Source: https://www.neworleanslegal.com/filing-a-claim
Timestamp: 2019-12-08 23:04:37
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Filing an OWC Claim in Court Under Louisiana Workers Compensation | New Orleans Legal, LLC
Filing an OWC Claim in Court Under Louisiana Workers Compensation
Basic Time Limits for Filing a Claim in Louisiana Workers Compensation
In Louisiana workers compensation, an injured worker must report his or her accident or injury to the employer within 30 days of the day that it occurs, or else the worker's right to recover workers compensation benefits may expire.
But, there also exist time limits under which an injured employee must take legal action, which means filing a Disputed Claim for Compensation (or Form 1008) with the Louisiana Office of Workers Compensation, if the employee is not receiving full benefits on time.
If the injured employee does not take legal action before these time limits, then the employee will lose his or her rights to make a claim for workers compensation benefits.
The time limits established for making a claim for lost wage benefits or for medical benefits are separate, and the payment for one type of benefit will not interrupt the time limits on the other type of benefit.
Time Limits for Medical Benefits
In Louisiana workers compensation, if no medical benefits have been paid, a worker has one year from the date of the accident to file a claim for medical benefits.
But, if any medical benefits have been paid, an employee has three years from the date of the last payment to file a claim for additional medical treatment.
So, in other words, a claim for medical benefits must be filed within one year of the date of the accident, or within three years of the date that the last payment for medical benefits was made by the workers compensation insurance company, whichever is later.
The voluntary payment of a medical bill after the 3 year prescriptive period has already passed will mean that the time limit will restart for another 3 year period.
Time Limits for Lost Wage (Indemnity) Benefits
If no benefits have been paid, a worker has one year from the date of the accident to file a claim for lost wage (or indemnity) benefits.
If any benefits have been paid, medical or indemnity, then an employee has one year from the date of the last payment of benefits to seek further benefits for Temporary Total Disability (TTD), Permanent Partial Disability (PPD) or Permanent Total Disability (PPD) benefits.
But, if the claim is for Supplemental Earnings Benefits (SEBs), and the employee previously received Temporary Total Disability (TTD), Permanent Partial Disability (PPD) or Permanent Total Disability (PPD) benefits, then the employee has three years from the date of last payment to pursue additional benefits.
But, if the claim is for Supplemental Earnings Benefits (SEBs), and the worker previously received only Supplemental Earnings Benefits (SEBs), then the employee has two years from the date of last payment to pursue additional benefits, if the employee did not receive Supplemental Earnings Benefits (SEBs) for 13 consecutive weeks during the two year period.
Time Limits for Occupational Disease Claims
Under Louisiana workers compensation, a claim for workers compensation benefits that is based not upon a specific accident - but instead is based on a work-related illness or disease (also called an occupational disease) - has a different time limits than a claim based on a specific accident.
Specifically, a Disputed Claim for Compensation (or Form 1008) for an illness or occupational disease must be filed with the Louisiana Office of Workers Compensation within 1 year of whichever of the following happens last:
The disease manifests itself.
The employee knows or has reasonable grounds to believe that the disease is occupationally related.
So again, if an employee suffers from an occupational disease, the employee's claim can be filed for up to one year from the day in which the disease appeared, the day the employee became unable to work because of the disease, or the day the employee learned (or should have learned) that the disease is related to his or her job - whichever happened last.
The "Developing Injury Rule" Exception
Generally speaking, in Louisiana workers compensation, if no benefits have been paid, an injured employee has one year from the date of the accident to file a claim for lost wage benefits or for medical benefits.
However, under the "Developing Injury Rule" exception, when a worker suffers a developmental injury that does not immediately result in disability, this injured worker may file a claim within one year of the date on which the injury develops, but no later than 3 years from the date of the accident.
However, in developmental injury cases, where the proceedings have begun after 2 years from the date of the accident but within 3 years from the date of the work accident, the employee may be entitled to Temporary Total Disability (TTD) benefits for a period not to exceed 6 months and the payment of such Temporary Total Disability (TTD) benefits will interrupt prescription (or time limits) as to any other type of lost wage benefit.
Under Louisiana law, an injury "develops" when it becomes clear that the employee can no longer perform employment duties in a satisfactory manner. Also, an employee who suffers a work-related injury that is immediately apparent, but only later develops into a disability, has a "developmental injury" for prescription purposes.
