WORKERS COMPENSATION: Provides relative to penalties and attorney fees for nonpayment, discontinuance of payment, or failure to consent for a medical treatment for workers' compensation claims, controversion of benefits, and preliminary determination hearings

HLS 26RS-490 ENGROSSED
2026 Regular Session
HOUSE BILL NO. 780
BY REPRESENTATIVE FIRMENT
WORKERS COMPENSATION: Provides relative to penalties and attorney fees for
nonpayment, discontinuance of payment, or failure to consent for a medical
treatment for workers' compensation claims, controversion of benefits, and
preliminary determination hearings
1 AN ACT
2 To amend and reenact R.S. 23:1201(F)(introductory paragraph) and (2) and 1201.1(A), (B),
3 (D), (E), (G) through (I), (J)(2) through (4), and (K)(1)(introductory paragraph) and
4 (2) through (5) and to enact R.S. 23:1201(F)(6), and to repeal R.S. 23:1201(I) and
5 1201.1(A)(4) and (5), relative to workers' compensation; to provide for the failure
6 to provide payment, discontinue payment, or consent for a medical treatment; to
7 provide exceptions for nonpayment, discontinuance of payment, or failure to give
8 consent; to provide for penalties and attorney fees; to provide for the controversion
9 of compensation and medical benefits; to require certain notice and delivery
10 requirements; to provide for preliminary determination hearings; and to provide for
11 related matters.
12 Be it enacted by the Legislature of Louisiana:
13 Section 1. R.S. 23:1201(F)(introductory paragraph) and (2) and 1201.1(A), (B), (D),
14 (E), (G) through (I), (J)(2) through (4), (K)(1)(introductory paragraph) and (2) through (5)
15 are hereby amended and reenacted and R.S. 23:1201(F)(6) is hereby enacted to read as
16 follows:
17 §1201. Time and place of payment; failure to pay timely; failure to authorize;
18 penalties and attorney fees
19 * * *
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1 F. Except as otherwise provided in this Chapter, failure to provide payment
2 in accordance with this Section, discontinuance of payment due pursuant to this
3 Chapter, or failure to consent to the employee's request to select a treating physician
4 or change physicians when such consent is required by R.S. 23:1121 shall result in
5 the assessment of a penalty in an amount up to the greater of twelve percent of any
6 unpaid compensation or medical benefits, or fifty dollars per calendar day for each
7 day in which any and all compensation or medical benefits remain unpaid or such
8 consent is withheld, together with reasonable attorney fees for each disputed claim;
9 however, the fifty dollars per calendar day penalty shall not exceed a maximum of
10 two thousand dollars in the aggregate for any claim. A party claiming penalties and
11 attorney fees pursuant to this Section bears the burden of proof by a preponderance
12 of the evidence. The maximum amount of penalties which may be imposed at a
13 hearing on the merits regardless of the number of penalties which might be imposed
14 under this Section is eight thousand dollars. An award of penalties and attorney fees
15 at any hearing on the merits shall be res judicata as to any and all claims for which
16 penalties may be imposed under this Section which precedes the date of the hearing.
17 Penalties shall be assessed in the following manner:
18 * * *
19 (2)(a) This Subsection shall not apply applies only if the claim is reasonably
20 controverted or if such nonpayment, discontinuance of payment, or failure to consent
21 to the employee's request to select a treating physician or change physicians when
22 such consent is required by R.S. 23:1121 is found to be arbitrary, capricious, or
23 without probable cause.
24 (b) This Subsection does not apply if the nonpayment, discontinuance of
25 payment, or failure to consent to the employee's request to select a treating physician
26 or change physicians when such consent is required by R.S. 23:1121 results from
27 conditions over which the employer or insurer had no control.
28 * * *
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HB NO. 780
1 (6) The provisions set forth in R.S. 23:1141 limiting the amount of attorney
2 fees do not apply to cases where the employer or insurer is found liable for attorney
3 fees pursuant to this Section.
