What Injuries and Illnesses Does Workers Compensation Cover?

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In the state of Louisiana, workers compensation covers injuries that are a result of an on-the-job accident, and covers occupational disease related to the employment.  

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 may be covered if the condition was aggravated by a work-related accident.

On-the-Job Accidents

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 sudden, unexpected 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.  But often there is not a clear answer as to whether a repetitive motion injury will be covered under Louisiana workers compensation.  Instead, a fact-specific determination will often be made based on the specific circumstances surrounding the injury.

Mental and Emotional Injuries

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.

Aggravations of Pre-existing Conditions

Louisiana workers compensation covers aggravations of pre-exisiting conditions.  Louisiana law also covers whenever the employee's work accelerates the injury.
 
Again, under Louisiana workers compensation, an "accident" means 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 progressive degeneration.
 

While this language is very specific, Louisiana courts have taken a much broader view of the term "accident."  Specifically, the courts have held that the mere presence of a gradual or deteriorating condition does not, in and of itself, preclude recovery.  Instead, an otherwise healthy employee with a pre-existing condition is entitled to benefits if he or she can prove that his or her work contributed to, aggravated, or accelerated her injury.  In essence, the employer takes his employees as he finds them.

Therefore, in a Louisiana workers compensation aggravation case, the critical factors to look for are:

  • whether the condition was asymptomatic prior to the alleged incident;
  • the sudden onset of symptoms; and
  • and the ability to identify some instigating incident at or during work.

Occupational Disease or Illness

Louisiana workers compensation covers some worker-related diseases or illnesses, commonly referred to as occupational disease 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, you 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.   

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