How to Find a Louisiana Employer's Workers Compensation Insurance Company
Employers in Louisiana have been known - in an attempt to escape a claim - to refuse to provide the injured employee with the name of the employer's workers compensation insurance company.
Or sometimes the employer will falsely claim that it has no workers compensation insurance, or that the injured employee is not covered by his workers compensation insurance, or the employer simply refuses to provide the employee with the name of the employer's Louisiana Workers Compensation insurance.
The best way to directly determine the employer's correct workers compensation insurance company is to simply follow this link.
Also, additional information about the employer's workers compensation insurance company - such as an address or telephone number can be found with the Louisiana Insurance Commissioner by simply following this link.
And, phone numbers for all Louisiana workers compensation insurance companies can be found here.
Must the Employer Have Insurance?
Under Louisiana law, no employer can opt out of workers' compensation coverage.
In other words, under Louisiana law, all employers are required to provide workers compensation insurance for their employees, through one of the following ways:
By obtaining workers compensation insurance from an authorized workers compensation insurance company;
By entering into an agreement with an authorized group self-insurance fund;
By entering into an agreement with an authorized interlocal risk management agency;
By using any combination of life, accident, health, property, casualty or other insurance policies offered through authorized insurance companies (also known as aggregate insurance); or
But the bottom line here is that, under Louisiana law, all employers are required to provide compensation to their injured workers through either some type of policy of workers compensation insurance policy or other satisfactory proof of the employer's financial ability to pay workers compensation benefits owed to an injured worker.
What If the Employer Does Not Have Insurance?
Under Louisiana law, if an employer does not have workers compensation insurance for its employees, then - in addition to being liable for the employee's workers compensation benefits - this employer will face stiff fines and penalties.
Specifically, if an employer does not have workers compensation insurance for its employees, then the employer will have to pay:
Civil penalties of up to $250.00 per employee for the first offense, and not more than $250.00 per employeefor subsequent offenses, not to exceed $10,000.00;
An additional 50% more in the amount of lost wage (indemnity) benefits due to the injured employee;
Criminal penalties, if the employer willfully failed to provide workers compensation, of fines of up to $250.00 per employee per day and/or imprisonment with or without hard labor for not more than one year; and
Criminal penalties, if the employer willfully misrepresents to any person that he has workers compensation coverage, of fines of up to $250.00 per day and/or imprisonment with or without hard labor for no less than one year and no more than ten years.
Additionally, the Office of Workers Compensation may actually close and discontinue a business if it repeatedly fails to provide workers compensation insurance for its employees.
And, in an exception to the regular rule, an injured worker CAN sue his or her employee for tort damages (including for pain and suffering damages), if:
The employer knowingly fails to obtain workers compensation insurance self-insurance certification;
The employer fails to pay a final judgment for sixty days after the parties have exhausted their rights of appeal; and
No other insurance policy or self-insurance policy or contract of workers compensation coverage has paid the benefits due to the injured employee.
Under such a scenario, the employee can file a tort lawsuit against the employer, and recover damages for pain and suffering.
Requesting a Trial in Louisiana Workers Compensation
A workers compensation trial - also know as a workers compensation hearing - is requested by filing a Disputed Claim for Compensation (Form 1008) with the Louisiana Office of Workers Compensation.
But before filing a Disputed Claim for Compensation (Form 1008) in Louisiana workers compensation, certain steps must be taken, and certain procedures must be followed.
First, the employee must be report the accident or injury to the employer within 30 days after the accident or injury occurs or is discovered by the employee.
Then, if the employee's workers compensation claim is denied - either in whole or in part - the employee can file a Disputed Claim for Compensation (Form 1008) with the Louisiana Office of Workers Compensation, which essentially requests a trial.
However, additional deadlines and procedures exist for authorization and appeal of requested medical treatment, and these procedures must be followed for medical claims before an injured employee can file a Disputed Claim for Compensation (Form 1008).
Specifically, Louisiana's "Utilization Review" rules provide the following process and procedures to be followed when an injured employee seeks approval from the workers compensation insurance company to begin or continue treatment beyond the limit of $750:
The medical provider requests authorization for treatment from the workers compensation insurance company, and the insurance company must notify the medical provider within 5 business days of receipt of the request of the action taken on it.
