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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

By: Andres Gomez  Does Permanently and Totally Disabled mean Permanently and Totally Disabled? As you know, Permanent and Totally Disabled (“PTD”) is not something that the claimant’s treating physician decides. While the physicians can render their opinion on whether the claimant is PTD, it is ultimately up to the court to determine that. While the

By: Corey Meaux It’s Settlement Season! Now that we are entering the last quarter of 2024, it is time to start thinking about settling some of your older claims. Remember, plaintiffs (and their attorneys) typically like settling claims before Christmas so they can end the year with more cash in their pockets. We recommend reaching

By: Patrick Johnson I swear that we had that video… What do you do when you’re in-store or in-vehicle video captures an accident on video that does not match the claimant’s story, or even better, it captures a lack of a claimed accident? The first thing that you avoid is assuming that the video will

By: Keith Landry DOCUMENT, DOCUMENT, DOCUMENT YOUR CLAIM NOTES AND BE PROACTIVE IN THE PAYMENT (OR NON-PAYMENT) OF BENEFITS 23:1201. Time, place of payment; failure to pay timely; failure to authorize; penalties and attorney fees 23:1201(F)(2) This Subsection shall not apply if the claim is reasonably controverted or if such nonpayment results from conditions over

By: Michael Parker The issue of whether someone injured in Texas (or any other state) can assert a claim under the Louisiana Compensation Act (Act) is one that occurs very frequently and as our society continues to be more and more mobile with work duties taking employees to many unexpected places this issue will continue

By: Charles Taylor Matthews An employer has the right to select their own treating physician to provide a Second Medical Opinion to counter the opinion of a claimant’s chosen physician. However, can an employer also choose their own physical therapist to conduct a Functional Capacity Examination? To understand this issue, it’s crucial to first grasp

By: Meghan Gomez There are many things in the law that sit within a sort of gray area—especially in Louisiana workers’ compensation. Often times, the questions you pose to us are met with responses like, “It depends” or “If the court would interpret the law this way, then….”.  The issues of prescription (i.e., the timeframe