La. Admin. Code tit. 40 § I-911
Current through Register Vol. 50, No. 11, November 20, 2024
Section I-911 - Employee NoticeA. It shall be the employer's duty to advise employees and keep posted at some convenient and conspicuous point in his place of business a notice reading substantially as follows. LOUISIANA DEPARTMENT OF LABOR
OFFICE OF WORKERS' COMPENSATION
ADMINISTRATION
POST OFFICE BOX 94040
BATON ROUGE, LA 70804 -9040
1. Notice of Compliance to Employees a. You should report to your employer any occupational disease or personal injury that is work related, even if you deem it to be minor.b. In case of occupational disease, all claims are barred unless the employee files a claim with his employer within six months of the date that: i. the disease manifests itself;ii. the employee is disabled as a result of the disease; andiii. the employee knows or has reasonable grounds to believe that the disease is occupationally related.2. In case of death arising from an occupational disease, all claims are barred unless the dependent(s) files a claim with the deceased employee's employer within six months of:a. the date of death; andb. the date the claimant has reasonable grounds to believe that the death resulted from an occupational disease.3. In case of personal injury or death arising out of an in the course of employment, an injured employee, or any person claiming to be entitled to compensation either as a claimant or as a representative of a person claiming to be entitled to compensation, must give notice to the employers within 30 days of the injury. If notice is not given within 30 days, no payments will be made under the law for such injury or death.4. The above mentioned claims should be filed with the employer at the address shown below.5. In the event you are injured, you are entitled to select a physician of your choice for treatment. The employer may choose another physician and arrange an examination which you would be required to attend.6. In order to preserve your right to benefits under the Louisiana Workers' Compensation Law, you must file a formal claim with the Office of Workers' Compensation Administration within one year after the accident if payments have not been made or within one year after the last payment of weekly benefits.7.a. This notice shall be given by delivering it or sending it by certified mail or return receipt requested to: ________________________________
Employer Representative
________________________________
Employer Name
________________________________
Address
________________________________
City
________________________________
State and Zip
b. Inaccuracies in this notice of disease, injury, or death regarding the time, place, nature, or the cause of injury or otherwise will not be held against the employee unless the employer can show harm from being misled about the facts.8. Failure to give notice may not harm the employee if the employer knew of the accident or if the employer was not prejudiced by the delay or failure to give notice. (Refer to R.S. 23:1304 and 1305 for the exact wording.)9. If you desire any information regarding your rights and entitlement to benefits as prescribed by law, you may call or write to the Office of Workers' Compensation Administration at the above address, or telephone (225) 342-7555 or toll-free (800) 824-4592. 10. This notice should be posted conspicuously in and about employer's place(s) of business.11. If the employer is insured, then include the name and address of insurance company.12. If the employer fails to keep such a notice posted, the time in which the notice of injury shall be given shall be extended to 12 months from the date of the injury.La. Admin. Code tit. 40, § I-911
Promulgated by the Department of Labor, Office of Workers' Compensation Administration, LR 11:779 (August 1985), repromulgated LR 13:308 (May 1987), repromulgated by the Department of Employment and Training, LR 17:178 (February 1991), amended by the Department of Labor, LR 19:757 (June 1993).AUTHORITY NOTE: Promulgated in accordance with R.S. 23:1302.