If the request is denied, “any aggrieved party” must file, within 15 calendar days, an appeal by filing a LWC-WC 1009 “Disputed Claim for Medical Treatment” appeal with the OWCA medical director, who then renders a decision “as soon as is practicable” but in no event more than 30 days from the filing of the appeal.
After the issuance of the OWCA medical director's decision, “any party who disagrees” with the decision may then appeal by filing a ‘Disputed Claim for Compensation' Form 1008 within 15 days after the mailing of the decision of the medical director.
This filing of the Form 1008 begins the ordinary legal process for other workers' compensation claims.
A workers' compensation judge then considers the decision by the medical director and may reverse it “when it is shown, by clear and convincing evidence” that the decision of the medical director “was not in accordance with the provisions of this Section.”
So again, if the workers compensation insurance company denies the medical treatment requested by the health care provider, or does not respond within 5 days, the decision can be appealed to the OWC Medical Director by filing a Form LWC-WC 1009 (Disputed Claim for Medical Treatment) within 15 calendar days of the date of denial.
And then, any party who disagrees with the decision of the OWCA Medical Director can seek a review by the workers compensation district Judge by filing a Form LWC-WC 1008 (Disputed Claim for Compensation) with the appropriate OWCA district office within 15 days of the date of which the Medical Director's decision is mailed to the parties.
Pre-Trial Procedures in Louisiana Workers Compensation
After the employee (or ideally the employee's attorney) files the Disputed Claim for Compensation (Form 1008), the workers compensation insurance company then has 15 days after it is served to file an answer, although it may request an extension of up to an additional 10 days.
Additionally, the answer of the workers compensation insurance company may request a preliminary determination hearing, which usually must be held within 90 days.
The workers compensation Judge will issue a preliminary determination within 30 days of the preliminary determination hearing, which the losing party must accept or challenge within 10 days after receipt of the preliminary determination.
If the losing party challenges or fails to comply with the judge's preliminary determination within 10 days, the dispute goes to trial before the workers compensation judge.
Initial Scheduling Telephone Conferences
Typically, a telephone conference is set within 15 days from the date on which the defendant (the workers compensation insurance company) files its answer.
In this telephone conference, the OWC court will select certain deadlines for the claim, such as:
A preliminary determination hearing shall be set within 90 days from the telephone status conference.
The deadline for any discovery shall be 30 days before the preliminary determination hearing.
The parties must exchange evidence 15 days before the hearing, with copies of the exhibits, the exhibit list and memorandum sent to the presiding workers' compensation Judge.
However, the Louisiana Office of Workers Compensation identifies that the following issues may be considered and determined at the scheduling conference:
The necessity or desirability of amendments to pleadings;
Discovery anticipated by the parties;
Deadlines for amendments to pleadings, completion of discovery and scheduling of pretrial motions;
Scheduling of the pretrial conference and the scheduling of a pretrial mediation conference;
Scheduling of the trial;
The need for and scheduling of a pretrial conference; and
A scheduling conference order shall be forwarded to the parties within three days of the telephone status conference.
Mediation is an opportunity for an injured employee to settle his or her disputed issues - or even settle the employee's entire claim - within the Office of Workers Compensation (OWC) system at no cost, before those disputed issues go to trial.
The mediator will start by explaining to the parties why they are there and how the mediation will work. Then, the sides will take turns introducing themselves, and explaining what they are seeking or offering, and why they are seeking or offering that.
Pre-Trial Statements and Pre-Trial Orders
Louisiana law and workers compensation rules require that all issues to be presented at trial, as well as potential witnesses and exhibits, must be listed in each party's Pre-Trial Statement to be presented to the Judge.
Specifically, the Louisiana Office of Workers Compensation requires that the Pre-Trial Statement include the following:
Stipulations agreed to by all parties;
Issues to be litigated;
A list and brief description of all exhibits to be offered at trial. (Exhibits to be used for impeachment or rebuttal need not be included in the list. Proposed stipulations as to exhibit authenticity and/or admissibility shall be noted in the exhibit list);
A list of all witnesses to be called at trial. (The list shall include a short statement as to the nature but not the content of their testimony, and whether the testimony will be live or by deposition. Except for the witnesses listed, no other witnesses may be called to testify except for good cause shown. This requirement shall not apply to impeachment and rebuttal witnesses); and
Outstanding discovery and depositions to be taken.
So the parties should certainly discuss any stipulations - meaning agreements on key issues or facts - prior to submission of their Pre-Trial Statements.
