Sword vs. Shield - The Complicated 1002 Process

The Louisiana Legislature enacted a law in 2013 which was supposed to be beneficial to all parties who complied with the procedural rules set out in the law. The problem? That law unfairly favors the insurance company and it is hopelessly complicated, as shown here. That complex, poorly drafted law is known as the 1002 process.

The 1002 process was originally drafted as a law that would shield insurance companies from monetary fines if they voluntarily corrected their mistakes. For example, if your compensation rate should be $350.05 and the adjuster miscalculated it to be $350.01, the adjuster who timely corrects that mistake cannot be penalized. Unfortunately, we have seen insurance companies use the 1002 process as a sword, rather than as the shield it was designed to be. As a result, we get phone calls all the time from prospective clients who have received 1002 notices of termination of benefits.

One prospective client caught the flu and, as a result, she missed a routine followup visit with her own doctor. The adjuster immediately terminated all benefits. Another prospective client was on his way to a medical appointment when he was involved in an automobile crash. He was not able to drive his vehicle, and he missed the appointment. The response from the adjuster? A 1002 notice of termination of all benefits. This process can be so disruptive!

We have a taken a very proactive role in analyzing every 1002 notice that we receive. There are many formalities that are required by law in order for the 1002 notice to be valid. Some of the strict 1002 notice requirements are:

  • The 1002 notice must be on the form published by the Office of Workers’ Compensation;
  • The 1002 notice must be sent to the location where the injured worker receives her indemnity benefits;
  • The 1002 notice must be sent to the Office of Workers’ Compensation on the same business day that it is sent to the injured worker.

If the insurance company does not comply with these or any other requirements, we attack the 1002 notice as defective and invalid. If you have any questions about a 1002 notice that you may have received, call us today.

Contact us today to schedule your free consultation