SLS 12RS-3742 ENGROSSED
Page 1 of 12
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
Regular Session, 2012
SENATE BILL NO. 763 (Substitute of Senate Bill No. 560 by Senator Donahue)
BY SENATOR DONAHUE
WORKERS' COMPENSATION. Provides relative to the workers' compensation law.
(8/1/12)
AN ACT1
To amend and reenact R.S. 23:1201(F) and (H), 1210(A), 1221(3)(a) and (4)(s)(i), 1224 and2
the heading of 1314, and to enact R.S. 23:1020.1 and 1314(D) and (E), relative to3
workers' compensation; to provide for legislative purpose; to provide for legislative4
intent; to provide for construction; to provide with respect to nonpayment of5
benefits; to provide with respect to burial benefits; to provide with respect to6
supplemental earnings benefits; to provide with respect to benefits for catastrophic7
injury; to provide with respect to prematurity of actions; and to provide for related8
matters.9
Be it enacted by the Legislature of Louisiana:10
Section 1. R.S. 23:1201(F) and (H), 1210(A), 1221(3)(a) and (4)(s)(i), 1224 and the11
heading of 1314 are hereby amended and reenacted and R.S. 23:1020.1 and 1314(D) and (E)12
are hereby enacted to read as follows:13
§1020.1. Citation, purpose; legislative intent; construction14
A. Citation. This Chapter shall be cited as the "Louisiana Workers'15
Compensation Law".16
B. Purpose. The legislature declares that the purpose of this Chapter is17 SB NO. 763
SLS 12RS-3742 ENGROSSED
Page 2 of 12
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
all of the following:1
(1) To provide for the timely payment of temporary and permanent2
disability benefits to all injured workers who suffer an injury or disease arising3
out of and in the course and scope of their employment as is provided in this4
Chapter.5
(2) To pay the medical expenses that are due to all injured workers6
pursuant to this Chapter.7
(3) To return such workers who have received benefits pursuant to this8
Chapter to the work force.9
C. Legislative intent. The legislature finds all of the following:10
(1) That the Louisiana Workers' Compensation Law is to be interpreted11
so as to assure the delivery of benefits to an injured employee in accordance12
with this Chapter.13
(2) To facilitate injured workers' return to employment at a reasonable14
cost to the employer.15
D. Construction. The Louisiana Workers' Compensation Law shall be16
construed as follows:17
(1) The provisions of this Chapter are based on the mutual renunciation18
of legal rights and defenses by employers and employees alike; therefore, it is19
the specific intent of the legislature that workers' compensation cases shall be20
decided on their merits.21
(2) Disputes concerning the facts in workers' compensations cases shall22
not be given a broad, liberal construction in favor of either employees or23
employers; the laws pertaining to workers' compensation shall be construed in24
accordance with the basic principles of statutory construction and not in favor25
of either employer or employee.26
(3) According to Article III, Section 1 of the Constitution of Louisiana,27
the legislative powers of the state are vested solely in the legislature; therefore,28
when the workers' compensation statutes of this state are to be amended, the29 SB NO. 763
SLS 12RS-3742 ENGROSSED
Page 3 of 12
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
legislature acknowledges its responsibility to do so. If the workers'1
compensation statutes are to be liberalized, broadened, or narrowed, such2
actions shall be the exclusive purview of the legislature.3
* * *4
§1201. Time and place of payment; failure to pay timely; failure to authorize;5
penalties and attorney fees6
* * *7
F. Failure Except as otherwise provided in this Chapter, failure to8
provide payment in accordance with this Section or failure to consent to the9
employee's request to select a treating physician or change physicians when such10
consent is required by R.S. 23:1121 shall result in the assessment of a penalty in an11
amount up to the greater of twelve percent of any unpaid compensation or medical12
benefits, or fifty dollars per calendar day for each day in which any and all13
compensation or medical benefits remain unpaid or such consent is withheld,14
together with reasonable attorney fees for each disputed claim; however, the fifty15
dollars per calendar day penalty shall not exceed a maximum of two thousand dollars16
in the aggregate for any claim. The maximum amount of penalties which may be17
imposed at a hearing on the merits regardless of the number of penalties which might18
be imposed under this Section is eight thousand dollars. An award of penalties and19
attorney fees at any hearing on the merits shall be res judicata as to any and all20
claims for which penalties may be imposed under this Section which precedes the21
date of the hearing. Penalties shall be assessed in the following manner:22
(1) Such penalty and attorney fees shall be assessed against either the23
employer or the insurer, depending upon fault. No workers' compensation insurance24
