Reasons for an Injured Employee to Hire an Attorney in Louisiana Workers Compensation

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When to Hire an Attorney in Louisiana Workers Compensation

Most injured workers will benefit greatly from representation by a qualified Louisiana workers compensation attorney.

Really, the only time when an injured employee doesn't need to hire a Louisiana workers compensation attorney is when the worker's injuries are very minor, require little or no time off from work, and fully and without doubt resolve themselves very quickly.

So for example, if an employee were to twist an ankle at work, but the ankle healed within one week and only required two days off of work, then this employee likely does not need to hire a workers compensation attorney.

However, if an employee's injury is more severe, then this employee should likely hire a workers compensation attorney since a Louisiana workers compensation attorney will be able to secure the worker's full benefits and maximize a settlement.

Given the 20% limit on workers compensation attorney's fees in Louisiana, the benefits of legal representation far outlay the costs for almost every injured employee.

Sadly, most injured employees wait too long before hiring an attorney.

It is never a good idea for an injured employee to wait until he or she "needs" an attorney, as by that time, the employee's rights have likely already been reduced, and the employee's claim value already diminished.

During the time before an employee hires an attorney, the insurance company is likely devaluing the employee's claim, and on the road to denial by stripping away the rights of the injured employee.  

For example, besides simply delaying an employee's claim, the insurance company will:

    1. Send the employee to the doctor of its choice, not of the employee's choice, which can produce medical records that can drastically limit or eliminate the claim;
    2. Unfairly limit or deny appropriate medical care, often causing permanent negative health and legal effects;
    3. Improperly calculate the number and amount of indemnity payments due to the employee;
    4. Wrongly force or pressure the employee to return to work, which will eliminate indemnity payments and limit medical care going forward;
    5. Insist upon inappropriate vocational rehabilitation, which can irreversibly eliminate indemnity payments to the employee;
    6. Pressure an injured employee into a low-ball settlement, by leveraging against the employee the present financial and medical stress of the employee; and
    7. Falsely claim that its settlement offer is a take-it-or-leave-it offer, even though it is never a take-it-or-leave-it offer.

In short, if an injured employee is not represented by a skilled Louisiana workers compensation attorney, then the employee is not effectively protected by the Louisiana workers compensation laws.

Does An Injured Employee Need an Attorney in Louisiana Workers Compensation?

Calculating the time limits for filing a claim is extremely complicated.  Knowing which forms to file, and when to file them, and how to complete them, is also very complicated.

But above all, an employee representing himself or herself in the Louisiana workers compensation court system - against the insurance company's team lawyers - is next to impossible.  

Given the 20% limit on workers compensation attorney's fees in Louisiana, almost every injured employee should strongly consider hiring a qualified attorney to represent him or her in the claim.  The benefits of legal representation far outlay the costs.

However, one of the biggest mistakes that employees make is waiting too long to hire a workers compensation attorney.  

By that time, the insurance company has likely already diminished, limited, or extinguished many of the employee's legal rights, and thus devalued the employee's claim.

Contrary to what the insurance company wants the employee to believe, the insurance company will not treat the employee better if the employee doesn't hire a lawyer, the insurance company will treat the employee worse (and often much much worse).

Important Considerations in Hiring a Workers Compensation Attorney

Any injured worker should strongly consider the following:

