Louisiana Worker's Compensation - Help For Injured Louisiana Workers

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  1. #1
    Join Date
    Aug 2010
    Location
    Louisiana
    Posts
    3

    Default Workers Compensation

    First, Let me tell you, I was hurt a a pryor job and i was on workers compensation because of it. I was released by my doctors, one gave me a full release then amonth later he gave me another full release. 4 months later the pain management doctor gave me a light duty release but i didn't know this until the other day when i looked in my copies of the slttlement records. I thought i was had a full released form both doctors.

    ok, after i got released from the last doctor, i went back to work about 3 months later.

    I applied for a job and on the app. i put left other job because of injury and the company had my employment on hold, no openings to put me to work.

    Now, I got a new job and 3 months after i started i got hurt again. not by my will.

    i reported the injury right after/ same day and asked for an accident report to be made. I didn't go to hospital that day, I Had weekend off and thought injury would pass. Assistant Manager stated the he had to get with Manager about making the accident repot, few days later Manager stated he had to get with his boss.

    Called in to work the monday because of hurting, but on Tuesday I was the opening manager but had the understanding with upper management that if i was still hurting when managers got in, i would go to the ER, assistant manager refused me to leave work. went after work.

    That was the last day i worked.

    They stated to me i had to do everything myself, do accident report, contact employer, contact workers compensation, find doctors for injury.

    after i found the right people to talk to (about a month & a half later) they gotme in contact with WC and after i gave recorded statement to workers' compensation adjuster, they paid me my back benefits, and started paying me my weekly benefits, they sent me to the doctor of my choice. (same doctor i went to for last injury.

    I signed all paper work and release of medical records that WC sent me.

    Well, WC adjuster stopped my benefits about amnth and a half later. (they didn't even send me a later of this, they left it on my answer machine/voice mail).

    They said, they were stopping it because one of the doctor i seen didn't send them my medical records, but they got the rest of them. they said that the medical records didn't have on them, that i told the doctors it was a work related injury,(which i did tell the doctors) but if they can get just one of the medical records had in it that i told the doctors it was a job related injury they would start my benefits back, including the ones that doctor didn't send in yet.

    Now, they finally got those medical records from that doctor (court order), and right there on the front page, it stated how i got hurt and the place i got hurt. that should have been enough right there.

    Well, about a month after recieving the medical records, WC denied my claim. Finally got a letter stating it was denied but no reason why. Finally got reason through email after i bugged them enough for the reason. Here it is: "After reviewing all medical records, and your prior work comp injury, you had a pre-existing medical condition to the same body parts. Therefore, your claim will remain denied as a pre-existing condition".

    Now, I filed a 1008 Form, "Disputed Claim For Compsation", with the Louisianas' (OWCA) Workers Compensation Office.

    Now, i found some violations that my adjuster and employer made with respect to my workers compsation claim.

    1) the Injury/Illness Report, " Form 1007, Employer Report of Injury/Illness", was not filed with the (OWCA) until about 3 months later. They has 10 days from Injury/Illness to report this to the (OWCA). that about 2 and 3/4 months late. I even think it was filled out when i got in touch with workers compensation about a month and a half after my injury/Illness.

    2) My adjustor didn't file the, 1002 form, Notice of Payment, with the (OWCA). You have 10 days to file this form after the firt payment of benefits is mailed to injuried party to the (OWCA). It's been 9 and a half months sense that first payment and it has yet to be filed with the (OWCA).

    3) My adjustor didn't file another, 1002 form, Notice of Payment, with the (OWCA). You have 10 days to file this form after the last payment, (stopped Payment) of benefits is paid to injuried party, to the (OWCA). It's been 7 months and a little bet sense then and that form has yet to be filed with the (OWCA).

    Now, does anyone know. Can Workers Compensation adjustors/company stop benefits, medical care, medinice, and test (MRI's) from the Injuried party without sending notice or filing forms of such to the (OWCA).

    Thank you,
    Free2speak

    What i mean is, Can my adjustor, stop my benefits after they have started paying me, without notifying me by mail or filing form 1002 "Notice of Payment" with the (OWCA).

    Also my ajustor sent me a letter for me to give my foodstamp worker, Charity Hospital worker, for free care, kids medical care worker.

    This is what the letter says:

    Dear To Whom lt May Concern:

    "Please be advised that we are authorized to administer the Workers' Compensation Program for the above named client.

    This letter will confirm that the claimant mentioned above has alleged an on job injury. As a result of this injury we have been paying the claimant as of xx-xx-xx to present $xxx.xx on a weekly basis".

    This is not part of letter.

