only go so far. When we can’t resolve through these initial methods, we’ll pursue litigation to secure the benefits you deserve. 

Choose a Team Focused on Workers’ Comp 

Workers’ comp is what we do. With the dedicated team at Workers’ Compensation, LLC, you won’t be treated like a number. We work closely with you starting on day one. Contact us for a free consultation and get one step closer to securing your financial future.