#LifeOnComp

Over the years, we have seen firsthand the hardships that our clients deal with while living on workers’ comp. The system is overly complicated and can be painfully slow. It is inherently difficult to navigate through your own workers’ comp claim.

Unfortunately, we have seen many cases of additional hardships created by overzealous insurance adjusters (and sometimes employers). These experiences inspired us to create our own hashtag - #LifeOnComp. Here are some real world examples of situations that we have encountered:

  • A client’s doctor made a mistake on a medical form and benefits were terminated. That same doctor corrected the mistake and directly notified the adjuster of the mistake, yet benefits were not reinstated.

  • An adjuster scheduled a second medical opinion for our client more than 60 miles from her home. The adjuster threatened to terminate benefits if our client did not make that trip.

  • A client hired us to represent her because she was confused about the workers’ comp system. The adjuster immediately denied the claim because the injured worker hired a lawyer.

  • A paralyzed client was told by her psychiatrist that church visits were essential for her mental health. We requested additional care to enable our client to attend church services. The adjuster denied the request.

  • A nurse case manager scheduled an appointment with our client’s doctor and did not notify us of the appointment. The appointment was held outside of our presence and the adjuster has refused to reschedule the appointment.

In each of these instances, we took action to protect our clients against the unreasonable insurance adjuster. The workers’ comp system is imperfect even on its best day. When adjusters make it more difficult just because they can…well, that’s #LifeOnComp.

Don’t give up. Call us today and let us help you.


Medical Treatment Denied? Now What?

At some point, many injured workers find themselves in a confusing position regarding their medical care. The workers' compensation adjuster has approved your choice of physician and you visit with the doctor for an evaluation. Thereafter, the doctor makes treatment recommendations and submits them to the adjuster for approval. The adjuster responds and sends a decision to you and your doctor

DENIED. 

Now what?   

The process for obtaining medical treatment can be very complicated.  Initially, your doctor needs to submit a Form 1010 specifically outlining what type of treatment is requested. Some of the information needed along with the 1010 includes the history of injury, physical findings, imaging results and treatment plan. Without this information, the 1010 will be denied. The 1010 is faxed to the adjuster and a decision must be made within five business days. If no decision is rendered within five business days, the treatment is considered to be denied.

Once treatment is denied, any aggrieved party may file an appeal called a Disputed Claim for Medical Treatment, Form 1009. The completed 1009 must be submitted to the Office of Workers' Compensation Administration (OWCA) within fifteen calendar days of the 1010 denial. Additionally, a copy of the 1010 and all relevant medical records must be submitted along with the 1009. Once the appeal is timely submitted, the Medical Director of the OWCA will review the appeal and make a decision about whether the treatment should be approved.

Complicated, isn't it?

To state it simply, this is not an easy process. We have successfully handled these types of appeals in the past and we look forward to helping you.  Mensman Law is committed to getting the treatment you are entitled to under the law.

 


We Are Growing!

We are proud to announce the expansion of Mensman Law to Livingston Parish!  Our modern, state of the art expansion location is now open at 8173 Vincent Road, Suite B, Denham Springs, Louisiana.  We are accepting new clients with personal injury or workers' compensation claims.

The flood of August 2016 devastated Livingston Parish. An estimated 50% of all homes in the parish were declared a total loss.  In Denham Springs, 72% of all buildings, commercial and residential, flooded.  This is a stunning figure for a single community.

There was tremendous concern about Livingston Parish following the flood.  Would businesses return?  Would residents return?  How would the cities in the parish rebuild?

We closed our office for the three weeks immediately following the flood to assist in search, rescue and home demolition.  Two of our employees suffered severe flooding.  We felt drawn to help the tight-knit community.

When talk began of expanding our practice to surrounding areas, we naturally gravitated to Livingston Parish.  We wanted to show the community that we will continue to be a part of the rebuilding process.  We decided to expand our business to Denham Springs.

