Blog

When an insurance company receives notice of your work-related injury, a claims adjuster will be assigned and often that claims adjuster will seek a statement from you. Most of the time, the statement will be recorded. The statement serves an investigative purpose but could also provide an insurance company with an opportunity to deny your claim.During the course of the statement, the claims adjuster will likely ask you very specific questions regarding the facts of the accident, the injury sustained, and witnesses. The claims adjuster may also ask about any prior accidents, injuries or medical treatment. It is critically important that you answer the questions fully and truthfully. Failure to do so could be used as a basis for your claim being delayed or denied.In some scenarios, multiple body parts are injured, but one body part may stand out as the most significant injury. During this stressful time, you may be focused on the most significant injury and you may mistakenly fail to report the secondary injuries. Failure to mention all of the body parts injured in the accident could result in a situation where the claim is accepted, but the secondary body injuries are denied based upon the information you provided during the recorded statement.During our initial meeting with new clients, we are focused on documenting all injuries. This ensures that all injuries are accurately reported when the recorded statement is given.‍

The Louisiana Workers’ Compensation Act provides that an injured employee is entitled to reimbursement for miles driven to obtain medical treatment. The reimbursement applies to travel to and from your doctor’s appointments, pharmacy visits, physical therapy appointments and others. There is no specific form necessary, but most insurance companies will provide you with a form that they have created. The form will generally contain space for you to report the date of the visit, the healthcare provider visited, and the total miles (round-trip) travelled. If you forget to track the specific mileage on the date of your visit, an alternative is to visit a reputable website to calculate the mileage driven.You can submit a mileage reimbursement request as often as you would like. Generally, most clients submit a mileage reimbursement request monthly, with multiple visits on each form. The insurance company must pay the mileage reimbursement request within 60 days of receipt. We always submit the mileage reimbursement request via facsimile or some other transmission which allows us to prove when the request was submitted. The current reimbursement rate is $0.51 per mile, but the rate changes and the rate is specific to the date of the visit. In other words, if you are submitting old reimbursement requests, the effective reimbursement rate may not be $0.51 per mile.It is very important to ensure the accuracy of the reimbursement request submitted to the insurance company. The particular adjuster assigned to handle your claim often will verify the dates and mileages submitted on your form. If the adjuster believes that you have made a false representation on your mileage reimbursement request, they could allege fraud and seek to have your benefits terminated.

While it is important that you show up for all of your medical appointments, it is just as important that you keep track of what any doctor is reporting to the Louisiana Workers’ Compensation insurance company about your medical condition, your ability to return to work, and any type of treatment you may need in the future.This is an important practice to follow, particularly when the insurance company sends you on an evaluation with a doctor that they choose. When you go to these appointments, the doctor, psychologist, or therapist your employer or your employer’s Workers’ Compensation insurance company has chosen for you should give you a copy of their report when they give a copy to the insurance company. You are entitled to a copy. Unfortunately, if you are unrepresented by an attorney, this is one of those rules that you will likely have to enforce yourself by asking for a copy from the Workers’ Compensation insurance company or the doctor’s, psychologist’s, or therapist’s office.At Mensman Law Firm, we are able to get these records for our clients. It helps us continue to protect their rights.

The question of settlement is a tremendously important consideration. Most simply stated, once you settle your workers’ compensation claim and receive a lump sum payment, the insurance company will no longer pay you any benefits of any sort.We tell our clients that the initial decision to consider settlement is entirely their decision. Once the client decides that it is appropriate to discuss settlement, we schedule a meeting to discuss all of the particulars involved in this evaluation. There are many elements involved and failure to consider all elements is a disservice to the client. That is why it is so vitally important to have an experienced and knowledgeable workers’ compensation attorney on your side.Are you permanently and totally disabled? Do you have a permanent impairment? Do you have any wage earning capacity? How many weeks of benefits are you entitled to? What is the medical exposure on your claim? Are you receiving Social Security Disability Benefits? Supplemental Security Income? Do you have a Medicare card? Do you need a special needs trust? Do you need a professionally administered medicare set aside allocation? Should you consider settlement of indemnity only? Is the insurance company entitled to any credit for any amounts they have previously paid to you?Those are just a few of the many details we discuss with our clients. Once we are satisfied that the client is fully informed and ready to proceed, we prepare an in-depth settlement analysis. From that analysis we prepare a settlement demand which is incredibly specific to the client. We have had tremendous success obtaining settlements for our clients. Those results are directly related to the personalized effort we apply in each case.