reglab/statecodes huggingface dataset:
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 15 - Drug Testing Programs in Job Related Accident Cases › Section I-1503 - Scientific and Technical Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. Compensation shall not be allowed to the
				  employee who receives personal injury from a job-related accident if the injury
				  was caused by the employee's intoxication. Compensation will not be precluded,
				  however, where the intoxication resulted from activities which were in pursuit
				  of the employer's interest or in which the employer procured the intoxicating
				  beverage or substance and encouraged its use during the employee's work hours.
				  When an employee receives personal injury from an accident arising out of and
				  in the course of his employment, his employer may test the employee for
				  alcohol, and for any drug identified in Schedules I, II, III, IV or V of
				  21 U.S.C.
				  812.
B. Definitions
Aliquot
- a portion of a specimen used for
					 testing.
Confirmatory Test
- a second analytical
					 procedure used to identify the presence of a specific drug or metabolite in a
					 specimen. The confirmatory test must be different in technique and chemical
					 principle from that of the initial test procedure to ensure reliability and
					 accuracy. [At this time gas chromatography/mass spectrometry (GC/MS) is the
					 only authorized confirmation method. Gas chromatography is authorized for
					 confirmation of alcohol (ethanol) concentrations in specimens.]
Initial Test
- a sensitive, rapid, and
					 inexpensive immunoassay screen to eliminate true negative specimens from
					 further consideration.
Intralaboratory Chain of Custody
-
					 procedures used by the laboratory to maintain control and accountability from
					 the receipt of specimens until testing is completed, results reported, and
					 while specimens are in storage.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1081(9).
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 15 - Drug Testing Programs in Job Related Accident Cases › Section I-1505 - Specimen Collection Procedures

Current through Register Vol. 50, No. 6, June 20, 2024
A. Collection Site
1. The collection site is a place where
				  individuals present themselves for the purpose of providing urine, blood,
				  breath or other specimens to be analyzed for abuse of drugs, including alcohol.
				  The site must possess all necessary personnel, materials, equipment,
				  facilities, and supervision to provide for the collection, security, temporary
				  storage, and transportation (shipping) of specimens to a drug testing
				  laboratory.
2. Procedures must
				  provide for the collection site to be secure. Proper chain of custody
				  procedures must be executed by collectors when handling specimens. The handling
				  and transportation of specimens from one authorized individual or place to
				  another must always be accomplished through the use of chain of custody
				  procedures.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 15 - Drug Testing Programs in Job Related Accident Cases › Section I-1507 - Laboratory Analysis Procedures

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Receiving/Preparation
1. The laboratory must
				  be secured at all times; procedures to control access by unauthorized personnel
				  shall be in place. Upon receipt of specimens, accession personnel shall inspect
				  packages for evidence of possible tampering and compare information on specimen
				  containers with that on chain of custody forms. Any discrepancies shall be
				  properly noted and described. Any direct evidence of tampering shall be
				  reported immediately to the employer and shall also be noted on the chain of
				  custody form which must accompany all specimens during laboratory
				  possession.
2. Specimen containers
				  and original chain of custody forms will normally be retained within the
				  accession area until all analyses have been completed. Aliquots and
				  intralaboratory chain of custody forms shall be used by laboratory personnel
				  for conducting the initial and confirmatory tests.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 15 - Drug Testing Programs in Job Related Accident Cases › Section I-1509 - Reporting and Review of Results

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  An essential part of the drug testing program is the final review of results. A
				  positive test result does not automatically identify an employee as a drug
				  abuser. A Medical Review Officer (MRO) with a detailed knowledge of possible
				  alternate medical explanations must be involved in the review process.
1.
Medical Review Officer
-a
				  licensed physician responsible for receiving laboratory results generated by
				  employer or testing entities' drug testing program who has knowledge of
				  substance abuse disorders and has appropriate medical training to interpret and
				  evaluate an individual's positive test result together with his medical history
				  and any other relevant biomedical information. The role of the MRO is to review
				  and interpret positive test results obtained through the office's testing
				  program. In the conduct of this responsibility, the MRO should undertake the
				  examination of alternate medical explanations for a positive test result. This
				  action could include conducting of employee medical interviews, review of
				  employee medical history, or the review of any other relevant biomedical
				  factors.
2. The MRO is required to
				  review all medical records made available by the tested employee when a
				  confirmed positive test could have resulted from legally prescribed medication.
				  After the MRO has reviewed the pertinent information and the laboratory
				  assessment is verified, the results are to be forwarded to the employer and the
				  Office of Workers' Compensation. Should any question arise as to the veracity
				  of a positive test result, the MRO is authorized to order a reanalysis of the
				  original sample. If the MRO determines there is a legitimate medical
				  explanation for the positive test result, MRO may deem that the result is
				  consistent with legal drug use, and take no further action.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1701 - Financial Compliance

