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Regular Session, 2012 ENROLLED
SENATE BILL NO. 763 (Substitute of Senate Bill No. 560 by Senator Donahue)
BY SENATORS DONAHUE AND LAFLEUR
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
all of the following:18
(1) To provide for the timely payment of temporary and permanent19
disability benefits to all injured workers who suffer an injury or disease arising20
out of and in the course and scope of their employment as is provided in this21
Chapter.22
(2) To pay the medical expenses that are due to all injured workers23
pursuant to this Chapter.24
(3) To return such workers who have received benefits pursuant to this25
Chapter to the work force.26
C. Legislative intent. The legislature finds all of the following:27
ACT No. 860 SB NO. 763 ENROLLED
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(1) That the Louisiana Workers' Compensation Law is to be interpreted1
so as to assure the delivery of benefits to an injured employee in accordance2
with this Chapter.3
(2) To facilitate injured workers' return to employment at a reasonable4
cost to the employer.5
D. Construction. The Louisiana Workers' Compensation Law shall be6
construed as follows:7
(1) The provisions of this Chapter are based on the mutual renunciation8
of legal rights and defenses by employers and employees alike; therefore, it is9
the specific intent of the legislature that workers' compensation cases shall be10
decided on their merits.11
(2) Disputes concerning the facts in workers' compensation cases shall12
not be given a broad, liberal construction in favor of either employees or13
employers; the laws pertaining to workers' compensation shall be construed in14
accordance with the basic principles of statutory construction and not in favor15
of either employer or employee.16
(3) According to Article III, Section 1 of the Constitution of Louisiana,17
the legislative powers of the state are vested solely in the legislature; therefore,18
when the workers' compensation statutes of this state are to be amended, the19
legislature acknowledges its responsibility to do so. If the workers'20
compensation statutes are to be liberalized, broadened, or narrowed, such21
actions shall be the exclusive purview of the legislature.22
* * *23
§1201. Time and place of payment; failure to pay timely; failure to authorize;24
penalties and attorney fees25
* * *26
F. Failure Except as otherwise provided in this Chapter, failure to27
provide payment in accordance with this Section or failure to consent to the28
employee's request to select a treating physician or change physicians when such29
consent is required by R.S. 23:1121 shall result in the assessment of a penalty in an30 SB NO. 763 ENROLLED
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amount up to the greater of twelve percent of any unpaid compensation or medical1
benefits, or fifty dollars per calendar day for each day in which any and all2
compensation or medical benefits remain unpaid or such consent is withheld,3
together with reasonable attorney fees for each disputed claim; however, the fifty4
dollars per calendar day penalty shall not exceed a maximum of two thousand dollars5
in the aggregate for any claim. The maximum amount of penalties which may be6
imposed at a hearing on the merits regardless of the number of penalties which might7
be imposed under this Section is eight thousand dollars. An award of penalties and8
attorney fees at any hearing on the merits shall be res judicata as to any and all9
claims for which penalties may be imposed under this Section which precedes the10
date of the hearing. Penalties shall be assessed in the following manner:11
* * *12
H. (1) Upon making the first payment of compensation and upon13
modification or suspension of payment for any cause, the employer or insurer shall14
immediately send a notice to the office, in the manner prescribed by the rules of the15
director, that payment of compensation has begun or has been suspended, as the case16
may be. After February 1, 2013, a payor, which shall mean that entity which is17
responsible by law or contract for the payment of benefits or medical expenses18
incurred by the claimant as a result of an injury covered by this Chapter, shall19
do all of the following:20
(a) Prepare a notice of payment. The form for the notice of payment21
shall be promulgated by the office pursuant to the Administrative Procedure22
Act.23
(b) Send the notice of payment to the injured employee, or the24
employee's representative, with the first payment of compensation.25
(c) Send the notice of payment to the injured employee, or the26
employee's representative, within ten days of a suspension or modification to27
compensation for any cause or within ten days of the suspension or modification28
of the supplemental earnings benefit.29
(d) Send a copy of the notice of payment to the office within ten days30 SB NO. 763 ENROLLED
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from the date that the original notice of payment was sent to the injured1
employee or the employee's representative.2
(2)(a) The injured employee or the employee's representative who3
disagrees with any information provided on the notice of payment shall, in4
writing, notify the payor of the basis for disagreement and provide the amounts5
believed appropriate.6
(b) The payor, within five business days of receipt of the notice of7