policy shall provide that these sums shall be paid by the insurer if the workers'25
compensation judge determines that the penalty and attorney fees are to be paid by26
the employer rather than the insurer.27
(2) This Subsection shall not apply if the claim is reasonably controverted28
or if such nonpayment results from conditions over which the employer or insurer29 SB NO. 763
SLS 12RS-3742 ENGROSSED
Page 4 of 12
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
had no control.1
(3) Except as provided in Paragraph (4) of this Subsection, any additional2
compensation paid by the employer or insurer pursuant to this Section shall be paid3
directly to the employee.4
(4) In the event that the health care provider prevails on a claim for payment5
of his fee, penalties as provided in this Section and reasonable attorney fees based6
upon actual hours worked may be awarded and paid directly to the health care7
provider. This Subsection shall not be construed to provide for recovery of more than8
one penalty or attorney fee.9
* * *10
H. (1) Upon making the first payment of compensation and upon11
modification or suspension of payment for any cause, the employer or insurer shall12
immediately send a notice to the office, in the manner prescribed by the rules of the13
director, that payment of compensation has begun or has been suspended, as the case14
may be. A payor, which shall mean that entity which is responsible by law or15
contract for the payment of benefits or medical expenses incurred by the16
claimant as a result of an injury covered by this Chapter, shall do all of the17
following:18
(a) Prepare a notice of payment. The form for the notice of payment19
shall be promulgated by the office pursuant to the Administrative Procedure20
Act.21
(b) Send the notice of payment to the injured employee, or the22
employee's representative, with the first payment of compensation.23
(c) Send the notice of payment to the injured employee, or the24
employee's representative, within ten days of a suspension or modification to25
compensation for any cause or within ten days of the suspension or modification26
of the supplemental earnings benefit.27
(d) Send a copy of the notice of payment to the office within ten days28
from the date that the original notice of payment was sent to the injured29 SB NO. 763
SLS 12RS-3742 ENGROSSED
Page 5 of 12
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
employee or the employee's representative.1
(2)(a) The injured employee or the employee's representative who2
disagrees with any information provided on the notice of payment shall, in3
writing, notify the payor of the basis for disagreement and provide the amounts4
believed appropriate.5
(b) The payor, within five business days of receipt of the notice of6
disagreement, shall do one of the following:7
(i) Send a revised notice of payment along with a revised payment in8
accordance therewith to the injured employee or the employee's representative.9
(ii) If the payor believes that the amount determined in the original10
notice of payment was correct, then the payor shall file a request for11
preliminary determination, on a form to be promulgated by the office, and shall12
provide a copy to the injured employee or the employee's representative.13
(c) The preliminary determination shall be performed by the director's14
designee, who shall be a workers' compensation judge specifically assigned to15
handle preliminary determinations. Such preliminary determination hearing16
shall occur within fifteen days of the filing of a request.17
(d) The injured employee, the employee's representative, the payor and18
the employer, which includes the direct employer of a statutory employee19
pursuant to R.S. 23:1061, shall participate in a preliminary determination20
hearing by phone. The workers' compensation judge may require any of these21
parties to produce relevant records necessary for the determination of22
compensation provided for in the notice of payment. No later than thirty days23
from the filing of the request for a preliminary determination, the workers'24
compensation judge shall provide, in writing, a recommended amount of25
compensation.26
(e) The payor shall, within ten calendar days of the mailing of the27
recommendation from the workers' compensation judge, either mail to the28
injured employee or the employee's representative a revised notice of payment29 SB NO. 763
SLS 12RS-3742 ENGROSSED
Page 6 of 12
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
with the recommended amount if such recommended amount is different from1
that which was previously provided on the initial notice of payment, or notify2
the injured worker or the employee's representative in writing that the payor3
does not accept the recommendation. No disputed claim for compensation4
regarding the amount of compensation due shall be filed until the provisions of5
this Subsection have been exhausted unless such a disputed claim is in regard6
to a payor's failure to provide a notice of payment as required by this7