Current through Register Vol. 50, No. 6, June 20, 2024
A. Every
				  employer subject to the jurisdiction of the Louisiana Workers' Compensation Act
				  shall file with the Office of Workers' Compensation proof of its compliance
				  with the workers' compensation insurance provision of the Act
				  R.S.
				  23:1168. A notice from the insurer, on a form
				  developed by the director, certifying compliance will be accepted as proof. The
				  form must be received within 30 days of the policy's effective date.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1168 and Act 938 of 1988 Regular
					 Session.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1703 - Termination of Coverage by Insurance Carriers; Employer to Obtain New Coverage

Current through Register Vol. 50, No. 6, June 20, 2024
A. Any insurance
				  carrier desiring to cancel or terminate an insurance policy before the
				  expiration date stated in the policy shall be required to give 20 days prior
				  notice thereof in writing to the Office of Workers' Compensation, the employer,
				  and the Commissioner of Insurance.
B. The employer whose policy has been
				  canceled or terminated shall, on or before the twentieth day after receipt of
				  the notice of cancellation or termination, file evidence with the Office of
				  Workers' Compensation of having obtained other coverage in accordance with the
				  Act. Failure on the part of the employer to file such evidence within 20 days
				  shall be considered by the Office of Workers' Compensation as prima facie
				  evidence of violation and subject the employer to the penalties prescribed
				  under
				  R.S.
				  23:1170 of the Act (effective July 1,
				  1989).
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1168 of Act 938 of 1988 Regular
					 Session.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1707 - Conditions for Obtaining Certificate of Self-Insurance

Current through Register Vol. 50, No. 6, June 20, 2024
A. The director shall prescribe aggregate and
				  specific excess insurance coverage and/or surety bonds or the deposit of other
				  security as a condition of obtaining a certificate of self-insurance.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1291,
					 R.S.
					 23:1168, and Act 938 of 1988 Regular
					 Session.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1711 - Filing of Reports- Penalties

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Each individual self-insurer shall file annual statements of financial
				  condition with the Office of Workers' Compensation in a form acceptable to the
				  Office of Workers' Compensation on or before May 1 of each year, except that
				  fiscal year end filers shall file annual statements of financial condition four
				  months after fiscal year end. These statements must be prepared by a certified
				  public accountant and must be certified audits, except that an individual
				  self-insurer may be allowed to submit another type of statement acceptable to
				  the Office of Workers' Compensation. An additional security deposit or surety
				  bond may be required in the absence of a certified audit.
B. Summary loss data will be filed with the
				  Office of Workers' Compensation by each individual self-insurer on or before
				  February 1 of each year. This report will include but not be limited to the
				  name of the employer, name of the injured employee, claim number, date of
				  accident, nature of injury, amounts paid on the claim for indemnity or medical
				  and outstanding reserves, if any. This report will cover all incurred losses
				  for the prior year as well as any pending claims where any type payment is made
				  or reserve is pending.
C. In
				  addition to the above required annual reports, the Office of Workers'
				  Compensation may require interim financial statements, summary loss data,
				  payroll audits, or such other reports or statements upon reasonable
				  notice.
D. This rule places the
				  responsibility on the employers, groups and service companies to perform their
				  prescribed duties and responsibilities without prompting from the office.
				  Failure or refusal of any self-insurer to file the required report with the
				  office within the prescribed time period shall subject the self-insurer to a
				  civil penalty in such amount as the office may prescribe, not to exceed $100
				  per infraction per day, and may be sufficient cause for the revocation of the
				  self-insurer privilege. Failure to pay such penalty within 30 days of the
				  notification may be considered additional cause for revocation of the
				  self-insurer privilege.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1168 of Act 938 of 1988 Regular
					 Session.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1713 - Contract of Excess Insurance