Additionally, preparation of a Pre-Trial Order is required so that the Judge can sign off on the issues, witnesses, exhibits and stipulations to be presented at trial.
Also, a Pre-Trial Conference is an opportunity to present an argument to the Judge, and perhaps receive a prediction about how the Judge will rule on the issues involved, and thereby be provided some guidance from the Judge as to a possible resolution of the issues involved prior to reaching an actual hearing.
The Discovery Process in Louisiana Workers Compensation
Prior to a hearing with an OWC Judge, the parties are permitted to ask questions and obtain information from each other in a process known as discovery.
The discovery process offers a way to investigate a workers compensation claim with the support of legal remedies.
Full discovery is permitted in Louisiana workers compensation claims, which includes:
The taking of depositions;
The propounding of Interrogatories, Requests for Production of Documents, and Requests for Admission; and
The issuance of subpoenas from the OWC.
So, Louisiana law and workers compensation rules permit the workers compensation Judges to issue subpoenas for the personal appearances of witnesses and for the production of records, but the workers compensation Judges can only issue subpoenas after one of the parties has properly requested such.
Nonetheless, the most commonly utilized methods of discovery in workers' compensation, generally, include written discovery (Requests for Admission, Interrogatories, Requests for Production), depositions, and subpoenas.
Also, the formal legal discovery process is extremely useful because it creates legally enforceable obligations.
Medical Records and Testimony
Generally speaking, medical evidence is the most important evidence in a workers compensation claim.
Medical evidence can be properly presented in the following ways:
Certified copies of the medical records/reports of the healthcare provider;
Deposition testimony of the healthcare provider; and
Trial testimony of the healthcare provider.
However, under Louisiana law, neither party may present more than two physicians at where the evidence of any additional physician would be cumulative testimony.
By far, the best and most frequently used manners in which to present medical evidence are to present certified copies of the medical records/reports and certified copies of deposition transcripts of the healthcare provider.
Trial Procedure in Louisiana Workers Compensation
Following the pre-trial and discovery processes, the workers compensation Judge presides over a hearing and renders a decision.
Trial proceedings before the Office of Workers Compensation are generally informal, but professional etiquette and appropriate conduct in a court of law should be exercised at all times.
Louisiana workers compensation trials are a hybrid between an administrative hearing (such as a social security disability hearing or an unemployment hearing) and Louisiana district courts (such as Civil District Court for the Parish of Orleans or Federal District Court).
Practically, this means that the rules of evidence and procedure are "relaxed" for workers compensation trials in Louisiana.
Generally speaking, it takes about 3-6 months from the time that a Disputed Claim for Compensation (Form 1008) is filed until the time that the claim actually goes to trial.
Usually, the only witnesses to testify live and in person at the trial are:
A representative of the employer;
A representative of the insurance company;
Any fact witnesses; and
Any impeachment witnesses.
The record is typically is closed at the end of the trial, though the workers compensation Judges usually allow for post-trial memoranda (or written argument) to be considered.
Whenever the workers compensation Judge does allow or order post­-trial/hearing briefs, the parties shall be allowed a maximum of 15 working days from the conclusion of the trial or final submission of all evidence, whichever occurs latest, to file the briefs.
Trial Judgments and Modifications in Louisiana Workers Compensation
At the conclusion of the trial, but usually only after considering the post-trial memoranda, the workers compensation Judge will render an order, decision, or award as is proper, and the OWC will serve a copy of the order, decision, or award on each party by certified mail.
Typically, the workers compensation Judge will issue an order, decision, or award no later than 45 days after the conclusion of trial, submission of all evidence, or filing of post-trial or hearing briefs, whichever occurs last.
If the workers compensation Judge finds that the trial proceedings have not been brought on a reasonable ground, or that denial of benefits was not based on a reasonable ground, then the Judge shall order the unreasonable party to pay the total cost of the proceedings to the other party.
Once an injured employee has exhausted all his or her appeals, a judgment that denies benefits to the employee is final and can not be pursued any further by the employee.
However, for any other type of workers compensation judgment, the workers compensation Judge has continuing jurisdiction, which means that the Judge can make modifications or changes to that judgment.
In order to have a judgment modified, an injured employee (or even the workers compensation insurance company) must motion the workers compensation court to have a contradictory hearing to decide on a modification, and such a hearing is required to modify a judgment.