  • The primary goal of the workers compensation insurance companies is to maximize profit.  Thus the insurance companies are much more interested in their profits than in paying injured workers the benefits they deserve.
  • Both the employer and the workers compensation insurance company will have lawyers working for them. The primary goal of the lawyers of the employer and the insurance company is to have the workers compensation insurance company pay as little as possible for the injured employee's claim.  That is their job, if they do not do their job they will be fired.
  • The workers compensation insurance company will have insurance adjusters working for them. The primary goal of these adjusters is to pay as little as possible for the injured employee's claim.  That is their job, if they do not do their job they will be fired.
  • Once the employee notifies the employer of the accident and injury, the employee will have to directly work with and directly deal with the insurance company's claims adjuster, if the injured employee does not hire an attorney. 
  • The insurance adjuster will run the claim of the injured employee. The adjuster decides which benefits the injured employee will receive, and which benefits the injured employee will not receive.  The adjuster will not advise the injured employee of his or her rights, and the adjuster will not advise the injured employee of however to maximize his or her claim.  That is not the adjuster's job; the adjuster's job is to minimize the employee's claim.  This is a zero-sum game: the more the insurance companies pay, the less they keep; the less the insurance companies pay, the more they keep.  So it is extremely important to understand that the adjuster - no matter how nice he or she appears - is NOT on the side of the injured party; the insurance adjuster is on the OPPOSITE side of the injured employee and is working AGAINST the injured employee.
  • Besides minimizing benefits, the insurance adjusters will dedicate as little time and effort as possible to the employee's claim, while trying close the employee's claim as soon as possible for as little as possible.  Again, this is the job that the adjusters were hired to do.  It does not matter if the adjuster is a nice person or appears to be a nice person.  They were hired to do a job, and they will do it or lose their job.  The bottom line is that the insurance adjusters are NOT looking out for the injured employee.
  • Very often, the first and primary concern if the employer is not the health of welfare or its employees, but rather how to keep its workers compensation insurance premiums as low as possible.  And that means not reporting claims, or trying to convince an employee that there was not really an accident, or that there was not really an injury, or that it is not in the employee's best interest to report the accident or injury to the insurance company. 

The Value of Hiring a Workers Compensation Attorney

An experienced qualified Louisiana workers compensation attorney knows exactly how to deal with and handle the workers compensation insurance companies, including their adjusters and their lawyers.  An attorney will make sure the employee receives their workers compensation in a timely and complete manner and will maximize the recovery to the employee.

Finally, when it is time to settle a workers compensation claim, an attorney will almost always recover many times more than an employee will recover, even after considering the attorney's 20% fee.  

For these reasons, despite what the workers compensation insurance companies want the employee to believe, it is almost always in the best interest of an injured employee to hire an attorney.  In particular, the worse the injury and the greater the lost wages, the more it is in the interest of the employee to hire a lawyer as soon as possible.  

It is a huge mistake for any employee who has suffered a serious work-related injury to not hire an experienced workers compensation attorney as soon as possible.  The attorney will handle all the work, and the employee will end up with a much greater financial result, and possibly a much better medical result.

Common Scenarios Where an Injured Employee Should Definitely Hire an Attorney in Louisiana Workers Compensation

Under Louisiana workers compensation law, when a worker is injured on the job, this worker is entitled to benefits including medical care and lost wages.

However, the workers compensation insurance companies frequently and regularly deny an injured employee these benefits, while trying to minimize the employee's settlement.

There exist many, many reasons for an injured worker to hire a Louisiana workers compensation attorney, including the following situations:

