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.
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 doctorDENIED. 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 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.
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.