Modifications or changes to judgments awarding benefits can occur whenever the Judge finds that those modifications or changes are justified and legal.
But typically, a Judgment will be modified based on a change of conditions or circumstances with the employee or the employee's medical situation, and this modification will result in the increase, decrease, or termination of the benefits previously awarded.
Appeals of OWC District Court Decisions in Louisiana Workers Compensation
After the workers compensation Judge renders an order, decision, or award, either party may appeal to the proper circuit court of appeal for that judicial district.
The party wishing to appeal must file a motion for an order of appeal with the OWC district office (where the trial was held), which will then prepare the record for the appellate court.
Louisiana has five Circuit Courts of Appeal, and these courts have appellate jurisdiction over workers compensation claims, meaning that these Courts of Appeal have the ability to overturn that district's workers compensation Judge.
Appeals from decisions of the Office of Workers Compensation Judges are filed in the Circuit Court of Appeal that has jurisdiction over the workers compensation district.
A workers compensation insurance company who appeals a decision of a workers compensation Judge must secure a bond, and an order for physical therapy or a work hardening program shall not be suspended while an appeal is pending.
Also, appellate courts review OWCA decisions using a "manifest error - clearly wrong" standard of review; in other words, Courts of Appeal will only overturn the workers compensation district Judge if the findings are clearly wrong.
The time limit for filing a suspensive appeal is 30 days, and the time limit for filing a devolutive appeal is 60 days.
Appeals from the Circuit Courts of Appeal are heard by the Louisiana Supreme Court.
However, parties do not have a right of appeal to the Louisiana Supreme Court; instead, a party seeking review by the Louisiana Supreme Court must file a Writ of Certiorari to the Louisiana Supreme Court, and the Louisiana Supreme Court may or may not hear or consider the appeal.
The Louisiana Statutes for Filing Claims in OWC Courts in Louisiana Workers Compensation
The primary Louisiana statutes regarding trials and trial procedure in Louisiana workers compensation courts are La. R.S. 23:1124.1, La. R.S. 23:1201.3, La. R.S. 23:1209, La. R.S. 23:1221, La. R.S. 23:1234, La. R.S. 23:1310.1, La. R.S. 23:1310.3, La. R.S. 23:1310.4, La. R.S. 23:1310.5, La. R.S. 23:1310.7, La. R.S. 23:1310.8, La. R.S. 23:1310.9 and La. R.S. 23:1317, which read as follows:
§1209. Prescription; timeliness of filing; dismissal for want of prosecution
B. Any claim may be filed with the assistant secretary, office of workers' compensation, by delivery or by mail addressed to the office of workers' compensation. The filing of such claims shall be deemed timely when the claim is mailed on or before the prescription date of the claim. If the claim is received by mail on the first legal day following the expiration of the due date, there shall be a rebuttable presumption that the claim was timely filed. In all cases where the presumption does not apply, the timeliness of the mailing shall be shown only by an official United States postmark or by official receipt or certificate from the United States Postal Service made at the time of mailing which indicates the date thereof.
D. When a petition for compensation has been initiated as provided in R.S. 23:1310.3, unless the claimant shall in good faith request a hearing and final determination thereon within five years from the date the petition is initiated, that claim shall be barred as the basis of any claim for compensation under the Worker's Compensation Act and shall be dismissed by the office for want of prosecution, which action shall operate as a final adjudication of the right to claim compensation thereunder.
Amended by Acts 1975, No. 583, §7, eff. Sept. 1, 1975. Acts 1983, 1st Ex. Sess., No. 1, §1, eff. July 1, 1983; Acts 1985, No. 884, §1; Acts 1985, No. 926, §1, eff. Jan. 1, 1986; Acts 1988, No. 938, §1, eff. July 1, 1989; Acts 1989, No. 260, §1, eff. Jan. 1, 1990; Acts 2008, No. 220, §8, eff. June 14, 2008; Acts 2012, No. 783, §1.
§1234. Minors and mental incompetents; rights and privileges, by whom exercised; prescriptions applicable
In case an injured employee is mentally incompetent or a minor or, where death results from the injury, in case any dependent as herein defined is mentally incompetent or a minor at the time when any right, privilege or election accrues to him under this Chapter, his duly qualified curator or tutor, as the case may be, may, in his behalf, claim and exercise such right, privilege or election, and no limitation of time, in this Chapter provided for, shall run, so long as such incompetent or minor has no curator or tutor, as the case may be.