At Mensman Law, we believe that successfully addressing client needs requires more than just knowledge of the law and a mastery of the rules that impact our clients' lives.  Our commitment to excellence, combined with our mission to deliver outstanding client service, has earned Mensman Law the excellent reputation it enjoys today.  We look forward to providing that service to the people of Livingston Parish.

 


Fraud...It Cuts Both Ways!

There is a fraud component of the Louisiana Workers' Compensation Act, and it indicates, "It shall be unlawful for any person, for the purpose of obtaining or defeating any benefit or payment under the provisions of this Chapter, either for himself or for any other person, to willfully make a false statement or representation."

Typically, fraud allegations are directed against injured workers.  The most common scenario occurs when an injured worker makes the representation that she is unable to work in any capacity, and because of that representation she is receiving a weekly check from the insurance company.  If that injured worker is receiving that weekly check while simultaneously working and receiving wages, she has likely violated the law, and a fraud allegation will probably soon be made.

An overlooked fact within that law is that the fraud allegation can also be made against an employer or insurance company. If an employer willfully makes a false statement for the purpose of defeating benefits that would be owed to an injured worker, then that employer likely violated the law, and a fraud allegation will probably soon be made. An example of a false statement made by an employer could be when an employer denies that an injured worker was its employee, even though the employee was working for the employer.

It cuts both ways!

The penalties associated with a judicial finding of fraud include monetary fines up to $10,000.00, termination of all benefits, civil penalty up to $5,000.00, and imprisonment up to 10 years.

It is vitally important that you always relay truthful information about your claim. If your employer has made a false statement for the purpose of defeating your claim for benefits, contact us today. We will gladly assist you and pursue all benefits you are owed. 

 


Home or Business Flood Claims - Have You Been Underpaid?

During the Great Flood of August 2016, many Louisiana communities were devastated.  However, only 25% of homes that were completely destroyed were covered by insurance.  A considerable amount of those claims were either denied or were severely underpaid.

Two employees of Mensman Law flooded. During the aftermath, we closed our office for three consecutive weeks in order to help neighbors begin the cleanup and rebuild process. We pulled soaked carpet out of destroyed homes. We cut out sheetrock. We removed cabinets. We pried wood floors. We hauled precious personal possessions out of homes, wheelbarrow by wheelbarrow. We helped any way we could.

Now, we want to help again.

Typically our practice is limited to personal injury and workers' compensation claims. However, because this flood has so deeply affected our community, we have decided to stand up and protect the rights of flood victims. 

Time may be running short on filing your Proof of Loss claim.  The deadline for completing this complex paperwork is 270 days from the date of loss.  For example, if the floodwaters reached your home on August 13, 2016, the current deadline would be May 10, 2017. If you haven't yet filed your Proof of Loss claim, call us today and we will help you.  If you have filed a Proof of Loss claim, there is a strong likelihood that your claim was underpaid. Our team of experienced flood professionals will review your claim and search for everything owed to you, even if you have already been paid by insurance.

We have heard many stories of denied or underpaid claims. Business owners have told us about permanent large equipment, bolted to the foundation, that was destroyed in the flood but not paid for by insurance.  Residential homeowners have told us that their claims for ceramic tile, door knobs, door hinges, siding, permanent generators and air conditioner units, all destroyed in the flood, yet all denied by insurance.

Call Mensman Law today. Too busy rebuilding your home?  We will come to you. 


DO I HAVE A WORKERS' COMP CLAIM OR A PERSONAL INJURY CLAIM?

You may have both!

If you are in an accident and sustain an injury while in the course and scope of your employment, then you will likely have a workers’ compensation claim.  Although your employer or a co-worker may have been negligent and caused your injury, your only remedy against your own employer will almost always be in workers’ compensation.

However, if you are in the course and scope of your employment and a third party causes an accident, then you may also have a personal injury claim.  For example:  Betty works for a delivery company.  While on her daily route in her company-provided vehicle, she is rear-ended by another vehicle owned by a national transportation company and being driven by the national transportation company’s employee.  Betty will probably have a workers’ compensation claim due to the fact that she was in an accident while at work.  In addition, she may have a personal injury claim against the national transportation company for the negligence of its employee causing the car accident.