Current through Register Vol. 50, No. 6, June 20, 2024
A.
				  Aggregate and specific excess insurance with liability limits and retention
				  amounts acceptable to the Office of Workers' Compensation shall be required as
				  a condition of approval of any individual self-insurer as hereinafter provided.
1. The retention of specific excess policies
				  shall be no more than $250,000 or one percent of the self-insurer's net worth,
				  whichever is greater. The maximum retention so calculated shall be rounded to
				  the nearest $50,000. Acceptable retention levels, subject to the above maximum,
				  shall be determined by the office for each self-insurer. Such acceptable
				  retention shall be based on an evaluation of the self-insurer's financial
				  condition and exposure to loss.
2.
				  In cases where the upper limit of a corporation's excess insurance is not
				  statutory, the Office of Workers' Compensation will require that the amount be
				  at least the greater of the average incurred workers' compensation losses for
				  the last three years or $5,000,000.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1715 - Servicing for Self-Insurer; Qualifications for Service Companies

Current through Register Vol. 50, No. 6, June 20, 2024
A. Each individual
				  self-insurer, as a condition of approval to self-insure, shall be required to
				  provide proof of compliance with the provisions of this Section as follows.
1. It shall be the sole responsibility of
				  each individual self-insurer to provide for qualified persons to service its
				  program in the areas of claims adjusting, underwriting, safety engineering and
				  loss control. Should the individual self-insurer be unable or unwilling to
				  provide any or all of these services through the use of its own employees, then
				  it shall contract with outside agencies with established qualifications, as
				  evidenced by their official certificates of approval issued by this office, to
				  provide these services.
2. In the
				  case where an individual self-insurer elects to contract with an approved
				  service company, the Office of Workers' Compensation may, at its discretion,
				  choose to use the service company as an intermediary in its dealings with the
				  employer. In the case where no service company is used, the office will deal
				  with the employer only.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1717 - Revocation or Termination of the Self-Insurer Privilege

Current through Register Vol. 50, No. 6, June 20, 2024
A. Failure to comply with any of the rules or
				  with any order of the Office of Workers' Compensation Administration within the
				  time prescribed may be considered good cause for revocation or termination of
				  self-insurer privilege, within the meaning of Louisiana Statutes. Noncompliance
				  with the provisions of the Workers' Compensation Act, in particular those
				  relating to time and method of compensation payments, the furnishing of medical
				  treatment and filing of accident and compensation reports and failure to pay
				  any assessment, may likewise be deemed good cause. The office shall give
				  written notice of such revocation or termination to the employer and/or his
				  agent(s). The employer shall have 15 days from the date of mailing of the
				  notice to request a hearing on the revocation or termination. Failure to
				  request a hearing within the time prescribed shall result in the revocation or
				  termination becoming effective 30 days from the date of mailing of the original
				  notice. In no event shall any revocation or termination become effective prior
				  to the date that a hearing on the question is scheduled. Such notice shall be
				  served personally or by registered mail upon all interested parties.
B. It will be necessary for a self-insurer to
				  notify the office if the status of the self-insurer is materially changed
				  (individual ownership to partnership or to corporation, merger, etc.), at which
				  time the new entity shall be required to qualify. In the event there is a
				  change in majority ownership of a self-insurer, the self-insurer privilege
				  granted to an individual self-insurer shall be at the discretion of the
				  office.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1168 of Act 938 of 1988 Regular
					 Session.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1719 - Enforcement by Office of Workers' Compensation of Order of Compliance ; Order of Denial ; or Order of Termination of Self-Insured Status

Current through Register Vol. 50, No. 6, June 20, 2024
A. If the Office of Workers' Compensation has
				  probable cause to believe that an order denying or terminating self-insurer
				  status is being violated or that an employer who is approved or has been
				  previously approved as a self-insurer is liquidating or may be about to
				  liquidate and distribute its assets to its stockholders or to its members
				  without providing for its obligation as a self-insurer to pay or arrange for
				  the payment of compensation and benefits as prescribed for in the Act, the
				  office may cause an action to be filed in the Court of East Baton Rouge Parish
				  or in the parish in which such person does business to enjoin and restrain such
				  person from engaging in such method, act or practice; in addition to the other
				  penalties it may assess according to law.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1168, 1169, 1170 and Act 938 of 1988
					 Regular Session.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1721 - Tenure of Authority