§1310.4. Place hearings to be held
A.(1) At the time a claim is initiated with the assistant secretary, the claimant shall elect the situs of necessary hearings by the workers' compensation judge.
(2) If the claimant is a domiciliary of the state of Louisiana, he shall be required to elect either the judicial district of the parish of his domicile at the time he sustained his injury, the judicial district of the parish where the injury occurred, or the judicial district of the parish of the principal place of business of the employer.
(3) In the event that the claimant is not a domiciliary of the state of Louisiana, the necessary hearings shall be held in the judicial district of the parish of the principal place of business of the employer, provided, that if the injury occurred within the state, the hearings shall be held in the judicial district of the parish where the injury occurred.
(4) In the event the claimant is not a domiciliary of the state of Louisiana and the accident resulting in injury occurred outside the territorial limits of the state, the hearings shall be held in the judicial district of the parish in this state wherein the contract of employment was made or in which the employment was principally localized.
B. After the election has been made as provided above, all future hearings affecting the claimant's case shall be held in the workers' compensation district so designated unless the workers' compensation judge, upon agreement by the claimant and the employer, shall transfer such cause for hearing to any other workers' compensation district agreed upon. In addition, hearings may be held in any workers' compensation district if the workers' compensation judge determines that good cause has been shown.
Acts 1988, No. 938, §2, eff. July 1, 1989; Acts 1989, No. 260, §1, eff. Jan. 1, 1990; Acts 1991, No. 892, §1; Acts 1997, No. 88, §1, eff. June 11, 1997; Acts 2004, No. 341, §1, eff. June 18, 2004.
§1310.5. Hearing and appellate procedures; reported opinions
A.(1) Insofar as may be possible, all the evidence pertaining to each case, except as to noncontested matters, shall be heard by the workers' compensation judge initially assigned to the case. Upon the completion of such hearing or hearings, the workers' compensation judge shall make such order, decision, or award as is proper, just, and equitable in the matter.
(2) Either party feeling aggrieved by such order, decision, or award shall, after receipt by certified mail of the order, decision, or award, have the right to take an appeal to the circuit court of appeal for the judicial district elected by the claimant upon the filing of the petition. The motion and order for appeal shall be filed with the district office assigned to handle the claim, which shall be responsible for preparation of the record for the appellate court.
B. The decision of the workers' compensation judge shall be final unless an appeal is made to the appropriate circuit court of appeal. An appeal which suspends the effect or execution of an appealable judgment or order must be filed within thirty days. An appeal which does not suspend the effect or execution of an appealable judgment or order must be filed within sixty days. The delay for filing an appeal commences to run on the day after the judgment was signed or on the day after the district office has mailed the notice of judgment as required by Louisiana Code of Civil Procedure Article 1913, whichever is later. Motions for new trial shall be entertained in disputes filed under this Chapter. The delay for filing an appeal when a motion for new trial has been filed shall be governed by the Louisiana Code of Civil Procedure.
C. When there has been an award of benefits by the workers' compensation judge, no appeal by an employer shall be entertained by the appellate court unless the employer secures a bond with one or more sureties to be approved by the workers' compensation judge, guaranteeing that the employer will pay the amount of the award rendered therein together with interest thereon as otherwise provided by law, and all costs of the proceeding. The time limits for perfecting the bond shall be as provided in the Code of Civil Procedure, but shall not commence to run against the appellant until the appellant is notified by the workers' compensation judge as to the amount of the bond fixed in accordance with law.
D. When the only controverted issue in a death claim is the determination of proper beneficiaries entitled to receive death benefits, and the competing beneficiaries appeal the decision of the workers' compensation judge, the employer or insurance carrier may pay the proceeds, as they accrue, to the assistant secretary. The assistant secretary shall hold the proceeds in trust in an interest-bearing account during the appellate period and shall distribute the proceeds and interest to the beneficiaries designated in final award or judgment. The employer or insurance carrier shall not be taxed interest or cost on the order of the death claim if payments have been made to the assistant secretary as they accrue.
E.(1) An order for physical therapy or a work hardening program shall not be suspended during the pendency of any appeal.