If you have both a workers’ compensation claim and a personal injury claim, then your employer and its workers’ compensation carrier may intervene in your personal injury action in an effort to recover any payments made in connection with the workers’ compensation claim. This can be a very confusing and complicated process. 

There are many aspects to every case which often require a careful review of all of the facts and circumstances.  There are also major differences between a workers’ compensation claim and a personal injury claim.  The most glaring difference is a very familiar term of art, "pain and suffering." This is a benefit available in the personal injury claim, but not in the workers' compensation claim.

Mensman Law handles both workers’ compensation and personal injury cases.  We are here to help you answer any questions you may have and pursue any and all benefits which may be available to you.


WE ARE LEADERS IN HANDLING CATASTROPHIC CLAIMS

Catastrophic claims present major complications and challenges for injured workers and their families. These types of claims involve severe injuries that result in a high level of permanent disability. In Louisiana, a claim qualifies as catastrophic if the injury results in paraplegia, quadriplegia or the total anatomical loss of both hands, both arms, both feet, both legs, both eyes, or one hand and one foot, or any two thereof. Louisiana law provides that, in addition to medical and indemnity benefits, injuries of this nature are also entitled to a one-time compensation payment of $50,000.00, which is due within one year of the date of catastrophic diagnosis.

At Mensman Law, we have handled several claims involving catastrophic injuries and we have learned the importance of high quality medical care. The complexity of the injuries requires an incredible level of competence from the medical professionals involved. Often, the underlying injury will lead to comorbidity. For example, the injured worker confined to a wheelchair will often develop urological, respiratory, circulatory and dermatological problems, among others.

At some point, it may become proper to enter settlement negotiations with the insurance company. This is a very complicated process. Because your long-term health in these situations depends directly upon the quality of medical care, the settlement negotiation is incredibly important and cannot be guesswork.

Our team spends a considerable amount of time analyzing the needs of the catastrophically injured worker and their family. We use that data to forecast the expenses and build upon that to accurately project the anticipated settlement value.

There are several pivotal issues that need to be addressed before settling a catastrophic claim. Failure to do so could lead to disastrous consequences. Do you need a spendthrift trust? A special needs trust? A spigot trust? A structured settlement? A Medicare Set-Aside?

Do you qualify for Medicare? Social Security Disability Benefits? Medicaid?

Are you eligible for Long Term Personal Care Services? Adult Day Health Care Waiver Program? Community Choices Waiver Program? Traumatic Head and Spinal Cord Injury Trust Fund Program?

At Mensman Law, we spend tremendous time and effort assisting catastrophically injured workers and their families with these types of challenges. Should you need assistance with these types of injuries, call Mensman Law, the leaders in handling catastrophic claims.


SEB...TTD...SMO...IME... WHAT DOES IT ALL MEAN?

In the course of your workers' compensation claim, you will hear many terms tossed around without much explanation of the terms.  Adjusters often use insurance industry jargon instead of taking the time to fully explain your rights.  We have summarized much of that jargon below to help you understand it all.

TTD - Temporary Total Disability:  This type of benefit is paid to you when your doctor indicates that you are totally unable to work.  There are very specific ways to calculate the benefit based upon your employment, which we have addressed in an earlier blog post.

SEB - Supplemental Earnings Benefits:  This type of benefit is paid to you once it is determined that you have work restrictions, but you are unable to earn at least 90% of your pre-accident wages.

COP - Choice of Physician:  You have the right to select your own physician in each field or specialty.  The insurance company will request that you sign this form choosing your physician before it will approve medical treatment.

SMO - Second Medical Opinion:  Since you have your choice of physician, the insurance company can also send you to a doctor of its choosing.  If proper notice is given and you fail to attend, then your benefits will be suspended.