Current through Register Vol. 50, No. 6, June 20, 2024
A. Certificates
				  of authority granting the privilege of being a self-insurer for workers'
				  compensation purposes shall expire on July 1 of each year or two months after
				  the annual report is due for fiscal year end filers. At the time of renewal,
				  the self-insurer must furnish or have on file with the office, an acceptable
				  financial statement for its current fiscal year and must fully comply with the
				  law and the rules of this office. Certificates of approval for service
				  companies must be renewed on an annual basis. Any information submitted by an
				  employer in its application to become a self-insurer, or in its request for
				  renewal of that authority, will be treated with strict confidence by the
				  office. Any information submitted by a service company in its application for
				  approval or in its request for renewal of that approval will be treated with
				  strict confidence by the office except that the name, address, and status of an
				  employer that is self-insured may be communicated effective September 1, 1991
				  pursuant to amendments to
				  R.S.
				  23:1168(A)(4).
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1168 of Act 938 of 1988 Regular
					 Session.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1725 - Security Requirements

Current through Register Vol. 50, No. 6, June 20, 2024
A. Pursuant
				  to
				  R.S.
				  23:1168, each individually self-insured
				  employer shall deposit with the office acceptable securities or post a surety
				  bond issued by a corporate surety authorized to do business in the state of
				  Louisiana and qualified as herein provided or make such other provision as may
				  be approved by the office in such amount as may be determined by the office in
				  accordance with the following rules.
1. In
				  every case where an application is favorably considered, the office will then
				  decide the amount of acceptable securities or surety bond which will be
				  required; provided, however, that in no case shall the amount of securities or
				  surety bond be less than the greater of:
a.
				  $100,000;
b. the average workers'
				  compensation losses incurred over the most recent three year period multiplied
				  by 110 percent; or
c. the total
				  amount of unpaid workers' compensation reserves at the time of application
				  multiplied by 110 percent.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1727 - Forfeiture of Security

Current through Register Vol. 50, No. 6, June 20, 2024
A. An injured
				  worker or group of injured workers can apply to the director for the payment of
				  benefits pursuant to
				  R.S.
				  23:1168.D if a self-insured employer has
				  failed to pay benefits for undisputed claims.
B. Upon default the office shall deposit the
				  proceeds from the security or the bond into an interest bearing account. The
				  interest derived therefrom shall be used to offset the administration of
				  claims. The office may thereafter contract for the administration of claims
				  from the account.
C. In the event
				  the director pursuant to
				  R.S.
				  23:1168.D provides for pro rata distribution
				  of security proceeds to claimants or issues an order or decision which may be
				  adverse to a claimant, he may within 60 days of the order or decision appeal to
				  the district courts of this state.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1168 of Act 938 of 1988 Regular
					 Session.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1729 - Financial Classes, Security Amounts, and Waiver of Security

Current through Register Vol. 50, No. 6, June 20, 2024
A. Each
				  self-insurer will be classified according to its net worth as shown on its most
				  recent year-ended financial statement submitted to our office. The following
				  classifications will be established and known as Financial Classes (FC).
1. An employer whose net worth is greater
				  than or equal to $750,000 but less than $5,000,000 shall be in Financial Class
				  I (FC I).
2. An employer whose net
				  worth is greater than or equal to $5,000,000 but is less than $50,000,000 shall
				  be in Financial Class II (FC II).
3. An employer whose net worth is greater
				  than or equal to $50,000,000 but less than $250,000,000 shall be in Financial
				  Class III (FC III).
4. An employer
				  whose net worth is greater than or equal to $250,000,000 shall be in Financial
				  Class IV (FC IV).
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1731 - Appeals