4 * * *
5 §1201.1. Controversion of compensation and medical benefits
6 A. Upon the first payment of compensation or upon any modification,
7 suspension, termination, or controversion of compensation or medical benefits for
8 any reason, including but not limited to issues of medical causation, compensability
9 of the claim, or issues arising out of R.S. 23:1121, 1124, 1208, and 1226, the
10 employer or payor, or their authorized agent or attorney, who has been notified of the
11 claim, shall do all of the following:
12 (1) Prepare a "Notice of Payment, Modification, Suspension, Termination,
13 or Controversion of Compensation and/or or Medical Benefits" on a LWC-WC 1002
14 form or such other form as may be promulgated by the assistant secretary in
15 accordance with the Administrative Procedures Act.
16 (2) Send the notice of the initial indemnity payment required by Paragraph
17 (1) of this Subsection to the injured employee on the same day as no later than ten
18 business days after the first payment of compensation is made by the payor after the
19 payor has received notice of the claim from the employer.
20 (3) Send a copy of the notice of the initial payment of indemnity required by
21 Paragraph (1) of this Subsection to the office within ten days from the on the same
22 date the original notice was sent to the injured employee or by facsimile to the
23 injured employee's representative.
24 B. The form of the "Notice of Payment, Modification, Suspension,
25 Termination, or Controversion of Compensation and/or Medical Benefits" shall be
26 promulgated by the office. Upon any modification, suspension, termination, or
27 controversion of compensation or medical benefits for any reason, including but not
28 limited to issues of medical causation, compensability of the claim, or issues arising
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1 out of R.S. 23:1121, 1124, 1208, or 1226, the employer or payor, or their authorized
2 agent or attorney, shall do all of the following:
3 (1) Prepare a "Notice of Payment, Modification, Suspension, Termination,
4 or Controversion of Compensation or Medical Benefits" on a LWC-WC 1002 form
5 or such other form as may be promulgated by the assistant secretary in accordance
6 with the Administrative Procedure Act.
7 (2) Send the notice required by Paragraph (1) of this Subsection to the
8 injured employee within three business days after the effective date of the
9 modification, suspension, termination, or controversion.
10 (3) Send a copy of the notice required by Paragraph (1) of this Subsection
11 to the office on the same date the original notice was sent to the employee.
12 * * *
13 D.(1) Any notice required to be sent to the injured employee pursuant to this
14 Section shall be sent by certified mail or commercial carrier to the address at which
15 the employee is receiving payment of indemnity benefits, electronic mail to the
16 employee's electronic mail address on file with the employer or payor, or hand
17 delivery to the employee.
18 (2) For purposes of receiving notice as required by this Section, the
19 employee shall provide a mailing address and an electronic mail address upon
20 request from the employer or payor.
21 (3) If the injured employee is represented by an attorney, the notice shall also
22 be provided sent to the employee's representative attorney by facsimile, certified
23 mail, commercial carrier, electronic mail, or hand delivery. Proof that the notice was
24 sent to the employee's representative by facsimile as required in this Paragraph shall
25 be prima facie evidence of compliance with Subsection A of this Section.
26 E. The provisions of this Section shall do not apply to questions of medical
27 necessity as provided by R.S. 23:1203.1, or disputes concerning the amount of
28 reimbursement pursuant to R.S. 23:1034.2.
29 * * *
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1 G.(1) If the employer or the payor provides the benefit that the employee
2 claims is due, including any arrearage, on the returned form or letter of amicable
3 demand within seven ten business days of receipt of the employee's demand, the
4 employer or payor shall not be subject to any claim for any penalties or attorney fees
5 arising from the disputed payment, modification, suspension, termination, or
6 controversion.
7 (2) If the employer or payor does not provide the benefit that the employee
8 claims is due, the employee may file a disputed claim for benefit provided it is filed
9 within the prescriptive period established under R.S. 23:1209. If the prescription
10 date of the claim occurs within the seven-day ten-day waiting period, the employee
11 will be allowed to file a disputed claim without waiting the seven ten business days
12 as provided in Paragraph (1) of this Subsection. However, the employer or payor
13 shall still be allowed seven ten business days to provide the benefit that the employee
14 claims is due, and if the employer does provide the benefit, the disputed claim will
15 be moot regarding the issues arising out of the payment, suspension, modification,
16 termination, or controversion of benefits. All other issues alleged in the disputed
17 claim will be unaffected by the payment.