(2) Regardless of whether the judgment rendered by the workers' compensation judge is in favor of the employer or the employee, when the workers' compensation judge has made a specific finding that further delay for surgery would, more likely than not, result in death, permanent disability, or irreparable injury to the claimant, any appeal of the judgment shall be entitled to preference and priority and handled on an expedited basis. In such cases, the record shall be prepared and filed within fifteen days of the granting of the order of appeal. The court of appeal shall hear the case within thirty days after the filing of the appellee's brief.
F. All workers' compensation decisions of the circuit courts of appeal shall be published opinions. The published opinions in any reporter shall identify the office of workers' compensation district from which the appeal was taken and the identity of the workers' compensation judge who rendered the judgment or award that is the subject of appeal.
Acts 1988, No. 938, §2, eff. July 1, 1989; Acts 1989, No. 26, §1; Acts 1989, No. 260, §1, eff. Jan. 1, 1990; Acts 1989, No. 454, §9, eff. Jan. 1, 1990; Acts 1995, No. 246, §1, eff. June 14, 1995; Acts 1995, No. 348, §1, eff. June 16, 1995; Acts 1995, No. 396, §1; Acts 1997, No. 88, §1, eff. June 11, 1997; Acts 2001, No. 361, §1; Acts 2001, No. 593, §1; Acts 2003, No. 485, §1; Acts 2003, No. 709, §1.
§1310.7. Orders; subpoenas; judgments; enforcement; contempt
A. A workers' compensation judge shall have the power to enforce any order or judgment he shall deem proper which is issued pursuant to the powers and jurisdiction provided for in this Chapter and the Constitution of Louisiana. This power shall not include the authority to order a person confined.
B.(1) Direct contempt in a workers' compensation proceeding shall be as defined in Louisiana Code of Civil Procedure Article 222, except that it shall be committed before or in response to a subpoena or summons of a workers' compensation judge instead of the court. In a case of direct contempt, the workers' compensation judge may assess a civil fine of up to five hundred dollars for each such contempt violation which shall be payable to the Kids Chance Scholarship Fund, Louisiana Bar Foundation.
(2) Constructive contempt in a workers' compensation proceeding shall be as defined in Louisiana Code of Civil Procedure Article 224, except that it shall be concerning the workers' compensation judge and hearing procedures instead of the court. In a case of constructive contempt, the workers' compensation judge may assess a civil fine of up to five hundred dollars for each such contempt violation which shall be payable to the Kids Chance Scholarship Fund, Louisiana Bar Foundation.
(3) In any case where the workers' compensation judge has found a party in direct or constructive contempt, or has imposed sanctions on a party for conduct in connection with the litigation of a claim, the workers' compensation judge shall issue written reasons in connection with said ruling and shall report such findings to the assistantsecretary on a form promulgated by the assistant secretary, within thirty days of the ruling.
C. Workers' compensation judges shall have the authority to issue subpoenas and subpoenas duces tecum as provided in Louisiana Code of Civil Procedure Articles 1351 through 1354. Subpoenas issued pursuant to this Section may be served by certified mail, return receipt requested.
D. Nothing in this Section shall be construed to limit the power of the workers' compensation judge to encourage compliance with and enforcement of his orders by means other than referral to the district courts for contempt proceedings.
Acts 1988, No. 938, §2, eff. July 1, 1989; Acts 1989, No. 260, §1, eff. Jan. 1, 1990; Acts 1992, No. 762, §1; Acts 1993, No. 884, §1; Acts 1995, No. 348, §1, eff. June 16, 1995; Acts 1997, No. 88, §1, eff. June 11, 1997; Acts 2005, No. 257, §1.
§1310.8. Jurisdiction continuing; determining as to final settlement
A.(1) The power and jurisdiction of the workers' compensation judge over each case shall be continuing and he may, upon application by a party and after a contradictory hearing, make such modifications or changes with respect to former findings or orders relating thereto if, in his opinion, it may be justified, including the right to require physical examinations as provided for in R.S. 23:1123; however, upon petition filed by the employer or insurance carrier and the injured employee or other person entitled to compensation under the Workers' Compensation Act, a workers' compensation judge shall have jurisdiction to consider the proposition of whether or not a final settlement may be had between the parties presenting such petition, subject to the provisions of law relating to settlements in workers' compensation cases.
(2) The workers' compensation judge may have a full hearing on the petition, and take testimony of physicians and others relating to the permanency or probable permanency of the injury, and take such other testimony relevant to the subject matter of such petition as the workers' compensation judge may require. The workers' compensation judge may consider such petition and dismiss the same without a hearing if in his judgment the same shall not be set for a hearing.