Current through Register Vol. 50, No. 6, June 20, 2024
A. A request for
				  hearing pursuant to
				  §1715.
				  E or
				  §1717.
				  A or an application for appeal from an
				  adverse discretionary decision made by the office may be made to the director
				  of the Office of Workers' Compensation by an applicant, self-insurer or service
				  company.
B. Requests for hearing or
				  applications for appeals must be in writing and filed within 30 days of the
				  notice of the decision or, if no notice is given, within 30 days from becoming
				  aware of or the date the aggrieved party should have been aware of the adverse
				  decision. The appeal must be addressed to the director of the Office of
				  Workers' Compensation and mailed to Box 94040, Baton Rouge, LA 70804, or hand
				  delivered to the office at 1001 North Twenty-Third Street, Baton Rouge, LA.
				  Appeals may not be supplemented or amended after the lapse of 30 days. An
				  appellant has the right to file a written appeal or have the appeal heard
				  orally. Requests for an oral hearing must be made within the 30-day time period
				  to file the appeal.
C. If no
				  request for an oral hearing is made, then the appellant may submit
				  documentation and/or written memorandum to support the appeal at least 15 days
				  prior to the review of the appeal. Appellant will be notified at least 30 days
				  prior to the date of the review by the director or the appeal committee
				  appointed by the director. The director or the appeal committee will review all
				  the evidence submitted and render a decision.
D. If the appellant requests an oral hearing,
				  then appellant will be given at least 30 days prior notice of the hearing. The
				  director may appoint a hearing officer to hear the appeal of the appellant. All
				  hearings shall be conducted in accordance with the provisions of the
				  Administrative Procedure Act,
				  R.S.
				  49:955 et seq. On the day of the oral hearing
				  appellant and appellee shall be prepared to start the hearing at the time
				  specified in the notice of hearing. The hearing may be continued for good cause
				  provided a written request for extension is received at the Office of Workers'
				  Compensation at least seven days prior to the date of the hearing.
E. If after the review of the appeal
				  committee or after a hearing held before the hearing officer or the director a
				  decision adverse to the appellant is made, then appellant within 30 days of the
				  date the order or decision is signed may appeal this administrative decision to
				  the district courts of this state.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1168 of Act 938 of 1988 Regular
					 Session.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1733 - Annual Reports

Current through Register Vol. 50, No. 6, June 20, 2024
A. All carriers
				  writing workers' compensation insurance and all self-insured employers shall
				  submit to the office, by April 30 of each year, an annual report on Form
				  LDOL-WC-1000 showing the amount of workers' compensation benefits paid in the
				  previous calendar year.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1291.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1735 - Assessments

Current through Register Vol. 50, No. 6, June 20, 2024
A. The annual
				  report will be used by the director in determining an assessment for the
				  administration of workers' compensation. The assessment shall be paid into the
				  Office of Workers' Compensation Administrative Fund within 30 days from the
				  date notice is served upon such carrier. If such amount is not paid within such
				  period there may be assessed, for each 30 days the amount assessed remains
				  unpaid, a civil penalty equal to 20 percent of the amount unpaid, which shall
				  be due and collected at the same time as the unpaid part of the amount
				  assessed.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1291.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 17 - Fiscal Responsibility Unit › Section I-1737 - Compliance Penalty

Current through Register Vol. 50, No. 6, June 20, 2024
A. If any
				  carrier fails to pay the amount assessed against it within 60 days from the
				  time such notice is served upon it, the commissioner of insurance, upon being
				  advised by the director, may suspend or revoke the authorization to insure
				  compensation in accordance with the procedures of the insurance code.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1291.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 19 - Fraud › Section I-1901 - Forms

Current through Register Vol. 50, No. 6, June 20, 2024
A. The following
				  forms are prescribed for use pursuant to
				  R.S.
				  23:1208:
1.
				  LDOL-WC-1025 Employee's and Employer's Certificate of Compliance; and
2. LDOL-WC-1026 Employee's Quarterly Report
				  of Earnings.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 19 - Fraud › Section I-1903 - Certification; Report

Current through Register Vol. 50, No. 6, June 20, 2024
A. For an
				  accident occurring on or after April 1, 1996, the employee and employer shall
				  certify their compliance with the Louisiana Workers' Compensation Act by filing
				  with their insurer Form LDOL-WC-1025, Employee's and Employer's Certificate of
				  Compliance.
B.
1. Whenever an employee receives workers'
				  compensation indemnity disability benefits for more than 30 days, the employee
				  shall report his other earnings to his employer's insurer quarterly on Form
				  LDOL-WC-1026, Employee's Quarterly Report of Earnings.
2. The requirements of
				  §1903.
				  B.1 are waived whenever an employee has
				  timely filed all necessary LDOL-WC-1020 Forms, or only has received medical
				  benefits.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 19 - Fraud › Section I-1905 - Penalty ; Hearing ; Appeal

Current through Register Vol. 50, No. 6, June 20, 2024
A. Any
				  person violating the provisions of
				  R.S.
				  23:1208 may be assessed civil penalties by
				  the director of not less than $500 nor more than $5000.
B. A person may appeal any penalty imposed
				  pursuant to this rule by filing Form LDOL-WC-1008, Disputed Claim for
				  Compensation, in the district where the person is located or in Baton Rouge,
				  LA. All such appeals shall be de novo. Any penalty imposed pursuant to this
				  rule becomes final and may be pursued for collection unless such an appeal is
				  filed within 30 days of the notice of penalty.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1208 and
					 23:1291(1)(5).
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 1 - General Administration › Chapter 19 - Fraud › Section I-1907 - Notice of Penalty ; Filing