Subsection. A payor who provides the compensation amounts due as8
recommended by the workers' compensation judge shall not be subject to any9
penalty and attorney fees regarding such calculation of the compensation due10
and payment provided with the revised notice of payment.11
(f) A payor who provides the compensation amounts due as12
recommended by the workers' compensation judge's preliminary13
recommendation and who disagrees with such preliminary recommendation14
shall file a disputed claim for compensation within fifteen days of mailing the15
revised notice of payment and compensation amount due.16
(3) Within fourteen days after the final payment of compensation has been17
made, the employer or insurer shall send a notice to the office, in the manner18
prescribed by the rules of the director, stating:19
(1)(a) The name of the injured employee or any other person to whom20
compensation has been paid, or both.21
(2)(b) The date of injury or death.22
(3)(c) The dates on which compensation has been paid.23
(4)(d) The total amount of compensation paid.24
(5)(e) The fact that final payment has been made.25
* * *26
§1210. Burial expenses; duty to furnish27
A. In every case of death, the employer shall pay or cause to be paid, in28
addition to any other benefits allowable under the provisions of this Part, reasonable29 SB NO. 763
SLS 12RS-3742 ENGROSSED
Page 7 of 12
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
expenses of the burial of the employee, not to exceed seven eight thousand five1
hundred dollars.2
* * *3
§1221. Temporary total disability; permanent total disability; supplemental earnings4
benefits; permanent partial disability; schedule of payments5
Compensation shall be paid under this Chapter in accordance with the6
following schedule of payments:7
* * *8
(3) Supplemental earnings benefits.9
(a)(i) For injury resulting in the employee's inability to earn wages equal to10
ninety percent or more of wages at time of injury, supplemental earnings benefits,11
payable monthly, equal to sixty-six and two-thirds percent of the difference between12
the average monthly wages at time of injury and average monthly wages earned or13
average monthly wages the employee is able to earn in any month thereafter in any14
employment or self-employment, whether or not the same or a similar occupation as15
that in which the employee was customarily engaged when injured and whether or16
not an occupation for which the employee at the time of the injury was particularly17
fitted by reason of education, training, and experience, such comparison to be made18
on a monthly basis. Average monthly wages shall be computed by multiplying his19
"wages" by fifty-two and then dividing the quotient by twelve.20
(ii) When the employee is entitled to monthly supplemental earnings21
benefits pursuant to this Subsection, but is not receiving any income from22
employment or self-employment and the employer has not established earning23
capacity pursuant to R.S. 23:1226, payments of supplemental earning benefits24
shall be made in the manner provided for in R.S. 23:1201(A)(1).25
* * *26
(4) Permanent partial disability. In the following cases, compensation shall27
be solely for anatomical loss of use or amputation and shall be as follows:28
* * *29 SB NO. 763
SLS 12RS-3742 ENGROSSED
Page 8 of 12
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
(s)(i) In addition to any other benefits to which an injured employee may be1
entitled under this Chapter, any employee suffering an injury as a result of an2
accident arising out of and in the course and scope of his employment shall be3
entitled to a sum of thirty fifty thousand dollars, payable within one year after the4
date of the injury. Interest on such payment shall not commence to accrue until after5
it becomes payable. Such payment shall not be subject to any offset for payment of6
any other benefit under this Chapter. Such payment shall not be subject to a claim7
for attorney fees; however, attorney fees may be awarded in a claim to collect such8
payment pursuant to R.S. 23:1201.2.9
* * *10
§1224. Payments not recoverable for first week; exceptions11
No compensation shall be paid for the first week after the injury is received;12
provided, that in cases where disability from injury continues for six two weeks or13
longer after date of the accident, compensation for the first week shall be paid after14
the first six two weeks have elapsed.15
* * *16
§1314. Necessary allegations; dismissal of premature petition; dispute of benefits17
* * *18
D. Disputes over medical treatment pursuant to the medical treatment19
schedule shall be premature unless a decision of the medical director has been20
obtained in accordance with R.S. 23:1203.1(J).21
E. Notwithstanding any other provisions of this Section, the employer22
shall be permitted to file a disputed claim to controvert benefits or concerning23
any other dispute arising under this Chapter.24
The original instrument and the following digest, which constitutes no part
of the legislative instrument, were prepared by Carla S. Roberts.