(3) The expenses of such hearing or investigation, including necessary medical examinations, shall be paid by the employer or insurance carrier, and such expenses may be included in the final award. If the workers' compensation judge decides it is in the best interest of both parties to said petition that a final award be made, a decision shall be rendered accordingly and the workers' compensation judge may make an award that shall be final as to the rights of all parties to said petition and thereafter the workers' compensation judge shall have no jurisdiction over any claim for the injury or any results arising from same. If the workers' compensation judge should decide the case should not be finally settled at the time of the hearing, the petition shall be dismissed without prejudice to either party, and the workers' compensation judge shall have the same jurisdiction over the matter as if said petition had not been filed.
B. Upon the motion of any party in interest, on the ground of a change in conditions, the workers' compensation judge may, after a contradictory hearing, review any award, and, on such review, may make an award ending, diminishing, or increasing the compensation previously awarded, subject to the maximum or minimum provided in the Workers' Compensation Act, and shall state his conclusions of fact and rulings of law, and the assistant secretary shall immediately send to the parties a copy of the award.
C. This Section shall not apply to the calculation of the monthly benefit amount pursuant to R.S. 23:1221(3).
D. A petition to modify a judgment awarding benefits shall be subject to the prescriptive limitations established in R.S. 23:1209.
E. A judgment denying benefits is res judicata after the claimant has exhausted his rights of appeal.
F. An award of temporary total disability benefits may be modified by the filing of a motion for modification with the same court that awarded the benefits and under the same caption and docket number without the necessity of filing a new dispute and appearing at a mediation conference. The court shall expedite the hearing on the modification proceedings in accordance with the procedure established in R.S. 23:1124(B).
Acts 1988, No. 938, §2, eff. July 1, 1989; Acts 1989, No. 260, §1, eff. Jan. 1, 1990; Acts 1989, No. 454, §9, eff. Jan. 1, 1990; Acts 1997, No. 88, §1, eff. June 11, 1997; Acts 1999, No. 323, §1; Acts 2001, No. 1189, §1, eff. June 29, 2001; Acts 2013, No. 337, §1.
§1310.9. Costs
If the workers' compensation judge before which any proceedings for compensation or concerning an award of compensation have been brought, under the Workers' Compensation Act, determines that such proceedings have not been brought on a reasonable ground, or that denial of benefits has not been based on a reasonable ground, the workers' compensation judge shall assess the total cost of the proceedings to the party who has brought them or the party who has unreasonably denied payment of benefits.
Acts 1988, No. 938, §2, eff. July 1, 1989; Acts 1989, No. 260, §1, eff. Jan. 1, 1990; Acts 1997, No. 88, §1, eff. June 11, 1997.
§1317. Hearing on the merits; rules of procedure; effect of judgment; costs; fees of medical witnesses
A. If an answer has been filed within the delays allowed by law or granted by the workers' compensation judge, or if no judgment has been entered as provided in R.S. 23:1316 at the time for hearing or any adjournment thereof, the workers' compensation judge shall hear the evidence that may be presented by each party. Each party shall have the right to be present at any hearing or to appear through an attorney. The workers' compensation judge shall not be bound by technical rules of evidence or procedure other than as herein provided, but all findings of fact must be based upon competent evidence and all compensation payments provided for in this Chapter shall mean and be defined to be for only such injuries as are proven by competent evidence, or for which there are or have been objective conditions or symptoms proven, not within the physical or mental control of the injured employee himself. The workers' compensation judge shall decide the merits of the controversy as equitably, summarily, and simply as may be.
B. Costs may be awarded by the workers' compensation judge, in his discretion, and when so awarded the same may be allowed, taxed, and collected as in other civil proceedings. The fees of expert witnesses shall be reasonable and fixed in the original judgment. The judgment rendered shall have the same force and effect and may be satisfied as a judgment of a district court.
Acts 1983, 1st Ex. Sess., No. 1, §1, eff. July 1, 1983; Acts 1988, No. 938, §1, eff. July 1, 1989; Acts 1989, No. 23, §1, eff. June 15, 1989; Acts 1989, No. 260, §1, eff. Jan. 1, 1990; Acts 1997, No. 88, §1, eff. June 11, 1997; Acts 2004, No. 341, §1, eff. June 18, 2004.