IME - Independent Medical Examination:  If your doctor and the insurance company's doctor (SMO) disagree regarding causation or work status, then either party may request a third doctor to issue an opinion.  This doctor is selected by the Office of Workers' Compensation.

1020 (Employee's Monthly Report of Earnings):  You are required by law to report any earnings from any source while receiving workers' compensation indemnity benefits (TTD or SEB).

1002 (Notice of Payment, Modification, Suspension, Termination or Controversion of Compensation or Medical Benefits):  This notice must be sent to you by the adjuster indicating any initiation or change in your benefits.

FCE - Functional Capacity Evaluation:  Your doctor may request this evaluation in order to more accurately determine your physical work ability (sedentary, light, medium, heavy).

1010 (Request for Medical Treatment):  This form is submitted by the healthcare provider to the insurance company in order to determine whether the treatment should be approved, denied, or modified in accordance with the Medical Treatment Guidelines (or MTG).

1009 (Disputed Claim for Medical Treatment):  If the 1010 is denied, then any aggrieved party, typically your doctor, may file this dispute with the Office of Workers' Compensation for a determination whether the treatment should be approved.  

1008 (Disputed Claim for Compensation):  This is a workers' compensation lawsuit which presents the disputed issues to a Judge for review.

The complex world of workers' compensation moves quickly which could require quick responses from you.  If you need help, please call our office to schedule a consultation.


DOES YOUR EMPLOYER HAVE WORKERS' COMPENSATION INSURANCE?

Each employer in Louisiana is legally required to ensure that its employees are provided workers' compensation coverage in the event of a workplace injury.  An employer cannot require an employee to pay for her own workers' compensation policy.  Neither can an employer classify an employee as an "independent contractor" for purposes of avoiding workers' compensation responsibilities.  If your employer is not adequately insured for workers' compensation benefits, you may seek those benefits directly from the employer and the employer could suffer legal sanctions and civil penalties.

However, what if your employer does not give you the name of the insurance company responsible for handling your workers’ compensation claim? How are you to proceed?  In the past, this proved to be a very difficult situation and further added to the difficulties encountered by the injured worker. Too often, our clients have been delayed or denied benefits because the employer refused to give her the insurance information. Now, the field has been leveled a bit.

To find the insurance company, access:

 http://www.laworks.net/WorkersComp/OWC_EmployerMenu.asp 

and click on “Employers’ Workers’ Compensation Coverage Verification”. Once there, you can enter all or part of the name of the employer along with the date of accident.  This search will soon reveal the name of the insurance company and the insurance policy number. A quick Google search will then give you the contact information for the insurance company.  Once the claim is reported to the insurance company, an adjuster is assigned and a determination is made regarding payment of benefits.  

Navigating this process can often be very complicated.  Call us at 225-293-9720 for help.

 


STATE WORKERS BEWARE! NEW CLAIMS COMPANY, AGGRESSIVE TACTICS

For many years, the workers' compensation claims of Louisiana state employees were handled by the Louisiana Office of Risk Management, a state agency.  Under the Jindal administration, Louisiana's risk management was privatized in 2010.

In late 2015, the contract for handling workers' compensation claims of state employees was awarded to Sedgwick Claims Management Services, a Tennessee-based company.  This contract is undoubtedly very lucrative for Sedgwick and part of the motivation for awarding the contract was the ability of Sedgwick to reduce costs.  

Be warned...reduced costs = reduced benefits for injured workers.  We have seen very aggressive, unreasonable claims handling from Sedgwick since they took over the state worker claims.  We have seen adjusters force unrepresented claimants to use their sick and annual leave when unable to work due to a work accident.  Once the leave was exhausted, the injured worker was subject to termination based upon the Civil Service rule relating to depletion of all sick and annual leave.

Additionally, we have seen misuse of the law regarding retirement of injured workers.  Generally, if an injured worker retires and voluntarily removes herself from the workforce, then she will be limited to only two years of indemnity benefits.  Just this week, we have met with two state employees with workers' compensation claims who had depleted all leave and who then retired due to medical disabilities related to the work injury.  The adjusters assigned to these files then alleged that the injured workers voluntarily removed themselves from the workforce and indicated that the two-year rule of indemnity benefits applied.  We disagree.