    • The employee's injuries are so severe that the employee requires surgery;
    • The employee has a pre-existing injury or condition related to the body part that was injured while at work;
    • The employee has developed an occupational disease due to hazardous common conditions in the workplace;
    • The employee has suffered a developmental or repetitive motion injury at work;
    • The employee's workers compensation claim has been unfairly denied or terminated;
    • The employee's time limits for filing a workers compensation claim might be approaching;
    • The employee is no longer able to maintain a regular job;
    • The employee is unable to return to work at his or her current job, but may someday be able to work in some capacity;
    • The employee is being forced to return to work before the employee is physically ready to do so;
    • The employee suspects that the workers compensation insurance company has hired a private investigator to conduct video surveillance of the employee;
    • The employee has been fired because he or she filed a workers compensation claim;
    • The employer does not have workers compensation insurance;
    • The employer promises to pay for the employee's medical bills out of the employer's own pocket;
    • The workers compensation insurance company is not sending weekly benefit checks on time;
    • The workers compensation insurance company is not approving all necessary medical treatments;
    • The workers compensation insurance company is not paying for all approved medical treatments;
    • The workers compensation insurance company is consistently delaying necessary medical treatments;
    • The workers compensation insurance company is limiting the employee's right to select his or her own doctor;
    • The workers compensation insurance company is preparing a Labor Market Survey;
    • The workers compensation insurance company has calculated the employee's weekly benefit check incorrectly;
    • The workers compensation insurance company has unfairly stopped paying weekly indemnity (lost wage) benefits;
    • The workers compensation insurance company has improperly delayed the employee's weekly benefit check;
    • The workers compensation insurance company has scheduled doctor appointments that are not legally required;
    • The workers compensation insurance company has sent the employee to a company-oriented physician or medical provider;
    • The workers compensation insurance company has sent the employee to vocational rehabilitation;
    • The workers compensation insurance company has hired a private investigator to conduct video surveillance of the employee;
    • The workers compensation insurance company has demanded a recorded statement before paying workers compensation benefits;
    • The workers compensation insurance company has demanded that the employee sign a Choice of Physician form listing the insurance company's doctor;
    • The workers compensation insurance company has demanded that the employee visit with its doctor fro a Second Medical Opinion (SMO);
    • The workers compensation insurance company's nurse case manager is attempting to sit in on the employee's doctor visit;
    • The workers compensation insurance company's nurse case manager is attempting to meet alone with the employee's doctor;
    • The workers compensation insurance company has offered the employee a settlement before or after the employee's case is ready to settle;
    • The workers compensation insurance company has refused to explain how it calculated a settlement offer;
    • The workers compensation insurance company has stated that its settlement offer is a take-it-or-leave-it offer;
    • The employee may have a third party claim or an underlying personal injury claim under which the employee may recover for pain and suffering; and
    • The employee's work-related accident was an automobile accident (in which case the employee may be able to recover for pain and suffering).

If an injured worker finds himself or herself in any of these situations, this injured worker should immediately contact a Louisiana workers compensation attorney

An Injured Employee Should Always Hire an Experienced Workers Compensation Attorney Before a Settlement in Louisiana Workers Compensation

An injured employee should always hire an experienced Louisiana workers compensation attorney to handle his or her settlement.

Not only will the attorney be able to obtain much more money for the employee even after a 20% attorney's fee, but the attorney will handle everything and provide the employee with peace of mind that everything was handled properly in order to maximize the employee's settlement amount.

If an injured employee attempts to settle his or her claim without an attorney, the adjuster for the workers compensation insurance company insurance will almost always undervalue the claim and take advantage of the employee by selling him or her short with an inadequate settlement amount.

An experienced Louisiana workers compensation attorney can maximize the amount that the injured worker will receive in settlement through a number of ways, including:

    1. Timing the settlement properly;
    2. Determining the true value of a claim;
    3. Using skillful negotiation tactics; and
    4. Properly handling a mediation.

So again, for these reasons, an injured employee should always hire an experienced Louisiana workers compensation attorney to handle his or her settlement.

An Attorney Can Maximize a Mediation Opportunity 

The best ways for an injured employee (and ideally the employee's attorney) to prepare for a mediation conference in Louisiana Works compensation are to:

    1. Make sure the injured employee and the employee's attorney know the proper value of the claim;
    2. Make sure that the workers compensation insurance company representative understands the employee's position; and
    3. Make sure that the mediator understands the facts of the claim and the employee's position.

Regarding point #1, information on determining the proper value of a claim can be found here.

Regarding point #2, an employee can make sure that the workers compensation insurance company representative understands the employee's position by having the employee's attorney submit a written settlement demand to the workers compensation insurance company at least several weeks before the mediation.

This settlement demand should include an analysis of all the relevant issues, as well as a specific demand for what the employee is seeking, including a specific monetary figure well above what the employee might actually settle for.

Regarding point #3, an employee can make sure that the mediator understands the facts of the claim and the employee's position by having the employee's attorney submit a confidential position paper to the mediator well in advance of the mediation.