18 H. The employer or the payor who wishes to have a preliminary
19 determination hearing shall request the hearing in his answer to the disputed claim
20 arising from the notice of initial payment or any subsequent modification,
21 suspension, termination, or notice of controversion. In cases where a disputed claim
22 is already pending when an issue arises from a subsequent notice of payment,
23 modification, suspension, termination, or controversion of benefits, such request
24 shall be made in an amended pleading filed within fifteen ten business days of the
25 expiration of the seven-day ten-day period set forth in Paragraph (G)(1) of this
26 Section.
27 I.(1) An Preliminary determinations as provided for in this Section are
28 favored under the law and an employer or payor who has not complied with the
29 requirements set forth in Subsection A or B of this Section, and who has provided
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1 notice as required in Subsection D, through E of this Section or has not initially
2 accepted the claim as compensable, subject to further investigation and subsequent
3 controversion shall not be entitled to a preliminary determination. An employer or
4 payor who is not entitled to a preliminary determination or who is so entitled but
5 fails to request a preliminary determination may be subject to penalties and attorney
6 fees pursuant to R.S. 23:1201 at a trial on the merits or hearing held pursuant to
7 Paragraph (K)(8) of this Section.
8 (2) If disputed by the parties, upon a rule to show cause held prior to the
9 preliminary determination or any hearing held pursuant to this Section, the workers'
10 compensation judge shall determine whether the employer is in compliance An
11 employee who objects to a request for a preliminary determination shall file a motion
12 to strike the request within ten business days of receiving the documentation required
13 to be produced by the employer or payor pursuant to Paragraph (J)(4) of this Section.
14 The motion shall state the factual and legal bases for the objection, and shall be
15 considered by the workers' compensation judge by a rule to show cause prior to any
16 preliminary determination hearing. Failure to file the motion to strike within the
17 prescribed time period shall be deemed a waiver of any objection to the preliminary
18 determination hearing.
19 J.
20 * * *
21 (2) The testimony of physicians may be introduced by certified records or
22 deposition. The parties may agree to allow uncertified medical records and
23 physician reports to be introduced into evidence. Witnesses may testify at the
24 hearing or, if agreed on by the parties, may offer testimony by introduction of a
25 deposition.
26 (3) The preliminary determination hearing shall be held no later than ninety
27 days from the scheduling conference. However, upon a showing of good cause, one
28 extension of an additional thirty days is permitted upon approval by the workers'
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1 compensation judge. The workers' compensation judge shall issue a preliminary
2 determination no later than thirty fifteen days after the hearing.
3 (4) Any employer or payor requesting a preliminary determination hearing
4 shall produce all documentation relied on by the employer or payor in calculating,
5 modifying, suspending, terminating, or controverting the employee's benefits. These
6 documents shall be disclosed to the employee or the employee's representative within
7 ten business days of the request for the preliminary determination hearing.
8 K.(1) The employer or payor shall, within ten calendar business days of the
9 mailing of the preliminary determination from the workers' compensation judge, do
10 either of the following:
11 * * *
12 (2) Any employer or payor who accepts and complies with the workers'
13 compensation judge's determination within ten calendar business days, shall not be
14 subject to any penalty or attorney fees arising out of the original notice which was
15 the subject of the preliminary hearing.
16 (3) Any employer or payor who accepts and complies with the workers'
17 compensation judge's determination, but who disagrees with such preliminary
18 determination, shall notify the court within ten business days of receipt of the
19 preliminary determination of his desire to proceed to a trial on the merits of the
20 matters that were the subject of the preliminary hearing.
21 (4) Any employer or payor who does not accept the workers' compensation
22 judge's determination or fails to comply with the determination within ten calendar
23 business days, may, at the trial on the merits, be subject to penalties and attorney fees
24 pursuant to R.S. 23:1201, arising out of the issues raised in the original notice of
25 payment, modification, suspension, termination, or controversion of benefits, which
26 was the subject of the preliminary hearing.