This type of unreasonable claims handling is no doubt spurred by Sedgwick's promise to cut costs on state claims.  Let us help you and aggressively protect your rights!


DO YOU NEED TO HIRE A LAWYER?

Often, injured workers contact our office and ask whether they need an attorney to help them with their workers' compensation claim. Sometimes, the injured worker believes they are getting all benefits they are entitled. However, this is rarely the case.

There are many benefits that are owed to an injured worker, and often the insurance company will not tell you what those benefits are. This is where we come in.  We have the knowledge and experience necessary to protect your rights.

Did the insurance adjuster calculate your compensation rate correctly? Have all of your medical bills been paid timely? Have you been timely authorized to seek treatment with the doctor of your choice in every field or specialty? Have your mileage reimbursement requests been timely paid at the correct rate? Have you been provided adequate vocational rehabilitation? Are you entitled to an award for scarring or disfigurement? Were your benefits terminated properly?

We strongly believe that all injured workers should be represented by attorneys experienced with workers' compensation claims. Contact us at Mensman Law today to schedule a free consultation. We stand ready to help you. 

 


ARE YOU BEING PAID THE CORRECT AMOUNT BY THE INSURANCE COMPANY?

Short Answer:  Probably not!

If your treating physician indicates that you are unable to work, then the insurance company owes you indemnity benefits. Typically, they will calculate this benefit based upon your wages during the four weeks before the accident. This calculation is called your average weekly wage.  The insurer must then multiply your average weekly wage by 2/3 to determine your corresponding compensation rate.

This simple calculation is often done incorrectly by the insurance company. The calculation could be done differently depending on your type of employment, schedule of pay, and seasonal nature of your employment.

If an employee is hired for 40 hours per week, the insurance company will multiply your hourly wage rate times 40. If an employee regularly works less than 40 hours per week, the calculation is done by averaging the wages earned in the four full weeks before the accident. If an employee is classified as a part-time employee, the calculation is done by averaging the actual hours worked and multiplying that times the wage rate.

There are additional different calculations based upon whether you are a salaried employee, a moonlighting employee, or a seasonal employee.

We met with a client recently and quickly determined that the insurance company was underpaying her by over $250.00 each week. We demanded that the insurance company correct this mistake and our client was very pleased that we protected her rights and obtained the compensation that was due to her. Not only did the insurance company correct the mistake, but they paid her the difference all the way back to the initial payment. This type of mistake and underpayment happens very often.

If you have a question about whether you are being paid the appropriate amount, contact us today for a free consultation.


YOU ARE AUTHORIZED TO SELECT YOUR OWN TREATING PHYSICIAN

When you are injured, often your employer will send you to an occupational clinic. These clinics are often crowded and unable to render quality care for seriously injured workers. What happens if those clinics simply send you back to work without a substantive evaluation or treatment?

The Louisiana Workers' Compensation Act provides that you are entitled to your choice of physician in each field or specialty. The request should be made directly to the insurance adjuster. If you are able, it is best to make this request in writing.

Once you make your choice of physician, you generally are not able to choose another physician in the same field.  However, you are authorized to choose a physician in a different field. For instance, if you are currently treating with an orthopedic surgeon, you generally cannot choose another orthopedic surgeon. However, you should be authorized to seek an evaluation with a pain management physician, while simultaneously treating with the orthopedic doctor.

At Mensman Law Firm, we assist our clients in choosing the appropriate field and physician to ensure they receive the best possible care. If the insurance company refuses to approve your choice of physician, contact us and we can protect your rights and seek to compel the authorization.


WHAT IF THE INSURANCE COMPANY FAILS TO PAY A JUDGMENT?

Often, insurance companies will offer to resolve conflicts with our clients. We always demand that any such resolution take the form of a judgment, which is signed by the court. We demand this because it offers great protection of the rights of our clients. It allows a mechanism for us to enforce the resolution. What if the insurance company offers to resolve a conflict and then they fail to pay the resolution?