Current through Register Vol. 50, No. 6, June 20, 2024
A. The
				  director shall notify the employee and employer of any civil penalty imposed
				  for violation of
				  R.S.
				  23:1208. In addition, the director shall file
				  the notice of penalty in the record of the disputed claim for
				  benefits.
AUTHORITY NOTE:
					 Promulgated in accordance with
					 R.S.
					 23:1208 and
					 23:1291.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 2 - Medical Guidelines › Chapter 20 - Spine Medical Treatment Guidelines › Subchapter A - Cervical Spine Injury › Section I-2001 - Introduction

Current through Register Vol. 50, No. 6, June 20, 2024
A. This document
					 has been prepared by the Louisiana Workforce Commission, Office of Workers'
					 Compensation (OWCA) and should be interpreted within the context of guidelines
					 for physicians/providers treating individuals qualifying under Louisiana's
					 Workers' Compensation Act as injured workers with cervical spine injuries.
					 Although the primary purpose of this document is advisory and educational,
					 these guidelines are enforceable under the Louisiana Workers Compensation Act.
					 All medical care, services, and treatment owed by the employer to the employee
					 in accordance with the Louisiana Workers' Compensation Act shall mean care,
					 services, and treatment in accordance with these guidelines. Medical care,
					 services, and treatment that varies from these guidelines shall also be due by
					 the employer when it is demonstrated to the medical director of the office by a
					 preponderance of the scientific medical evidence, that a variance from these
					 guidelines is reasonably required to cure or relieve the injured worker from
					 the effects of the injury or occupational disease given the circumstances.
					 Therefore, these guidelines are not relevant as evidence of a provider's legal
					 standard of professional care. To properly utilize this document, the reader
					 should not skip nor overlook any sections.
AUTHORITY
						NOTE: Promulgated in accordance with
						R.S.
						23:1203.1.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 2 - Medical Guidelines › Chapter 20 - Spine Medical Treatment Guidelines › Subchapter A - Cervical Spine Injury › Section I-2005 - Initial Diagnostic Procedures

Current through Register Vol. 50, No. 6, June 20, 2024
A. The OWCA recommends the following
					 diagnostic procedures be considered, at least initially, the responsibility of
					 the workers' compensation carrier to ensure that an accurate diagnosis and
					 treatment plan can be established. Standard procedures, that should be utilized
					 when initially diagnosing a work-related cervical spine complaint, are listed
					 below.
1. History-taking and physical
					 examination (Hx and PE). These are generally accepted, well-established and
					 widely used procedures that establish the foundation/basis for and dictate
					 subsequent stages of diagnostic and therapeutic procedures. List of medications
					 patient is taking should be included in every history, including over the
					 counter medicines as well as supplements. When findings of clinical evaluations
					 and those of other diagnostic procedures are not complementing each other, the
					 objective clinical findings should have preference. The medical records should
					 reasonably document the following.
a. History
					 of Present Injury. A detailed history, taken in temporal proximity to the time
					 of injury, should primarily guide evaluation and treatment. The history should
					 include pertinent, positive and negative information regarding the following:
i. Mechanism of Injury. This includes details
					 of symptom onset and progression. The mechanism of injury should include a
					 detailed description of the incident and the position of the body before,
					 during, and at the end of the incident. Inclusion of normal work body postures,
					 frequency during the workday and lifting/push/pull requirements, should be
					 included in the absence of a known specific
					 incident
;
ii. Location of pain, nature of symptoms, and
					 alleviating/exacerbating factors (e.g. sleep positions). Of particular
					 importance, is whether raising the arm over the head alleviates radicular-type
					 symptoms. The history should include both the primary and secondary complaints
					 (e.g., primary neck pain, secondary arm pain, headaches, and shoulder girdle
					 complaints). The use of a patient completed pain drawing, such as Visual Analog
					 Scale (VAS) is highly recommended, especially during the first two weeks
					 following injury to assure that all work related symptoms are being
					 addressed;
iii. presence and
					 distribution of upper and/or lower extremity numbness, paresthesias, or
					 weakness, especially if precipitated by coughing or sneezing;
iv. alteration of bowel, bladder, or sexual
					 function; and for female patients, alteration in their menstrual
					 cycle;
v. any treatment for current
					 injury and result; and
vi. ability
					 to perform job duties and activities of daily living.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 2 - Medical Guidelines › Chapter 20 - Spine Medical Treatment Guidelines › Subchapter A - Cervical Spine Injury › Section I-2009 - Therapeutic Procedures-Non-Operative

