Scarring, Disfigurement and Permanent Disability in Louisiana Workers Compensation
Louisiana workers compensation offers a separate awards for injuries involving permanent scarring or disfigurement.
In most cases, injured workers can receive workers compensation benefits for 100 weeks when scarring or disfigurement occurs, and these benefits expire after that time runs out.
Additionally, if the injured worker suffered a catastrophic injury (such as loss of limb, a severe burn, quadriplegia or paraplegia), this injured worker may be entitled to a lump sum in addition to other benefits.
Recovery for permanent scarring or disfigurement depends on how the the worker's injury is classified under Louisiana workers compensation law.
The four types of disability benefits in Louisiana workers compensation are:
- Temporary Partial Disability (TPD);
- Temporary Total Disability (TTD);
- Permanent Partial Disability (PPD); and
- Permanent Total Disability (PTD).
Scarring and disfigurements (such as a loss of limb) are permanent injuries, since they will never truly heal. That means that scarring and disfigurements are classified as either Permanent Partial Disability (PPD) or Permanent Total Disability (PTD).
However, in Louisiana it is extremely difficult to demonstrate that an injury is a Permanent Total Disability (PTD). To do so, an injured worker must prove that he or she is incapable of performing any work for the rest of his or her life.
For these reasons, scarring and disfigurements (such as a loss of limb) are usually classified as Permanent Partial Disability (PPD).
In fact, an injured worker can receive Permanent Partial Disability (PPD), even if the worker does not miss any work.
Permanent Partial Disability (“PPD”) Benefits in Louisiana Workers Compensation
Permanent Partial Disability benefits in Louisiana workers compensation are paid to an injured worker for loss of use of a body part or for permanent scarring or disfigurement.
In the following cases, workers compensation benefits shall be solely for anatomical loss of use or amputation and shall be paid to the injured worker as follows:
- For the loss of a thumb, 66.67% of wages during 50 weeks.
- For the loss of a first finger, commonly called the index finger, 66.67% of wages during 30 weeks.
- For the loss of any other finger, or a big toe, 66.67%of wages during 20 weeks.
- For the loss of any toe, other than a big toe, 66.67% of wages during 10 weeks.
- For the loss of a hand, 66.67% of wages during 150 weeks.
- For the loss of an arm, 66.67% of wages during 200 weeks.
- For the loss of a foot, 66.67% of wages during 125 weeks.
- For the loss of a leg, 66.67% of wages during 175 weeks.
- For the loss of an eye, 66.67% of wages during 100 weeks.
- Loss of both hands, or both arms, or both feet, or both legs, or both eyes, or one hand and one foot, or any of two thereof, or paraplegia, or quadriplegia shall, in the absence of conclusive proof of a substantial earning capacity, constitute permanent total disability.
- The loss of the first phalanx of the thumb or big toe, or two phalanges of any finger or toe, shall be considered to be equal to the loss of one-half of such member, and the compensation shall be one-half of the amount above specified.
- The loss of more than one phalanx of a thumb, or more than two phalanges of any finger or toe shall be considered as the loss of the entire member; provided, however, that in no case shall the amount received for more than one finger exceed the amount provided in this schedule for the loss of a hand, or the amount received for the loss of more than one toe exceed the amount provided in this schedule for the loss of a foot.
- Amputation between the elbow and the wrist shall be considered as equivalent to the loss of a hand and amputation between the knee and the ankle shall be equivalent to the loss of a foot.
- A permanent total anatomical loss of the use of a member is equivalent to the amputation of the member.
In all these situations listed above (which involve a permanent partial anatomical loss of use or amputation), the injured worker will receive compensation based on the percentage of impairment to the body part.
So if the injured worker has a 50% impairment rating, then the worker will receive 50% of the allowed weekly benefits listed above.
The impairment rating is assigned by the treating physician based on the American Medical Association's “Guides to the Evaluation Permanent Partial Disability.”
However, the employer or the workers compensation insurance company may be entitled to a credit for other disability benefits paid against any amount of Permanent Partial Disability.
Last, the injured will not receive any befits for permanent partial disability unless anatomical loss of use, or amputation, or loss of physical function is greater than twenty-five percent as established in the American Medical Association "Guides to the Evaluation of Permanent Impairment."
Scarring and Disfigurement Benefits in Louisiana Workers Compensation
Aside from the Permanent Partial Disability benefits listed above, other permanent partial disabilities not falling within those injuries are covered as follows under the Louisiana Workers Compensation Act:
In cases not falling within any of the provisions already made, where the employee is seriously and permanently disfigured or suffers a permanent hearing loss solely due to a single traumatic accident, or where the usefulness of the physical function of the respiratory system, gastrointestinal system, or genito-urinary system, as contained within the thoracic or abdominal cavities, is seriously and permanently impaired, compensation not to exceed sixty-six and two-thirds percent of wages for a period not to exceed one hundred weeks may be awarded. In cases where compensation is so awarded, when the disability is susceptible to percentage determination, compensation shall be established in the proportions set forth in Subparagraph (o) of this Paragraph. In cases where compensation is so awarded, when the disability is not susceptible to percentage determination, compensation as is reasonable shall be established in proportion to the compensation hereinabove specifically provided in the cases of specific disability.
Therefore, in order to be a compensable permanent partial disability, a scar must render the employee “seriously and permanently disfigured.”
Typically, most scars are permanent. But often the workers compensation insurance companies argue that scars are not sufficiently serious so as to be compensable.
Louisiana courts have defined disfigurement as “that which impairs or injures the beauty, symmetry, or appearance of a person or thing; that which renders unsightly, misshapen, or imperfect, or deforms in some manner.” Also, a serious disfigurement is a disfigurement “of such a character that it substantially detracts from the appearance of the person disfigured.”
Again, as per Louisiana law on scarring and disfigurement:
- Compensation is not to exceed 66.67% of wages for a period not to exceed 100 weeks may be awarded;
- When the disability is susceptible to percentage determination, compensation shall be established in the proportions detailed above; and
- When the disability is not susceptible to percentage determination, compensation as is reasonable shall be established in proportion to the compensation provided in the cases of specific disability.
And basically, workers compensation judges are allowed great discretion in determining the reasonableness of an award for serious and permanent scarring or disfigurement.