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Regular Session, 2012
SENATE BILL NO. 763 (Substitute of Senate Bill No. 560 by Senator Donahue)
BY SENATORS DONAHUE AND LAFLEUR
WORKERS' COMPENSATION. Provides relative to the workers' compensation law.
(8/1/12)
AN ACT1
To amend and reenact R.S. 23:1201(F)(introductory paragraph) and (H), 1210(A),2
1221(3)(a) and (4)(s)(i), 1224 and the heading of 1314, and to enact R.S. 23:1020.13
and 1314(D) and (E), relative to workers' compensation; to provide for legislative4
purpose; to provide for legislative intent; to provide for construction; to provide with5
respect to nonpayment of benefits; to provide with respect to burial benefits; to6
provide with respect to supplemental earnings benefits; to provide with respect to7
benefits for catastrophic injury; to provide with respect to prematurity of actions; and8
to provide for related matters.9
Be it enacted by the Legislature of Louisiana:10
Section 1. R.S. 23:1201(F)(introductory paragraph) and (H), 1210(A), 1221(3)(a)11
and (4)(s)(i), 1224 and the heading of 1314 are hereby amended and reenacted and R.S.12
23:1020.1 and 1314(D) and (E) 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
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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' compensation 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
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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
* * *23
H. (1) Upon making the first payment of compensation and upon24
modification or suspension of payment for any cause, the employer or insurer shall25
immediately send a notice to the office, in the manner prescribed by the rules of the26
director, that payment of compensation has begun or has been suspended, as the case27
may be. A payor, which shall mean that entity which is responsible by law or28
contract for the payment of benefits or medical expenses incurred by the29 SB NO. 763
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claimant as a result of an injury covered by this Chapter, shall do all of the1
following:2
(a) Prepare a notice of payment. The form for the notice of payment3
shall be promulgated by the office pursuant to the Administrative Procedure4
Act.5
(b) Send the notice of payment to the injured employee, or the6
employee's representative, with the first payment of compensation.7
(c) Send the notice of payment to the injured employee, or the8
employee's representative, within ten days of a suspension or modification to9
compensation for any cause or within ten days of the suspension or modification10
of the supplemental earnings benefit.11
(d) Send a copy of the notice of payment to the office within ten days12
from the date that the original notice of payment was sent to the injured13
employee or the employee's representative.14
(2)(a) The injured employee or the employee's representative who15
disagrees with any information provided on the notice of payment shall, in16
writing, notify the payor of the basis for disagreement and provide the amounts17
believed appropriate.18
(b) The payor, within five business days of receipt of the notice of19
disagreement, shall do one of the following:20
(i) Send a revised notice of payment along with a revised payment in21
accordance therewith to the injured employee or the employee's representative.22
(ii) If the payor believes that the amount determined in the original23
notice of payment was correct, then the payor shall file a request for24
preliminary determination, on a form to be promulgated by the office, and shall25
provide a copy to the injured employee or the employee's representative.26
(c) The preliminary determination shall be performed by the director's27
designee, who shall be a workers' compensation judge specifically assigned to28
handle preliminary determinations. Such preliminary determination hearing29 SB NO. 763
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shall occur within fifteen days of the filing of a request.1
(d) The injured employee, the employee's representative, the payor and2
the employer, which includes the direct employer of a statutory employee3
pursuant to R.S. 23:1061, shall participate in a preliminary determination4
hearing by phone. The workers' compensation judge may require any of these5
parties to produce relevant records necessary for the determination of6
compensation provided for in the notice of payment. No later than thirty days7
from the filing of the request for a preliminary determination, the workers'8
compensation judge shall provide, in writing, a recommended amount of9
compensation.10
(e) The payor shall, within ten calendar days of the mailing of the11
recommendation from the workers' compensation judge, either mail to the12
injured employee or the employee's representative a revised notice of payment13
with the recommended amount if such recommended amount is different from14
that which was previously provided on the initial notice of payment, or notify15
the injured worker or the employee's representative in writing that the payor16
does not accept the recommendation. No disputed claim for compensation17
regarding the amount of compensation due shall be filed until the provisions of18
this Subsection have been exhausted unless such a disputed claim is in regard19
to a payor's failure to provide a notice of payment as required by this20
Subsection. A payor who provides the compensation amounts due as21
recommended by the workers' compensation judge shall not be subject to any22
penalty and attorney fees regarding such calculation of the compensation due23
and payment provided with the revised notice of payment.24
(f) A payor who provides the compensation amounts due as25
recommended by the workers' compensation judge's preliminary26
recommendation and who disagrees with such preliminary recommendation27