Current through Register Vol. 50, No. 6, June 20, 2024
A. Before initiation of any therapeutic
					 procedure, the authorized treating provider, employer, and insurer must
					 consider these important issues in the care of the injured worker.
B. First, patients undergoing therapeutic
					 procedure(s) should be released or returned to modified or restricted duty
					 during their rehabilitation at the earliest appropriate time. Refer to
					 "Return-to-Work" in this section for detailed information.
C. Second, cessation and/or review of
					 treatment modalities should be undertaken when no further significant
					 subjective or objective improvement in the patient's condition is noted. If
					 patients are not responding within the recommended duration periods,
					 alternative treatment interventions, further diagnostic studies or
					 consultations should be pursued.
1.
					 Reassessment of the patient's status in terms of functional improvement should
					 be documented after each treatment. If patients are not responding within the
					 recommended time periods, alternative treatment interventions, further
					 diagnostic studies or consultations should be pursued. Continued treatment
					 should be monitored using objective measures such as:
a. return-to-work or maintaining work
					 status;
b. fewer restrictions at
					 work or performing activities of daily living;
c. decrease in usage of
					 medications;
d. measurable
					 functional gains, such as increased range of motion or documented increase in
					 strength;
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 2 - Medical Guidelines › Chapter 20 - Spine Medical Treatment Guidelines › Subchapter A - Cervical Spine Injury › Section I-2011 - Therapeutic Procedures-Operative

Current through Register Vol. 50, No. 6, June 20, 2024
A.
					 All operative interventions should be based on a positive correlation with
					 clinical findings, the natural history of the disease, the clinical course, and
					 diagnostic tests. A comprehensive assimilation of these factors should have led
					 to a specific diagnosis with positive identification of the pathologic
					 condition(s). It is imperative for the clinician to rule out non-physiologic
					 modifiers of pain presentation, or non-operative conditions mimicking
					 radiculopathy or instability (peripheral compressive neuropathy, chronic soft
					 tissue injuries, and psychological conditions), prior to consideration of
					 elective surgical intervention. Early intervention may be required in acute
					 incapacitating pain or in the presence of progressive neurological deficits.
					 Patients who are not candidates for or refuse surgical treatment should be
					 treated with non-operative therapy as indicated.
B. Operative treatment is indicated when the
					 natural history of surgically treated lesions is better than the natural
					 history for non-operatively treated lesions. All patients being considered for
					 surgical intervention should first undergo a comprehensive neuromusculoskeletal
					 examination to identify mechanical pain generators that may respond to
					 non-surgical techniques, or may be refractory to surgical intervention.
1. Referral for surgical evaluation and
					 treatment. Consultation should be made to an appropriate surgical specialist
					 for surgical evaluation and treatment when operative treatment is considered.
a. The decision and recommendation for
					 operative treatment, and the appropriate informed consent should be made by the
					 operating surgeon.
b. Prior to
					 surgical intervention, the patient and treating physician should identify
					 functional operative goals and the likelihood of achieving improved ability to
					 perform activities of daily living or work activities and the patient should
					 agree to comply with the pre- and post-operative treatment plan and home
					 exercise requirements. The patient should understand the length of partial and
					 full disability expected post-operatively
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 2 - Medical Guidelines › Chapter 20 - Spine Medical Treatment Guidelines › Subchapter B - Low Back Pain › Section I-2013 - Introduction

Current through Register Vol. 50, No. 6, June 20, 2024
A. This document
					 has been prepared by the Louisiana Workforce Commission, Office of Workers'
					 Compensation (OWCA) and should be interpreted within the context of guidelines
					 for physicians/providers treating individuals qualifying under Louisiana
					 Workers' Compensation Act as injured workers with low back pain. Although the
					 primary purpose of this document is advisory and educational, the guidelines
					 are enforceable under the Louisiana Workers Compensation Act. All medical care,
					 services, and treatment owed by the employer to the employee in accordance with
					 the Louisiana Workers' Compensation Act shall mean care, services, and
					 treatment in accordance with these guidelines. Medical care, services, and
					 treatment that varies from these guidelines shall also be due by the employer
					 when it is demonstrated to the medical director of the office by a
					 preponderance of the scientific medical evidence, that a variance from these
					 guidelines is reasonably required to cure or relieve the injured worker from
					 the effects of the injury or occupational disease given the circumstances.
					 Therefore, these guidelines are not relevant as evidence of a provider's legal
					 standard of professional care. To properly utilize this document, the reader
					 should not skip nor overlook any sections.
AUTHORITY NOTE: Promulgated in accordance with
						  R.S.
						  23:1203.1.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 2 - Medical Guidelines › Chapter 20 - Spine Medical Treatment Guidelines › Subchapter B - Low Back Pain › Section I-2017 - Initial Diagnostic Procedures

