Who Is Covered By Workers’ Compensation Law?

Who Is Covered By Workers Compensation Law

Workers’ compensation is a legal remedy whereby an employee who is injured on the job may be entitled to certain benefits. The benefits can include medical care for the injury, indemnity wage benefits, vocational rehabilitation services, or death benefits. These benefits are the obligation of the employer and are paid directly to the employee by the employer or its workers’ compensation insurer. Every employer, unless statutorily exempted, is responsible for the medical care and the payment of indemnity wage benefits to any employee who is injured while in the course and scope of his or her employment.

Employers are required to have workers’ compensation insurance or to be approved to self-insure by the state. Most employees in Louisiana are covered from the first day they start employment. Employees may be full-time, part-time, seasonal, or even minors to be covered under worker’s compensation protection. Subcontractors and certain independent contractors may be considered employees if they are involved in the pursuit of the employer’s trade, business or occupation or if they are performing substantial manual labor in the course of the work.

The law does contain some limited exemptions, however: domestic employees, most real estate salespersons, uncompensated officers and directors of certain non-profit organizations, and public officials are specifically exempted. Most volunteer workers would also not be entitled to workers’ compensation benefits.

Within 10 days of actual knowledge of an on the job injury resulting in death or lost time in excess of one week, the employer must report the injury to their insurer on a Form LWC-WC IA-1 (First Report of Injury or Illness). The insurer will then submit the report to the Office of Workers’ Compensation Administration (OWCA). Any employer that fails to report such an injury to its workers’ compensation insurer or to the OWCA is subject to a penalty for failure to do so. You are still required to provide the employer with a notice of the incident within 30 days after the date of injury or death in order to qualify for workers compensation.

What Injuries Are Covered By The Workers’ Compensation Law?

The law covers both mental and physical injuries from either accidents or occupational diseases. However, a mental injury must be the result of a physical injury or of a sudden, unexpected and extraordinary stress related to the employment and in either case must be proved by clear and convincing evidence.

An accident is defined by the Louisiana Workers’ Compensation Act as an unexpected or unforeseen actual, identifiable, precipitous event happening suddenly or violently. This can be 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.

An occupational disease is defined by the Louisiana Workers’ Compensation Act as only that 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. The event causing the injury must arise out of and be within the course and scope of the employee’s employment.

Generally, the fault of the employer or employees will not affect the compensability of an injury; however, no compensation may be allowed if the injury was caused by the employee’s willful intention to injure himself/herself or others; or by the injured employee’s intoxication at the time of the injury. An employee may also not be entitled to benefits if he is the aggressor in an unprovoked physical altercation. The employee may not be entitled to benefits if it is determined that he/she was a participant in “horseplay” at the time that the injury occurred.

If you have been involved in an on the job accident and require the legal assistance of an experienced workers’ compensation attorney, please contact Fischer & Procell today for a free consultation.