This confidential position paper should include relevant information about the claim, including: 

    1. The employee's age and date of birth;
    2. The employee's average weekly wage;
    3. The date of the accident with the number of weeks benefits paid so far;
    4. A description of the injury with a summary of the employee's medical status;
    5. A summary of the employee's vocational rehabilitative efforts;
    6. The employee's medication names and costs;
    7. The status of any third-party claims or subrogation interests;
    8. The status of any health insurance or health care provider liens; and
    9. The status of any SSDI/Medicare concerns.

It is also very important to provide the mediator with an accurate future value of a claim in order for the mediation to be successful.

An Injured Employee Should Also Always Hire an Experienced Workers Compensation Attorney Before Vocational Rehabilitation in Louisiana Workers Compensation

Despite its stated purpose, vocational rehabilitation is a trap, because the workers compensation insurance company will simply use vocational rehabilitation as a means to reduce or terminate the employee's lost wage benefits (which can be done regardless of whether the employee gets a new job).

To avoid the vocational rehabilitation trap, an injured employee should hire an experienced Louisiana workers compensation attorney to handle his or her entire workers compensation claim.

In fact, the only way for an injured employee really to fight against the insurance company's efforts to reduce or terminate the employee's lost wage benefits is to retain an experienced Louisiana workers compensation attorney to push back against and refute the insurance company's efforts to reduce or terminate the employee's lost wage benefits.

A skilled Louisiana workers compensation attorney can help in defeating the insurance company's efforts to reduce or terminate the employee's lost wage benefits and can prevent the employee from accepting a pre-mature or low-ball settlement as a result of the vocational rehabilitation trap.

The earlier a workers compensation attorney can begin handling an injured employee's claim, the better.

However, an experienced workers compensation attorney's skills can be most effective during the vocational rehabilitation process, and especially effective in refuting the insurance company's Labor Market Survey,

An experienced Louisiana workers compensation attorney can fight back against the insurance company, while assisting the injured employee, by:

    1. Ensuring that the employee's lost wage benefits are being paid in full and on time;
    2. Preparing the employee for the employee's meetings with the vocational rehabilitation counselor;
    3. Accompanying the employee to his or her first meeting with the vocational rehabilitation counselor;
    4. Being present for any interview conducted with the employee by the vocational rehabilitation counselor or the insurance company representative;
    5. Supervising the vocational rehabilitation process to make sure the vocational rehabilitation counselor and the insurance company are complying with the law;
    6. Supervising the vocational rehabilitation process to make sure the vocational rehabilitation counselor and the insurance company are not coercing the employee into giving up benefits;
    7. Instructing the employee on how to properly handle a Functional Capacity Evaluation (FCE);
    8. Challenging the validity of a Labor Market Survey through research and evidence;
    9. Investigating all positions identified by the vocational rehabilitation counselor in a Labor Market Survey;
    10. Refuting the availability and wage rates of jobs listed on a Labor Market Survey;
    11. Challenging whether jobs listed in a Labor Market Survey actually fall within the treating physician's work restrictions;
    12. Challenging whether jobs listed in a Labor Market Survey contain a true and proper job description for the treating physician to review;
    13. Investigating whether the treating physician actually signed off on each job listed in a Labor Market Survey, without additional limitations;
    14. Investigating whether each job listed in a Labor Market Survey actually falls inside of the employee's education, training, and skills;
    15. Determining whether each job listed in a Labor Market Survey actually existed on the date on which the employee was made aware of it; and
    16. Determining whether each job listed in a Labor Market Survey actually is located where it is described, and within 30 miles of the employee.

The bottom line is that vocational rehabilitation is a trap because its real purpose is not to find the injured employee a new job or to provide retraining, but instead merely to give the insurance company the ability to terminate the employee's lost wages (indemnity) benefits. 

So an injured employee should aggressively fight against the insurance company's efforts to reduce or terminate the employee's lost wage benefits, and the best way to do that is with the help of a skilled, experienced Louisiana workers compensation attorney.

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