DIGEST
Donahue (SB 763)
Present law provides that the office of workers' compensation shall oversee the payments
and benefits regarding workers' compensation. SB NO. 763
SLS 12RS-3742 ENGROSSED
Page 9 of 12
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
Proposed law maintains present law and provides that the law be cited as the "Louisiana
Workers' Compensation Law."
Proposed law provides legislative purpose as follows:
1. To provide for the payment of timely, temporary and permanent disability benefits
to all injured workers who suffer an injury or disease arising out of and in the course
and scope of their employment as is required by workers' compensation laws.
2. To pay the medical expenses that are due to all injured workers who are covered
under the workers' compensation laws.
3. To return such workers, who have received workers' compensation benefits to the
work force.
Proposed law provides legislative intent as follows:
1. That the Louisiana Workers' Compensation Law is to be interpreted so as to assure
the delivery of benefits to an injured employee in accordance with the law.
2. To facilitate injured workers' return to employment at a reasonable cost to the
employer.
Proposed law provides that the Act shall be construed as follows:
1. The provisions of the Act are to be based on the mutual renunciation of legal rights
and defenses by employers and employees alike; therefore, it is the specific intent
of the legislature that workers' compensation cases shall be decided on their merits.
2. Disputes concerning the facts in workers' compensations cases shall not be given a
broad, liberal construction in favor of either employees or employers; therefore, the
laws pertaining to workers' compensation shall be construed in accordance with the
basic principles of statutory construction and not in favor of either employer or
employee.
3. According to the La. Constitution Art. III, Sec. 1, the legislative powers of the state
are vested solely in the legislature; therefore, when the workers' compensation
statutes of this state are to be amended, the legislature acknowledges its
responsibility to do so. Proposed law further provides that if the workers'
compensation statutes are to be liberalized, broadened, or narrowed, such actions
shall be the exclusive purview of the legislature.
Present law provides that, when an employer fails to timely pay a covered employee the
accurate amount of monetary benefits due or fails to provide the required medical or
vocational services, the employer shall be required to pay certain penalties and attorney fees.
Proposed law provides that a payor means that entity which is responsible for the payment
of benefits or medical expenses incurred by the claimant as a result of an injury covered by
the workers' compensation law.
Proposed law provides that a payor will do all of the following:
1. Prepare a notice of payment. The form for the notice of payment shall be
promulgated by the office of workers' compensation pursuant to the A.P.A.
2. Send the notice of payment to the injured employee, or the employee's
representative, with the first payment of compensation. SB NO. 763
SLS 12RS-3742 ENGROSSED
Page 10 of 12
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
3. Send the notice of payment to the injured employee, or the employee's
representative, within 10 days of a suspension or modification to compensation for
any cause or within 10 days of the suspension or modification of the supplemental
earnings benefit.
4. Send a copy of the notice of payment to the office within 10 days of the original
notice of payment being sent to the injured employee or the employee's
representative.
Proposed law provides that the injured employee who disagrees with any information
provided on the notice of payment is to notify, in writing, the payor of the basis for
disagreement and provide the amounts believed appropriate.
Proposed law provides that a payor, within five business days of receipt of the notice of
disagreement, shall do one of the following:
1. Send a revised notice of payment along with a revised payment in accordance
therewith to the injured employee or the employee's representative.
2. If the payor believes that the amount determined in the original notice of payment
was correct, then the payor shall file a request for preliminary determination, on a
form to be promulgated by the office, and shall provide a copy to the injured
employee or the employee's representative.
Proposed law provides that the preliminary determination shall be performed by the
designee of the director of the office of workers' compensation. Proposed law further
provides that the designee shall be a workers' compensation judge specifically assigned to
handle preliminary determinations.
Proposed law provides that the preliminary determination hearing will occur within 15 days
of the filing of a request.