Current through Register Vol. 50, No. 6, June 20, 2024
A. The OWCA recommends the following
					 diagnostic procedures be considered, at least initially, the responsibility of
					 the workers' compensation carrier to ensure that an accurate diagnosis and
					 treatment plan can be established. Standard procedures, that should be utilized
					 when initially diagnosing a work-related low back pain complaint, are listed
					 below.
1. History-taking and physical
					 examination (Hx and PE) are generally accepted, well-established and widely
					 used procedures that establish the foundation/basis for and dictates subsequent
					 stages of diagnostic and therapeutic procedures. List of medications patient is
					 taking should be included in every history, including over the counter
					 medicines as well as supplements. When findings of clinical evaluations and
					 those of other diagnostic procedures are not complementing each other, the
					 objective clinical findings should have preference. The medical records should
					 reasonably document the following.
a. History
					 of Present Injury-a detailed history, taken in temporal proximity to the time
					 of injury should primarily guide evaluation and treatment. The history should
					 include pertinent positive and negative information regarding the following:
i. mechanism of injury. This includes details
					 of symptom onset and progression. The mechanism of injury should include a
					 detailed description of the incident and the position of the body before,
					 during, and at the end of the incident. Inclusion of normal work body postures,
					 frequency during the workday, and lifting/push/pull requirements should be
					 included in the absence of a known specific incident;
ii. location of pain, nature of symptoms, and
					 alleviating/exacerbating factors (e.g., sitting tolerance). The history should
					 include both the primary and secondary complaints (e.g., primary low back pain,
					 secondary hip, groin). The use of a patient completed pain drawing, such as
					 Visual Analog Scale (VAS), is highly recommended, especially during the first
					 two weeks following injury to assure that all work related symptoms are
					 addressed;
iii. presence and
					 distribution of lower extremity numbness, paresthesias, or weakness, especially
					 if precipitated by coughing or sneezing;
iv. alteration in bowel, bladder, or sexual
					 function; and for female patients, alteration in their menstrual
					 cycle;
v. any treatment for current
					 injuries or results;
vi. ability to
					 perform job duties and activities of daily living.
Louisiana Administrative Code › Title 40 - LABOR AND EMPLOYMENT › Part I - Workers' Compensation Administration › Subpart 2 - Medical Guidelines › Chapter 20 - Spine Medical Treatment Guidelines › Subchapter B - Low Back Pain › Section I-2021 - Therapeutic Procedures-Non-Operative

Current through Register Vol. 50, No. 6, June 20, 2024
A. All treatment plans begin with shared
					 decision making with the patient. Before initiation of any therapeutic
					 procedure, an authorized treating healthcare provider, employer, and insurer
					 should consider these important issues in the care of the injured
					 worker.
B. First, patients
					 undergoing therapeutic procedure(s) should be released or returned to modified
					 or restricted duty during their rehabilitation at the earliest appropriate
					 time. Refer to "Return-to-Work" in this section for detailed
					 information.
C. Second, cessation
					 and/or review of treatment modalities should be undertaken when no further
					 significant subjective or objective improvement in the patient's condition is
					 noted.
1. Reassessment of the patient's
					 status in terms of functional improvement should be documented after each
					 treatment. If patients are not responding within the recommended time periods,
					 alternative treatment interventions, further diagnostic studies or specialist
					 and/or surgeon consultations should be pursued. Continued treatment should be
					 monitored using objective measures such as:
a. return-to-work or maintaining work
					 status;
b. fewer restrictions at
					 work or performing activities of daily living (ADL);
c. decrease in usage of medications; related
					 to the work injury; and
d.
					 measurable functional gains, such as increased range of motion, documented
					 increase in strength;, increased ability to stand, sit or lift, or patient
					 completed functional evaluations.