Defense Data

Even under the most enlightened management, occasions will arise where the employer is engaged in a dispute with an employee or a health care provider who is treating the employee. The following is an introduction to the procedures and legal issues an employer should know so they can help the adjuster and attorney prepare for [Read More…]

29 U.S.C. Section 2601 et. sea. On February 5, 1993, President Clinton signed the Family and Medical Leave Act of 1993. The Act took effect on August 5, 1993 and will have an impact on all employers with 50 or more employees. Interim rules for interpreting the Act were issued on June 4, 1993. Pertinent [Read More…]

42 U.S.C. Section 12101 et. seq. La. Rev. Stat. 23:1021 et. seq. Employee Medical Questionnaires Prior to the passage of the ADA, many employers required job applicants to complete a medical questionnaire. These medical questionnaires later assisted the employers in documenting the knowledge requirement for a Second Injury Fund claim. However, with the passage of [Read More…]

The Second Injury Fund was created to encourage the hiring and retention in employment of handicapped employees who have a permanent, partial disability. The Second Injury Fund provides relief to employers and insurers from excess liability for compensation and medical benefits when a subsequent injury to such an employee merges with a preexisting permanent physical disability [Read More…]

The Louisiana law granting employers a defense to workers’ compensation claims due to drug or alcohol intoxication [La. Rev. Stat. 23:1081] has become a model for other states seeking to reform their compensation laws. The Louisiana law gives the employer the right to require employees to submit to drug testing if they are injured on [Read More…]

Although most claims are legitimate, many are inflated or fraudulent and should be reviewed for possible fraud. While the appearance of one or more of these indicators does not mean fraud has been committed, IT DOES MEAN THAT THE CLAIM SHOULD BE CLOSELY REVIEWED. Attorney letter dated the day of the incident. New on the [Read More…]

State and Federal law require employers to post certain employment information and notices for their employees in a conspicuous area. Notices required include, but are not limited to, warnings and information concerning unemployment, employment of minors, minimum wage, employment discrimination, Family and Medical Leave Act, and OSHA warnings. The Louisiana Workers’ Compensation Act requires the [Read More…]

Medical Only Claims There is no duty to report these claims to the Office of Workers’ Compensation (OWC). Lost Time Claims The employer must report accidents involving death or lost time to the insurer and the OWC within ten (10) days of actual knowledge that the injury has resulted in death or lost time in [Read More…]

Statutory Provisions: (Accidents) La. Rev. Stat. 23:1209 Medical Benefits Claims for medical benefits are barred by prescription after one (1) year from the date of the accident IF NO MEDICAL BENEFITS HAVE BEEN PAID. In cases in which any medical benefits have been paid, the claim for medical benefits prescribes after three (3) years from [Read More…]

For a moment, let’s imagine that Arnold Schwartzenegger has joined forces with your TPA or insurance company to help you Terminate your SEB claims (not your claimants). What weapons would he use to bring an end to the SEB payments? The following is a checklist of events which the Workers’ Compensation Act [La. Rev. Stat. [Read More…]

SOCIAL SECURITY DISABILITY OFFSET – LA. REV. STAT. 23:1225(A): Requirement: permanent and total disability. Effective date: September 8, 1978. Cost of living increases not included in calculation. Judicial Demand: OWC Calculation: Convert weekly worker’s compensation benefits to monthly: WC x 13 divided by 3 = monthly Biweekly x 6.5 divided by 3 = monthly Semi-monthly [Read More…]