What Injuries and Illnesses Does Louisiana Workers Compensation Cover?
In the state of Louisiana, workers compensation covers physical injuries that are a result of an on-the-job accident, and covers occupational diseases related to the employment.
An accident is defined by Louisiana law as a sudden, unexpected event that causes “objective findings of an injury.”
Occupational disease is defined by Louisiana law as a disease or illness “characteristic of and peculiar to” a specific position or line of work.
Louisiana workers compensation covers some mental and emotional injuries, but only when these mental and emotional injuries are connected to a serious accident or traumatic event that happened at work.
Additionally, pre-existing conditions are be covered if the condition was aggravated by a work-related accident.
Physical Work Accidents and Injuries
Louisiana law defines a workers compensation accident as "an unexpected or unforeseen actual, identifiable, precipitous event happening suddenly or violently, with or without human fault, and directly producing at the time objective findings of an injury which is more than simply a gradual deterioration or a progressive degeneration."
Therefore, in order to have a workers compensation claim for a work-related accident, an injured employee must have a work-place event that causes “objective findings of an injury.”
However, Louisiana workers compensation does cover some injuries that are caused by repetitive motion. Examples of repetitive motion injuries include lifting, bending, or typing.
Specific Types of Common Work-Related Physical Injuries
Common physical injuries generally covered by Louisiana workers compensation include, but are not limited to:
- Ankle injuries
- Back injuries
- Blood vessel injuries
- Bone injuries
- Brain injuries
- Broken bones
- Bruises and bruising
- Carpal tunnel syndrome
- Chemical burns
- Crushed limbs
- Cuts and lacerations
- Ear injuries and impairment of hearing
- Eye injuries and impairment of vision
- Feet injuries
- Hand injuries
- Head injuries
- Hearing loss or damage
- Heart injuries
- Herniated and slipped disks
- Hip injuries
- Injuries and illnesses caused by toxic exposure to chemicals
- Injuries to extremities
- Joint and orthopedic injuries
- Knee injuries
- Losses of limb
- Muscular injuries
- Neck injuries
- Permanent injuries
- Repetitive motion injuries
- Repetitive use injuries
- Repetitive stress injuries
- Respiratory organ injuries
- Rotator cuff injuries
- Shoulder injuries
- Spinal cord injuries resulting in paralysis, paraplegia or quadriplegia
- Sunstroke in heat prostration
- Tendonitis and tendonosis
- Torn ligaments
- Traumatic brain injuries (TBIs)
- Wrist injuries
Types of Common Work Accidents Producing Physical Injuries
- Animal accidents
- Burn and heat accidents
- Catastrophic work-related accidents
- Cold-exposure accidents
- Construction accidents
- Falling accidents
- Falling from heights accidents
- Falling-object accidents
- Faulty machinery accidents
- Freezing and frostbite accidents
- Hazardous working environment accidents
- Heavy machinery accidents
- Industrial accidents
- In-sufficient training accidents
- Ladder accidents
- Lifting accidents
- Lightning accidents
- Overexertion accidents
- Pile driving and blasting accidents
- Plant and refinery accidents
- Repetitive motion injuries
- Repetitive use injuries
- Safety violation accidents
- Service industry accidents
- Slip and fall accidents
- Trip and fall accidents
- Twisting accidents
- Work-related car accidents
- Violent acts
Mental and Emotional Injuries in Louisiana Workers Compensation
Louisiana workers compensation covers some mental and emotional injuries, but these injuries need to be connected to a serious accident or traumatic event that happened at work.
Such a covered mental injury could be a mental injury that was caused by mental stress, if the mental injury was the result of a sudden, unexpected, and extraordinary stress related to the employment. Or the mental injury could be a mental injury caused by physical injury.
Either way, the mental injury or illness must be diagnosed by a licensed psychiatrist or psychologist.
So essentially, there are two types of mental stress claims: (1) mental injury caused solely by mental stress, and (2) mental injury caused by a physical injury or trauma. Each of these are governed by different rules under Louisiana workers compensation.
However, the Louisiana Supreme Court has clearly held that mental stress and trauma cases are compensable, even without physical injuries or objective symptoms, so long as the cause was stress arising out of employment related issues.
Specific Types of Covered Mental and Emotional InjuriesLouisiana workers compensation generally covered the following mental and emotional injuries:
- Anxiety disorders caused by stressful work environments
- Bipolar disorder
- Post-traumatic stress disorder (PTSD)
- Obsessive-compulsive disorder (OCD)
- Various mental and emotional disability conditions
Occupational Diseases and Illnesses in Louisiana Workers Compensation
Louisiana workers compensation covers some work-related diseases or illnesses, commonly referred to as occupational diseases or occupational illnesses.