shall file a disputed claim for compensation within fifteen days of mailing the28
revised notice of payment and compensation amount due.29 SB NO. 763
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(3) Within fourteen days after the final payment of compensation has been1
made, the employer or insurer shall send a notice to the office, in the manner2
prescribed by the rules of the director, stating:3
(1)(a) The name of the injured employee or any other person to whom4
compensation has been paid, or both.5
(2)(b) The date of injury or death.6
(3)(c) The dates on which compensation has been paid.7
(4)(d) The total amount of compensation paid.8
(5)(e) The fact that final payment has been made.9
* * *10
§1210. Burial expenses; duty to furnish11
A. In every case of death, the employer shall pay or cause to be paid, in12
addition to any other benefits allowable under the provisions of this Part, reasonable13
expenses of the burial of the employee, not to exceed seven eight thousand five14
hundred dollars.15
* * *16
§1221. Temporary total disability; permanent total disability; supplemental earnings17
benefits; permanent partial disability; schedule of payments18
Compensation shall be paid under this Chapter in accordance with the19
following schedule of payments:20
* * *21
(3) Supplemental earnings benefits.22
(a)(i) For injury resulting in the employee's inability to earn wages equal to23
ninety percent or more of wages at time of injury, supplemental earnings benefits,24
payable monthly, equal to sixty-six and two-thirds percent of the difference between25
the average monthly wages at time of injury and average monthly wages earned or26
average monthly wages the employee is able to earn in any month thereafter in any27
employment or self-employment, whether or not the same or a similar occupation as28
that in which the employee was customarily engaged when injured and whether or29 SB NO. 763
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not an occupation for which the employee at the time of the injury was particularly1
fitted by reason of education, training, and experience, such comparison to be made2
on a monthly basis. Average monthly wages shall be computed by multiplying his3
"wages" by fifty-two and then dividing the quotient product by twelve.4
(ii) When the employee is entitled to monthly supplemental earnings5
benefits pursuant to this Subsection, but is not receiving any income from6
employment or self-employment and the employer has not established earning7
capacity pursuant to R.S. 23:1226, payments of supplemental earning benefits8
shall be made in the manner provided for in R.S. 23:1201(A)(1).9
* * *10
(4) Permanent partial disability. In the following cases, compensation shall11
be solely for anatomical loss of use or amputation and shall be as follows:12
* * *13
(s)(i) In addition to any other benefits to which an injured employee may be14
entitled under this Chapter, any employee suffering an injury as a result of an15
accident arising out of and in the course and scope of his employment shall be16
entitled to a sum of thirty fifty thousand dollars, payable within one year after the17
date of the injury. Interest on such payment shall not commence to accrue until after18
it becomes payable. Such payment shall not be subject to any offset for payment of19
any other benefit under this Chapter. Such payment shall not be subject to a claim20
for attorney fees; however, attorney fees may be awarded in a claim to collect such21
payment pursuant to R.S. 23:1201.2.22
* * *23
§1224. Payments not recoverable for first week; exceptions24
No compensation shall be paid for the first week after the injury is received;25
provided, that in cases where disability from injury continues for six two weeks or26
longer after date of the accident, compensation for the first week shall be paid after27
the first six two weeks have elapsed.28
* * *29 SB NO. 763
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§1314. Necessary allegations; dismissal of premature petition; dispute of benefits1
* * *2
D. Disputes over medical treatment pursuant to the medical treatment3
schedule shall be premature unless a decision of the medical director has been4
obtained in accordance with R.S. 23:1203.1(J).5
E. Notwithstanding any other provisions of this Section, the employer6
shall be permitted to file a disputed claim to controvert benefits or concerning7
any other dispute arising under this Chapter.8
The original instrument was prepared by Carla S. Roberts. The following
digest, which does not constitute a part of the legislative instrument, was
prepared by Ann S. Brown.
DIGEST
Donahue (SB 763)
Present law provides that the office of workers' compensation shall oversee the payments
and benefits regarding workers' compensation.
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 employer s 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 SB NO. 763
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Coding: Words which are struck through are deletions from existing law;
words in boldface type and underscored are additions.
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.
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. SB NO. 763
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words in boldface type and underscored are additions.
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.
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. SB NO. 763
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words in boldface type and underscored are additions.
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.
(Amends R.S. 23:1201(F)(intro para) 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))
Summary of Amendments Adopted by Senate
Senate Floor Amendments to engrossed bill
1. Makes Legislative Bureau technical changes.