disagreement, shall do one of the following:8
(i) Send a revised notice of payment along with a revised payment in9
accordance therewith to the injured employee or the employee's representative.10
(ii) If the payor believes that the amount determined in the original11
notice of payment was correct, then the payor shall file a request for12
preliminary determination, on a form to be promulgated by the office, and shall13
provide a copy to the injured employee or the employee's representative.14
(c) The preliminary determination shall be performed by the director's15
designee, who shall be a workers' compensation judge specifically assigned to16
handle preliminary determinations. Such preliminary determination hearing17
shall occur within fifteen days of the filing of a request.18
(d) The injured employee, the employee's representative, the payor and19
the employer, which includes the direct employer of a statutory employee20
pursuant to R.S. 23:1061, shall participate in a preliminary determination21
hearing by phone. The workers' compensation judge may require any of these22
parties to produce relevant records necessary for the determination of23
compensation provided for in the notice of payment. No later than thirty days24
from the filing of the request for a preliminary determination, the workers'25
compensation judge shall provide, in writing, a recommended amount of26
compensation.27
(e) The payor shall, within ten calendar days of the mailing of the28
recommendation from the workers' compensation judge, either mail to the29
injured employee or the employee's representative a revised notice of payment30 SB NO. 763 ENROLLED
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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
expenses of the burial of the employee, not to exceed seven eight thousand five30 SB NO. 763 ENROLLED
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hundred dollars.1
* * *2
§1221. Temporary total disability; permanent total disability; supplemental earnings3
benefits; permanent partial disability; schedule of payments4
Compensation shall be paid under this Chapter in accordance with the5
following schedule of payments:6
* * *7
(3) Supplemental earnings benefits.8
(a)(i) For injury resulting in the employee's inability to earn wages equal to9
ninety percent or more of wages at time of injury, supplemental earnings benefits,10
payable monthly, equal to sixty-six and two-thirds percent of the difference between11
the average monthly wages at time of injury and average monthly wages earned or12
average monthly wages the employee is able to earn in any month thereafter in any13
employment or self-employment, whether or not the same or a similar occupation as14
that in which the employee was customarily engaged when injured and whether or15
not an occupation for which the employee at the time of the injury was particularly16
fitted by reason of education, training, and experience, such comparison to be made17
on a monthly basis. Average monthly wages shall be computed by multiplying his18
"wages" by fifty-two and then dividing the quotient product by twelve.19
(ii) When the employee is entitled to monthly supplemental earnings20
benefits pursuant to this Subsection, but is not receiving any income from21
employment or self-employment and the employer has not established earning22
capacity pursuant to R.S. 23:1226, payments of supplemental earning benefits23
shall be made in the manner provided for in R.S. 23:1201(A)(1).24
* * *25
(4) Permanent partial disability. In the following cases, compensation shall26
be solely for anatomical loss of use or amputation and shall be as follows:27
* * *28
(s)(i) In addition to any other benefits to which an injured employee may be29
entitled under this Chapter, any employee suffering an injury as a result of an30 SB NO. 763 ENROLLED
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accident arising out of and in the course and scope of his employment shall be1
entitled to a sum of thirty fifty thousand dollars, payable within one year after the2
date of the injury. Interest on such payment shall not commence to accrue until after3
it becomes payable. Such payment shall not be subject to any offset for payment of4
any other benefit under this Chapter. Such payment shall not be subject to a claim5
for attorney fees; however, attorney fees may be awarded in a claim to collect such6
payment pursuant to R.S. 23:1201.2.7
* * *8
§1224. Payments not recoverable for first week; exceptions9
No compensation shall be paid for the first week after the injury is received;10
provided, that in cases where disability from injury continues for six two weeks or11
longer after date of the accident, compensation for the first week shall be paid after12
the first six two weeks have elapsed.13
* * *14
§1314. Necessary allegations; dismissal of premature petition; dispute of benefits15
* * *16
D. Disputes over medical treatment pursuant to the medical treatment17
schedule shall be premature unless a decision of the medical director has been18
obtained in accordance with R.S. 23:1203.1(J).19
E. Notwithstanding any other provisions of this Section, the employer20
shall be permitted to file a disputed claim to controvert benefits or concerning21
any other dispute arising under this Chapter.22
PRESIDENT OF THE SENATE
SPEAKER OF THE HOUSE OF REPRESENTATIVES
GOVERNOR OF THE STATE OF LOUISIANA
APPROVED: