Insurance Dispute Lawyer Blog
If you are injured on the job, one of your primary concerns is likely finding competent medical care. Under the Louisiana Workers’ Compensation Act, injured workers can select one physician of any specialty without their employer’s approval. What happens if your employer refuses to pay for your selected physician?
Marvin Ray Scott brought a workers’ compensation claim against his employer, Packaging Corporation of America (“PCA.”) Scott claimed he had lost his hearing because of his work at the Boise Paper Mill in DeRidder, Louisiana. Scott then filed a motion to have an expedited hearing under La. R.S. 23:1121. Scott claimed PCA had not authorized his initial visit to his selected physician. PCA responded, claiming Scott had improperly used summary proceedings because he was not just trying to get approval for his selected physician, but he was also seeking attorney’s fees and penalties. At the hearing, the workers’ compensation judge ruled in favor of Scott and ordered PCA to pay Scott’s relevant medical bills and pay separate penalties and attorney’s fees, totaling $7,000. PCA filed an appeal.
Louisiana Workers’ Compensation Act sets forth rights and remedies for injured workers. Under La. R.S. 23:1121, an employee is permitted to select one physician of any specialty without their employer’s approval. If the employer denies that, the employee is entitled to an expedited proceeding. Under La. R.S. 23:1201(F), the employer can also be required to pay penalties and attorneys’ fees if it does not comply with its statutory obligations to an injured worker.
PCA raised numerous arguments on the appeal of why the workers’ compensation judge had erred in ruling in favor of Scott. Although PCA claimed Scott had waited too long to bring his workers’ compensation claim, the court found no evidence Scott’s hearing loss had prevented him from completing his work. Because the employee being disabled is one of the conditions in La. R.S. 23:1031.1(E) that starts the one-year clock running for bringing a workers’ compensation claim, Scott’s time for bringing his claim had not yet ended. Additionally, there had not yet been any discovery into this issue.
PCA also argued it was improper for the court to have awarded Scott attorneys’ fees and penalties. While PCA admitted there were other cases where the court had awarded the employee penalties and attorneys’ fees where the employer did not permit the injured employee to select one physician of any specialty without approval, it claimed those were inapplicable here because it had filed an exception claiming Scott had improperly used summary proceedings.
The appellate court disagreed because Scott was entitled to a visit with his choice of physician even before a formal investigation of the merits of the claim. Therefore, the appellate court found the workers’ compensation judge had not erred in denying PCA’s exception of unauthorized use of summary proceedings and awarding Scott attorneys’ fees and penalties.
Navigating the Louisiana workers’ compensation system can be complex, and it is essential to have the guidance of an experienced attorney who can not only help you understand your rights but also assist you in seeking compensation if your employer fails to adhere to the statutory requirements of the Workers’ Compensation Act. An attorney’s expertise can make a significant difference in ensuring you receive the necessary support and benefits following a workplace injury.
Additional Sources: Marvin Ray Scott v. Packaging Corp. of Am.
Article Written By Berniard Law Firm
Additional Berniard Law Firm Article on Selection of Medical Professionals in Workers’ Compensation Claims: Workers’ Compensation Claimant Denied Choice of Physical Therapist to Conduct Functional Capacity Evaluation (“FCE”)