An employer or insurance company that fails to pay a judgment providing installment payments timely may also be subject to a proceeding at which the judgment may be accelerated. At this proceeding, all installment payments may be ordered to be immediately payable, even future installment payments. 

Additionally, if an employer or insurance company fails to pay a final, non-appealable judgment within 30 days after it becomes due, the court shall add to such award an amount equal to 24 percent thereof or $100 per each calendar day it remains unpaid, whichever is greater, unless such nonpayment resulted from conditions over which the employer or insurance company had no control. 

At Mensman Law, we continue to protect your rights by monitoring and enforcing agreements made by insurance companies. We hold them accountable.

 


WHAT TYPES OF ACCIDENTS QUALIFY FOR BENEFITS?

An accident that occurs while you are actively engaged in the performance of your duties during working hours will be regarded as having occurred in the course of your employment. Even if the work being done at the time of the accident was not within the scope of the specific job for which you were hired, as long as it was being performed pursuant to the orders of your superior, the claim would be compensable. Additionally, if you were following orders or were performing your duties, it is immaterial that the accident occurred at some place distant from the employer's premises.

Ordinarily, if you leave your employer's premises and take your lunch meal at home or at some other place of your own choosing, you will be considered outside the course of your employment from the time you leave work, until the time that you return. Accidents that occur on the premises during meal hours are generally regarded as occurring in the course of employment. 

With few exceptions, an accident that occurs while you are going to or returning from work is not considered to have occurred in the course of employment and benefits will be denied. If an accident happens on the employer's premises while you are proceeding to and from work, that will be considered a compensable claim. Similarly, a journey home will still be considered in the course of employment if you are charged with some duty which you must perform en route or even immediately after you have reached home. Another exception exists generally with reference to accidents occurring at certain unusually hazardous places which, although not on the employer's property, are immediately adjacent thereto. Finally, an accident that happens while you are being transported to or from work by your employer is compensable if the transportation is furnished as an incident of the employment.

 


History of the Louisiana Workers’ Comp Act

Posted on March 5, 2015

In 1912 the Louisiana Legislature directed Governor Luther Hall to appoint a commission of five members to consider possible shortcomings in the law of industrial accidents in this state. The commission included both manufacturing interests and labor organizations. The members undertook careful investigation of the problem.

Public hearings were held. Experts in the area of workers’ compensation legislation from other jurisdictions were consulted. In 1914 the commission submitted a detailed report to the Louisiana Legislature.  The commission recommended that the needs of this state would be most effectively addressed with a workers’ compensation act.

The statute which the commission drafted and recommended was adopted almost verbatim by the legislature in 1914 and persisted until 1975 without fundamental change. The legislative adjustments between 1914 and 1975 usually affected the amount of compensation to be allowed, or the various listed disabilities, or other minor corrections based upon experience.

The most significant changes in 1975 were the definitions of total and partial disability. The previous definition of total disability was the inability “to do work of any reasonable character.” The new definition of total disability was the inability to “engage in any gainful occupation for wages.” The definition of partial disability was changed from “partial disability to do work of any reasonable character,” to “partial disability…to perform the duties in which he was customarily engaged when injured.”

In the years since 1975, more changes have been made to the act, most significantly in 1983, 1988, 1989, and thereafter.  Changes continue to be made up to the present time, and we track these changes, in an effort to benefit our clients.


Your Employer Can Send You For a Second Medical Opinion

Originally Posted on January 27, 2015

An injured worker in Louisiana is entitled to choose her own physician in every field or specialty. The choice of physician must be reasonable.  For example, if you have a foot injury, you will not be approved for an evaluation with a dentist. The choice of physician is very important.  Once you make your choice, you will not be able to change physicians within the same field or specialty, without the insurance company’s authorization. For example, if your physician moves out of state, the insurance company would authorize a new choice.  However, if you simply do not like what your physician is telling you, the insurance company will not authorize a new choice.