Proposed law provides that the injured employee, the employee's representative, the payor
and the employer, which includes the direct employer of a statutory employee pursuant to
R.S. 23:1061, shall participate in a preliminary determination hearing by phone. Proposed
law provides that the workers' compensation judge may require any of these parties to
produce relevant records necessary for the determination of compensation provided for in
the notice of payment.
Proposed law provides that no later than 30 days from the filing of the request for a
preliminary determination, the workers' compensation judge will provide a recommended
amount of compensation.
Proposed law provides that the payor shall, within 10 calendar days of the mailing of the
recommendation from the workers' compensation judge, either mail to the injured employee
or the employee's representative a revised notice of payment with the recommended amount
if such recommended amount is different from that which was previously provided on the
initial notice of payment, or notify the injured worker or the employee's representative in
writing that the payor does not accept the recommendation.
Proposed law provides that no disputed claim for compensation, regarding the amount of
compensation due shall be filed until the provisions of this preliminary determination has
been exhausted unless such a disputed claim is in regard to a payor's failure to provide a
notice of payment. Proposed law further provides that a payor who provides the
compensation amounts due as recommended by the workers' compensation judge shall not
be subject to any penalty and attorney fees regarding such calculation of the compensation
due and payment provided with the revised notice of payment. SB NO. 763
SLS 12RS-3742 ENGROSSED
Page 11 of 12
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
Proposed law provides that the payor who provides the compensation amounts due as
recommended by the workers' compensation judge's preliminary recommendation, and who
disagrees with such preliminary recommendation shall file a disputed claim for
compensation within 15 days of mailing the revised notice of payment and compensation
amount due.
Present law provides that an employer will pay reasonable expenses of the burial of the
covered employee, who dies as a result of a work related injury, in an amount not to exceed
$7,500. Proposed law increases the amount from $7,500 to $8,500.
Present law provides that for injury resulting in the employee's inability to earn wages equal
to ninety percent or more of wages at time of injury, supplemental earnings benefits, equal
to 66 2/3% of the difference between the average monthly wages at time of injury and
average monthly wages earned or average monthly wages the employee is able to earn in any
month thereafter in any employment or self-employment.
Proposed law retains present law and provides that supplemental earnings benefits shall be
paid monthly.
Present law provides that payments of compensation will be paid as near as may be possible,
at the same time and place as wages were payable to the employee before the accident;
however, when the employee is not living at the place where the wages were paid, or is
absent therefrom, such payments shall be made by mail, upon the employee giving to the
employer a sufficient mailing address. Present law further provides that a longer interval, not
to exceed one month, may be substituted by agreement without approval of the director. An
interval of more than one month must be approved by the director.
Proposed law retains present law but provides that, when the employee is entitled to monthly
supplemental earnings benefits but is not receiving any income from employment or self-
employment and the employer has not established earning capacity, supplemental earning
benefits shall be made in the manner as present law.
Present law provides that, in addition to any other benefits to which an injured employee
may be entitled, any employee suffering an injury as a result of an accident arising out of and
in the course and scope of his employment shall be entitled to a sum of $30,000, payable
within one year after the date of the injury. Proposed law increases the amount from $30,000
to $50,000.
Present law provides that when an injured employee seeks medical treatment and a dispute
arises with the payor over the necessity of such treatment, the injured employee may seek
review of the denial of medical treatment with the medical director with the office of
workers' compensation.
Present law provides that no compensation shall be paid for the first week after the injury
is received provided that the disability from the injury continues for six weeks or longer after
the date of the accident, compensation for the first week shall be paid after the first six
weeks.
Proposed law changes the number of weeks from six to two in both instances.
Proposed law provides that disputes over medical treatment pursuant to the medical
treatment schedule shall be premature unless a decision of the medical director has been
obtained.
Present law clarifies that the employer shall be permitted to file a disputed claim to
controvert benefits or concerning any other dispute arising under workers' compensation law.
Effective August 1, 2012. SB NO. 763
SLS 12RS-3742 ENGROSSED
Page 12 of 12
Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
(Amends R.S. 23:1201(F) and (H), 1210(A), 1221(3)(a) and (4)(s)(i), 1224, and the heading
of 1314; adds R.S. 23:1020.1 and 1314(D) and (E))