Practice: Workers’ Compensation

• Workers' Compensation

  Terminating Workers’ Compensation Benefits: The Arbitrary and Capricious Standard

  • June 15, 2021
  • By Allen & Gooch

    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 […]

• Workers' Compensation

  Best Practices – Points to Remember When Settling a Claim Fully and Finally

  • May 5, 2021
  • By Allen & Gooch

  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 […]

• Workers' Compensation

  April 2021 Legal Updates

  • May 5, 2021
  • By Allen & Gooch

  Proof of disability necessary to support entitlement to indemnity Moya v. Lucas, 20-329 (La. App. 5 Cir. 3/24/21), 2021 WL 1114293 Mr. Moya filed Disputed Claim for Compensation asserting that he was entitled to compensation benefits due to a work-related injury in January 2018, from which he claimed to have suffered fractures of his spine […]

• Workers' Compensation

  My Claimant is Returned to Light Duty – Now What?

  • May 5, 2021
  • By Eric Waltner

  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 […]

• Workers' Compensation

  BEST PRACTICES

  • March 26, 2021
  • By Allen & Gooch

  Are your claimants completing the Employee Certificate of Compliance 1025 form? In this post-COVID world, along with the increase of weekly unemployment benefits, we have noticed an increase in claimants receiving unemployment benefits, but failing to report the benefits. Under La. R.S. 23:1225(B) no workers’ compensation benefits are payable for temporary or permanent total disability […]

• Workers' Compensation

  MARCH 2021 LEGAL UPDATES

  • March 26, 2021
  • By Allen & Gooch

  Louisiana Supreme Court Clarifies the Arrant Decision Regarding Eligible Benefits in Hearing Loss Cases The hearing loss issue made its way back to the Supreme Court recently in Hartman v. St. Bernard Parish Fire Dept. and FARA, 2020-00693, (La. 3/24/21). The Claimant, who was employed by St. Bernard Parish Fire Department, alleged he was exposed […]

• Workers' Compensation

  CALCULATING THE AVERAGE WEEKLY WAGE OF AN HOURLY EMPLOYEE

  • March 26, 2021
  • By Allen & Gooch

  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 […]

• Workers' Compensation

  Best Practices

  • February 5, 2021
  • By Allen & Gooch

  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 […]

• Workers' Compensation

  January 2021 Legal Updates

  • February 5, 2021
  • By Allen & Gooch

  What is an unconditional tender, and what is the problem with a condition upon a settlement check? Very few cases have caused this much concern recently as the Louisiana Supreme Court’s ruling in Zinn v. Zagis, USA, LLC, 307 So.3d 193 (La. 12/322/20). In that case, the parties reached a full and final settlement, and […]

• Workers' Compensation

  Fun with Surveillance

  • February 5, 2021
  • By Allen & Gooch

  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 […]