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The Workers’ Compensation program is a social compromise in which employers provide insurance coverage for workplace injuries regardless of fault in exchange for employees waiving their right to pursue tort liability. This foundational principle is encapsulated in the “exclusive remedy” doctrine, which dictates that an injured worker must seek workers’ compensation benefits or pursue a […]

Under the Louisiana Workers’ Compensation Act (“LWCA”), the insurer or self-insured employer, as the workers’ compensation payor, is obligated to furnish an injured employee with all medical treatment that is both causally related to the work injury and medically necessary.  And, if the employee, is able to return to work with restrictions, but due to

Planning for Fraud   By: Andres Gomez The question of whether to file fraud under La. R.S. 23:1208 is generally very fact specific and individualized to each case. It would be impossible to go over all of the different issues that would apply to fraud in an email blast. However, there are certain items that

New Mileage Rates for 2025   By: Corey Meaux It’s that time of the year again! Please be advised that the IRS has provided new mileage reimbursement rates for 2025. As of January 1, 2025, rates have increased to $0.70 per mile. This means that you will pay $0.70 per mile for any mileage reimbursement

Navigating Choice of Physician Challenges: Emergency Room Treatment and Beyond   By: Keith Landry We have had all sorts of scenarios arise in the choice of physician issues. One recent issue was treatment by an orthopedicist at the emergency room. The claimant then had follow-up treatment with that orthopedist. Then, you received a choice of

Approval of Multiple Office Visits Under the Medical Treatment Guidelines   By: Michael Parker The Medical Treatment Guidelines have a provision where once a doctor obtains approval for routine maintenance visits, sometimes referred to as continuity of care, the doctor does not have to submit a new 1010 for each subsequent office visit.  The rule

Understanding Solidary Liability in Workers’ Compensation Claims: Contribution Between Successive Employers and Insurers   By: Charles Taylor Matthews In workers’ compensation law, when an employee’s injury results from a combination of accidents involving different employers or insurers, the concept of solidary liability comes into play. Under Louisiana law, successive employers and their insurers may be

1010s – Proceed with Caution By: Andres Gomez We are seeing providers increasingly attempting to circumvent the Reimbursement Schedule with the 1010 process. It is important to be on the lookout for some of these red flags to avoid potential issues later on with the payment of the treatment: CPT Codes – WE are seeing

“Go directly to jail. Do not collect indemnity (and medical)” By: Patrick Johnson While it is a rare circumstance, what you do with a claimant who is incarcerated but otherwise entitled to indemnity does occasionally arise. In what may be a shock to some who see everything in Louisiana as benefiting the employee, there are

What happens when an accident goes unwitnessed? By: Charles Taylor Matthews As attorneys and claims adjusters know, workers’ compensation operates under a no-fault system, meaning that workers do not need to prove fault to receive benefits. However, unwitnessed accidents can present significant challenges, both legally and practically, for employers, insurers, and injured workers. While there