Louisiana law defines a workers compensation occupational disease as a disease or illness which is due to causes and conditions characteristic of and peculiar to the particular trade, occupation, process, or employment in which the employee is exposed to such disease.
Therefore, in order to have a workers compensation claim for an occupational disease, the employee must have a disease or illness “characteristic of and peculiar to” a specific position or line of work.
Louisiana workers compensation covers certain occupational disease including injuries due to work-related carpal tunnel syndrome. Louisiana workers compensation also covers an occupational disease or illness that is the direct result of exposure to hazardous or toxic materials in the workplace, which is particularly important to those working in Louisiana's oil and gas or chemical and petrochemical industries.
Unfortunately, Louisiana workers compensation does not cover other types of occupational disease, such as degenerative disc disease, spinal stenosis, arthritis of any type, mental illness, and heart-related or perivascular disease. However, even though these diseases may be excluded from workers comp, they may still have a big impact on the severity of an work-related injury, as well as the time needed to return to work because of an injury.
Also, any occupational disease contracted by an employee while performing work for a particular employer in which he has been engaged for less than twelve months shall be presumed not to have been contracted in the course of and arising out of such employment. However, this presumption can be overcome, though doing so will likely happen during court proceedings.
Specific Types of Covered Occupational Diseases (Common Occupational Diseases)
Louisiana workers compensation generally has covered the following occupational diseases:
- Black lung
- Bright's disease
- Cardiovascular diseases
- Caisson disease
- Diabetic neuritis
- Diseases resulting from contact with poisonous substances
- Diseases resulting from contact with chemicals
- Hearing loss
- Heat stroke
- Immune system disorders
- Inhalations of gas, fumes or dust
- Injuries from chemicals
- Kidney diseases
- Lung diseases
- Mental and emotional disability
- Multilobar ganglia
- Ovarian cysts
- Post-traumatic stress disorder
- Ruptured ulcers
- Typhoid fever
- Ulcers abscesses and felons
Fatal Work Accidents in Louisiana Workers Compensation
Louisiana workers compensation entitles surviving family members of a deceased worker to financial support, if the worker was killed in a work-related accident.
Louisiana law specifically provides worker compensation death benefits, in the form of a percentage of the deceased person's average weekly wage — plus a one-time funeral benefit — to be paid to:
- The deceased worker's spouse living with the worker at the time of the accident and death.
- The deceased worker's children who are under age 18;
- The deceased worker's children who are full-time students in any accredited educational institution and are under the age of 24;
- The deceased worker's children who are physically or mentally incapacitated from earning; and
- Any other individuals who can prove actual dependency on the deceased worker.
Also, if the deceased worker had no dependents, but is survived by biological or adopted children, the children are entitled to a single one-time payment of $75,000.00. This $75,000.00 payment is to be divided between the children equally.
If the deceased worker had no dependents and no biological or adopted children, each surviving parent is entitled to a single one-time payment of $75,000.00.
The payments to the dependents of a deceased workers are computed and divided equally among them on the following basis:
- If the widow or widower alone, then 32.5% of wages;
- If the widow or widower and one child, 46.25% of wages;
- If the widow or widower and two or more children, 65% of wages.
- If one child alone, 32.5% of wages;
- If two children, 46.25% of wages;
- If three or more children, 65% of wages;
- If there are neither widow, widower, nor child, then to the father or mother, 32.5% of wages of the deceased. If there are both father and mother, 65% of wages;
- If there are neither widow, widower, nor child, nor dependent parent entitled to compensation, then to one brother or sister, 32.5% of wages with 11% additional for each brother or sister in excess of one. If other dependents than those enumerated, 32.5% of wages for one, and 11% additional for each such dependent in excess of one, subject to a maximum of 65% of wages for all, regardless of the number of dependents.
The total payment to all dependents may not exceed 65% of average weekly wage or the maximum compensation rate, whichever is lower.
Louisiana workers compensation entitles surviving family members of a deceased worker to receive a lump sum benefit for funeral and burial expenses.
The maximum benefit for funeral and burial expenses is currently $8,500.
But if the reasonable expenses for the burial of an employee are less than $7,500, the difference between such reasonable expenses and $7,500 shall be paid to the heirs of the deceased worker, and such payment shall be in addition to any other benefits paid on behalf of the deceased employee.
Scarring, Disfigurements, and Permanent Injuries 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.
Scarring and disfigurements (such as a loss of limb) are usually classified as Permanent Partial Disability (PPD).
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 one hundred 50 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.
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.
For scarring and disfigurement benefits in Louisiana workers compensation:
- 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.
Therefore, in order to be a compensable permanent partial disability, a scar must render the employee “seriously and permanently disfigured.”
Louisiana workers compensation judges are allowed great discretion in determining the reasonableness of an award for serious and permanent scarring or disfigurement.