    Now, it doesn't say anything about it being temp. or that it is still under review and a decision has not been made on this claim, nor does it say it still has a chance to be denied.

    To me, it kind of looks like an award letter

    Thank you,
    Free2speak

  2. #2
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: Workers Compensation

    Looks like all your questions are "is this legal?"... or "can the adjuster stop paying me?".
    First question, you need to talk to an attorney. That's where 'Is this legal" is answered.
    Second... yes, the adjuster can stop paying you. Those decisions are generally based on a Dr, yours or theirs saying you don't need those WC benefits because 1...the injury may not be the responsibility of the employer...either one, or 2, you are stable/MMI and released to go back to work.

    You said the first injury/claim '' I was released by my doctors, one gave me a full release then amonth later he gave me another full release.''
    Did that claim settle...? How ?
    I got a new job and 3 months after i started i got hurt again.
    That would be a new injury/claim. You file the first report of injury with the new ER.
    Reinjury, or aggreviation to a prior injury is a 'new injury' and claim. There would not be ''pre exsisting'' in a WC claim, but it's not unusual for the CA to use this to deny your claim.

    Now you have to go to court to get a judge to order benefits paid. Litigation it's called, and you'll probably need the services of an attorney.

  3. #3
    Join Date
    Aug 2010
    Location
    Louisiana
    Posts
    3

    Default Re: Workers Compensation

    The doctors i've went to, didn't release me to go back to work, the work status report presently on me is "unable to go back to work".

    On my last WC injury, before this job. I was released to go back to work by my doctors. yes, we settled the WC injury case. I didn't have an Attorney. The settlement was called a "compromise lump sum settlement"
    Don't know what the means.

    Now, my adjustor stated to me in an email, this is what she stated: " however, if you would have been truthful with the doctors regarding how your injury took place then we wouldn't be having this conversation".

    Now, to me that sounds like my adjustor is saying that I lied to the doctors that I saw for this injury. So, I went and picked up the medical record from the Emer. Rooms (2) and the doctor that i went to. The records show basicly the same thing and show on them that I even told the doctors of my past injury. there is nothing showing that i was lieing to the doctors.

    Thanks,
    Free2speak

    Also, I had my injury on my job application for this new job and when i went in for the interview the manager and i spoke about the injury. I also stated to him that if they needed the doctors release papers, i would be happy to get them for him. He told me he didn't need them.

    Thanks,
    Free2speak

  4. #4
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: Workers Compensation

    The settlement was called a "compromise lump sum settlement"
    Don't know what the means.
    C&R means you took the cash payment, and released the carrier from ANY further claim for benefits to that injury. That claim is over, done.

    When you are hired for a job, the employer takes you/us "AS IS", there are no pre exsisting conditions in WC. The CA is using this BS to deny the claim. As such, you have to take it to court. To do that, you'll probably need an attorney.

    The best thing at this point is for us to stop discussing this on a message board, and you get on the phone making a few appts to talk to an atty. There are strict time frames for disputing denied claim...you miss it, and you're on your own.

  5. #5
    Join Date
    Aug 2010
    Location
    Louisiana
    Posts
    3

    Default Re: Workers Compensation

    Thanks, for your help

    P.S. I do have an Attorney for about 2 months now.

    He told me a week after i hired him, that he sent out 2 letters to Louisiana(OWCA) and to my workers comp. adjustor. I called my attorney two weeks ago and he never returned my call that week and the next week i called back and he would not be in that week. so, I called my adjustor & the (OWCA) right after and both stated to me that I didn't have an Attorney on their files. My attorney so says he sent it to them a month and a half ago. they should have recieved them.

    Just for my family to live, I had to sell our boat we owned, no liens on it, then, I had to pawn our genarator, used once after Gustav, Now we have our 2006 Chevrolet Uplander for sale on ebay. It's about to get reposessed.

    My doctor was filling out the disablitiy form on it, but my adjustor didn't pay the last 2 doctors visits and they won't fill it out until i pay the bill. Then, I will have to pay to see the doctor because they fill the disablitiy form on my last visit.

    so, when will lose eveything before we know something

    Thanks,
    Free2speak

  6. #6
    Join Date
    Feb 2007
    Location
    Calif
    Posts
    18,045

    Default Re: Workers Compensation

    Make an appt with your atty and sit down face to face to discuss your concerns.
    No one on a message board can really give you any more info that is generic to your situation at best.
    We don't have the files... don't know what your AA has in mind, or what has transpired.
    WC takes time just as any legal/litigation process. Unfortunately, all those other IW's in line ahead of you trying to get a judge to hear their cases are in the same dire circumstance as you and your family.

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