Fill and Sign the Blank Release Paid in Full Form

Workers Compensation Claim Workers Compensation Benefit Overview – Louisiana Major Developments: Last major legislation in 2004 (SB899), affected indemnity rates, disability rating, medical treatment, medical-legal disputes, penalties, and apportionment. 2007 legislation affects caps on TD and postsurgical treatments. Indemnity Issues Temporary Total Benefits Current min is $146, max is $546 through August 31, 2009, 7 day waiting period, unlimited benefits, after six weeks of disability, first seven days owed. AWW calculated using average of four full weeks preceding accident. 40 hour presumption, given unless specifically hired for part-time. TTD rate is 2/3 AWW Supplemental Earnings Benefits Only owed if worker unable to earn 90% of pre-injury wage. 520 week cap, including all indemnity benefits paid. Two-thirds of pre-injury wages minus post-injury wages equals benefit rate, subject to max comp rate. Permanent Partial Benefits Scheduled loss in Section 1221(4). Percentage loss of scheduled benefit calculated by taken percentage from total number of weeks for loss of entire body part and corresponding percentage of AWW. Max and min same as TTD. Week to week credit for other benefits “voluntarily paid”. AMA Guidelines in effect. Permanent Total Benefits Same min and max and comp. rate calculation as TTD. Unlimited benefits, retro period same as TTD. Reverse offset if employee is receiving SSD benefits. Fatality Benefits Min and max same as TTD. Death must be causally related and occur within two years of accident. Benefits are calculated based on # of dependants. (Section 1332). Benefits for dependant children expire at age 18 or until 23 if enrolled as a full time student at accredited educational institution. Benefits for dependant spouse (no common-law) expire upon her death or remarriage. Funeral benefits is $7500 Vocational Rehabilitation Employer has a duty to furnish this service. Beneficial to determine value of claim and reduce or eliminate SEB exposure. Settlement Allowed Yes, upon agreement of parties. Waivable (by employee) initial mediation conference and mandatory in-person pre-trial mediation. Cap on benefits, exceptions If employee voluntarily retires, benefits may stop. © 2009 The Travelers Companies, Inc. All rights reserved. C E - 1 0 1 8 9 New 8-09 Page 1 of 3 Medical Issues Initial Choice of Provider Employee and Employer each get one choice in any field or specialty. Must still show medical necessity. Change of Provider Only upon reasonable request by either party. Medical Fee Schedule Yes Managed Care None Utilization Review - All non-emergency hospital admissions must be pre-certified with an appropriate length of stay being assigned. Continued stay review must also be performed on each approved admission. - Either party can file for State Independent Medical Examination by a third physician appointed by the Department of Labor or Hearing Officer if in litigation. Treatment Guidelines None Medical Mileage Reimbursement Rate Ability to Terminate Medical Treatment Settlement Allowed Yes. Reimbursement is at .52 cents Cap on benefits, exceptions None, unless judgment obtained. No limit on medical treatment that is reasonable and necessary. Yes. Other Issues Staff Counsel Waller and Assoc. 3838 N Causeway Ste 3160 Metairie, LA 70161 504-832-7625 Maricle & Associates Three United Plaza Ste 350 8545 United Plaza Blvd, Baton Rouge LA 70809 225-924-9585 Hearings require attorney or claim handler participation Yes. However, attorney handling is strongly recommended. © 2009 The Travelers Companies, Inc. All rights reserved. C E - 1 0 1 8 9 New 8-09 Page 2 of 3 Occupational Diseases Yes. Section 1031.1 “only that disease or illness which is due to causes and conditions characteristic of and peculiar to the particular trade, occupation, process or employment.” Second Injury Fund availability Yes. Must be filed within 52 weeks of first benefit paid. 130 week cap on exposure and $25,000 on medical. Pre-accident disability must merge with disability related to work accident to create a greater disability. Expert opinion required. Other Offset Opportunities Social Security Disability upon declaring P&T. State workers compensation website link: www.laworks.net The Travelers Indemnity Company and its property casualty affiliates One Tower Square Hartford, CT 06183 travelers.com This material does not amend, or otherwise affect, the provisions or coverages of any insurance policy or bond issued by Travelers. It is not a representation that coverage does or does not exist for any particular claim or loss under any such policy or bond. Coverage depends on the facts and circumstances involved in the claim or loss, all applicable policy or bond provisions, and any applicable law. Availability of coverage referenced in this document can depend on underwriting qualifications and state regulations. © 2009 The Travelers© 2009 The Travelers All rights reserved. C Ereserved. C E - 1 08-09 New 8-09 Companies, Inc. Companies, Inc. All rights - 1 0 1 8 9 New 1 8 9 Page 3 of 3 Page 3 of 3