Louisiana Outpatient Services Get Higher Workers Comp Payments, Premiums Higher

In a recent survey of 16 states, conducted by the Workers Compensation Research Institute, Louisiana workers comp payments for medical care were higher, and growing faster, than other states surveyed.

The WCRI study, CompScope Medical Benchmarks for Louisiana 14th Edition, found that medical payments from workers comp grew 7% per year from 2006 to 2011 – a faster growth rate than other states surveyed.

The major contributor to the high workers comp payments per claim was the cost of outpatient hospital treatment, which also reportedly contributed to the more rapid growth. Louisiana’s fee schedule sets reimbursement for hospital outpatient services at 90% of billed charges, so as medical costs go up, so do workers comp costs.

“The study can help policymakers and system stakeholders identify current cost drivers and emerging trends in payments, prices, and utilization of medical services among nonhospital and hospital providers,” said Ramona Tanabe, WCRI’s deputy director and counsel. “Recent policy debates around ways to manage medical care and costs have considered revisions to the hospital reimbursement approach.”

The statute, however, calls for “the mean of usual and customary charges” withworkers comp payments, and disagreement over that exact definition leads to several workers comp claims going to court.

Workers Comp in South Carolina

Any full-time employee (working for an employer with four or more employees) who has an employment related injury and needs medical attention should be covered under workers’ compensation insurance. It doesn’t matter if the injury was a complete accident or the fault of a co-worker.

South Carolina does not award workers compensation to workers who are intoxicated on the job. This accusation could be used as “employer retaliation,” however, and the claim is difficult to prove. Just because your employer, or your employer’s insurance company, denies your workers’ compensation claim does not mean that they are right to deny your workers’ comp benefits.

If the employer is using a legal reason to deny workers’ comp, you need to determine if the reason is valid, or if it is a false accusation against you (such as a work injury due to intoxication). Your employer also may not want to accept your work injury, especially if your injury is difficult to prove and requires you to seek legal assistance. Some job-related injuries employers may initially deny are from repetitive injuries, stress, mental conditions, and environmental conditions such as claims of toxic exposure.

The Strom Law Firm Can Help with Workers Comp Claims in South Carolina

The workers comp lawyers at The Strom Law Firm, LLC proudly seek justice on behalf of employees injured or killed on the job who work for private companies, as well as employees working for local county, city, and state government. We are licensed to practice throughout South Carolina, as well as Georgia and New York. If you are confused about worker’s comp laws, or have had your worker’s comp claim denied, contact us. We offer free consultations to discuss the facts of your case.803.252.4800.