Conversely, your employer or insurance company is allowed its own choice of physician. This is referred to as a second medical opinion. Often, the second medical opinion doctor will address the findings and recommendations of your choice of physician. The injured worker is entitled to at least 14 days notice of the scheduling of a second medical opinion. It is vitally important that you attend the second medical opinion evaluation. Failure to attend the appointment will likely result in the suspension of all benefits. If suspended, your benefits will not be reinstated until you comply with attending the second medical opinion evaluation.


Giving a Recorded Statement

Originally Posted on June 27, 2014

When an insurance company receives notice of your work-related injury, a claims adjuster will be assigned and often that claims adjuster will seek a statement from you. Most of the time, the statement will be recorded. The statement serves an investigative purpose but could also provide an insurance company with an opportunity to deny your claim.

During the course of the statement, the claims adjuster will likely ask you very specific questions regarding the facts of the accident, the injury sustained, and witnesses. The claims adjuster may also ask about any prior accidents, injuries or medical treatment. It is critically important that you answer the questions fully and truthfully. Failure to do so could be used as a basis for your claim being delayed or denied.

In some scenarios, multiple body parts are injured, but one body part may stand out as the most significant injury. During this stressful time, you may be focused on the most significant injury and you may mistakenly fail to report the secondary injuries.  Failure to mention all of the body parts injured in the accident could result in a situation where the claim is accepted, but the secondary body injuries are denied based upon the information you provided during the recorded statement.

During our initial meeting with new clients, we are focused on documenting all injuries. This ensures that all injuries are accurately reported when the recorded statement is given.

 


How to Submit a Mileage Reimbursement Request

Originally Posted on May 7, 2014

The Louisiana Workers’ Compensation Act provides that an injured employee is entitled to reimbursement for miles driven to obtain medical treatment. The reimbursement applies to travel to and from your doctor’s appointments, pharmacy visits, physical therapy appointments and others. There is no specific form necessary, but most insurance companies will provide you with a form that they have created. The form will generally contain space for you to report the date of the visit, the healthcare provider visited, and the total miles (round-trip) travelled. If you forget to track the specific mileage on the date of your visit, an alternative is to visit a reputable website to calculate the mileage driven.

You can submit a mileage reimbursement request as often as you would like. Generally, most clients submit a mileage reimbursement request monthly, with multiple visits on each form. The insurance company must pay the mileage reimbursement request within 60 days of receipt. We always submit the mileage reimbursement request via facsimile or some other transmission which allows us to prove when the request was submitted. The current reimbursement rate is $0.51 per mile, but the rate changes and the rate is specific to the date of the visit. In other words, if you are submitting old reimbursement requests, the effective reimbursement rate may not be $0.51 per mile.

It is very important to ensure the accuracy of the reimbursement request submitted to the insurance company. The particular adjuster assigned to handle your claim often will verify the dates and mileages submitted on your form. If the adjuster believes that you have made a false representation on your mileage reimbursement request, they could allege fraud and seek to have your benefits terminated.


Always Keep Your Medical Records

Originally Posted on September 6, 2013

While it is important that you show up for all of your medical appointments, it is just as important that you keep track of what any doctor is reporting to the Louisiana Workers’ Compensation insurance company about your medical condition, your ability to return to work, and any type of treatment you may need in the future.

This is an important practice to follow, particularly when the insurance company sends you on an evaluation with a doctor that they choose.  When you go to these appointments, the doctor, psychologist, or therapist your employer or your employer’s Workers’ Compensation insurance company has chosen for you should give you a copy of their report when they give a copy to the insurance company. You are entitled to a copy. Unfortunately, if you are unrepresented by an attorney, this is one of those rules that you will likely have to enforce yourself by asking for a copy from the Workers’ Compensation insurance company or the doctor’s, psychologist’s, or therapist’s office.

At Mensman Law Firm, we are able to get these records for our clients.  It helps us continue to protect their rights.