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Workers' Compensation
Terminating Workers’ Compensation Benefits: The Arbitrary and Capricious Standard
The Louisiana Third Circuit Court of Appeal recently ruled on the case entitled Martin v. Doerle Food Services, LLC, 2021-94 (La. App. 3 Cir. 6/2/21), 2021 WL 2217087, which discusses the arbitrary and capricious standard. In the Martin case, the plaintiff, Mr. Martin, argued that his employer, Doerle Food Services, was arbitrary and capricious […]
- June 15, 2021
- By Allen & Gooch
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Workers' Compensation
Best Practices – Points to Remember When Settling a Claim Fully and Finally
There is more to settling a case than getting everyone to agree to a number that will settle the claim. Offering an amount that the other side will accept is only the start of the process. A lot of things go into reaching that perfect – and trouble free – settlement. Below are some specific […]
- May 5, 2021
- By Allen & Gooch
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Workers' Compensation
My Claimant is Returned to Light Duty – Now What?
So, the claimant is released to light duty work. What do I do now? I write to share my recommendations and response to this question because this is one of the most frequently asked questions. First of all, what was claimant’s original job description, and is the claimant physically capable of returning to the original […]
- May 5, 2021
- By Eric Waltner
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Workers' Compensation
CALCULATING THE AVERAGE WEEKLY WAGE OF AN HOURLY EMPLOYEE
Hypotheticals and Ruminations Calculating the proper Average Weekly Wage (AWW) is a critical part of any compensation claim. When miscalculating the AWW can give rise to an underpayment of indemnity, inevitably leading to a penalty claim, you only have one chance to get the calculation perfect. You will have the protections of the 1002 process […]
- March 26, 2021
- By Allen & Gooch
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Workers' Compensation
Best Practices
Document, document, document Have you ever received the file from another adjuster only to realize that the adjuster never documented their file? Were you ever told by your defense counsel that you are likely going to have to pay penalties on an issue, because there is nothing in the claims file documenting your reasons to […]
- February 5, 2021
- By Allen & Gooch
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Workers' Compensation
Fun with Surveillance
Surveillance is one of the most important weapons in your workers’ compensation arsenal, but it is important to know when and how to properly use it to build a fraud claim, understand the employee’s true limitations, etc. Some adjusters or claims managers may order surveillance of a claimant too quickly or without properly tailoring the […]
- February 5, 2021
- By Allen & Gooch
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Business Litigation
Tension Between New Tort Reform Law and Direct Action Statute
The Louisiana Direct Action Statute, La. Rev. Stat. 22:1269, generally allows Plaintiffs to sue its insurance company and another’s insurance company directly when the policy is written or delivered upon in Louisiana, or when the accident occurs in Louisiana. The Plaintiff must name both the insured and the insurer; however, when certain circumstances exist, the […]
- July 27, 2020
- By Brent Maggio
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Workers' Compensation
The Independent Medical Examination – Can It Be Used to Address Causation?
Under the Louisiana Workers’ Compensation Act, both the employee and the employer have a right to choose their own physicians. While the employee has a right to an initial choice of treating physician, the employer has the right to choose its own physician in order to examine the employee and render a Second Medical Opinion […]
- June 26, 2020
- By Allen & Gooch
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Workers' Compensation
The Impact of Pain on a Permanent & Total Disability Claim
Prior to the 1983 amendments to the Workers’ Compensation statute, pain played a large role in permanent and total disability claims. For example, the 1980 Louisiana Supreme Court in Whitaker v. Church’s Fried Chicken, Inc. presented an injured janitor that burned his legs with hot grease, causing severe pain. The court found the claimant to be permanently and total […]
- March 19, 2020
- By Allen & Gooch
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Workers' Compensation
Return to Work – Is a Physician Review Required?
When an employee is injured on the job, the goal of any employer is to assist in getting their employee returned to work. This process often includes consultations with a vocational rehabilitation counselor and can also just involve the employer presenting the employee with a modified duty offer of employment. When the employee with a […]
- January 22, 2020
- By Allen & Gooch