27 (5) Any injured employee who disagrees with the preliminary determination
28 shall notify the court within ten business days of the receipt of such preliminary
29 determination of his desire to proceed to a trial on the merits of the matters that were
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1 the subject of the preliminary hearing. If the employer or payor has accepted and
2 complied with the preliminary hearing determination, the employer or payor shall
3 also be entitled to litigate all issues including those issues presented at the
4 preliminary determination hearing.
5 * * *
6 Section 2. R.S. 23:1201(I) and 1201.1(A)(4) and (5) are hereby repealed in their
7 entirety.
DIGEST
The digest printed below was prepared by House Legislative Services. It constitutes no part
of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute
part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)]
HB 780 Engrossed 2026 Regular Session Firment
Abstract: Provides relative to the nonpayment, discontinuation of payment, or failure to
consent for a medical treatment for workers' compensation claims, controversion of
benefits, and preliminary determination hearings.
Present law imposes a penalty on an employer or insurer for failing to pay benefits or to
provide consent when an employee requests to select a treating physician or change
physicians. Present law provides that the penalty can be an amount up to 12% or $50 per
a day, in addition to attorney fees.
Proposed law adds the condition of discontinuance of payment owed to the aforementioned
conditions on what shall be considered as grounds for being penalized.
Proposed law mandates that the party claiming penalties and attorney fees shall bear the
burden of proof by a preponderance of the evidence.
Present law allows a maximum penalty amount of $8,000 to be imposed at a hearing on the
merits. Proposed law retains present law.
Present law provides that present law (R.S. 23:1201(F)) does not apply if the claim is
reasonably converted or if the employer or insurer fails to pay due to conditions which they
had no control over.
Proposed law instead provides that present law (R.S. 23:1201(F)) shall only apply if the
nonpayment, discontinuance of payment, or failure to consent to the employee's request to
select a treating physician or change physicians is found to be arbitrary, capricious, or
without probable cause.
Proposed law also provides that present law (R.S. 23:1201(F)) shall not apply if the
nonpayment, discontinuance of payment, or failure to consent to the employee's request to
select a treating physician or change physicians is the result of conditions the employer or
insurer had no control over.
Present law provides upon the first payment of compensation or upon any modification,
suspension, termination, or controversion of compensation or medical benefits for any
reason, including but not limited to issues of medical causation, compensability of the claim,
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or issues arising out of provisions of present law, the employer or payor, or their authorized
agent or attorney, who has been notified of the claim shall do all of the following:
(1) Prepare a "Notice of Modification, Suspension, Termination, or Controversion of
Compensation or Medical Benefits".
(2) Send the notice of the initial indemnity payment to the injured employee on the same
day as the first payment of compensation is made by the payor after the payor has
received notice of the claim from the employer.
(3) Send a copy of the notice of the initial payment of indemnity to the office within 10
days from the date the original notice was sent to the injured employee or to his
representative.
(4) Send the "Notice of Payment, Modification, Suspension, Termination, or
Controversion of Compensation or Medical Benefits" to the injured employee by
certified mail, to the employee's address where he receives payments of
compensation, on or before the effective date of a modification, suspension,
termination, or controversion.
(5) Send a copy of the "Notice of Payment, Modification, Suspension, Termination, or
Controversion of Compensation or Medical Benefits" to the office on the same
business day as sent to the employee or his representative.
Proposed law removes provisions of present law that reference sending a copy of the
indemnity payment. Proposed law also adds certain delivery requirements that must be
made within 10 business days.
Present law requires the office of workers' compensation administration (OWCA) to
promulgate the "Notice of Payment, Modification, Suspension, Termination, or
Controversion of Compensation or Medical Benefits" form.
Proposed law instead requires upon any modification, suspension, termination, or
controversion of compensation or medical benefits for any reason, including but not limited
to issues of medical causation, compensability of the claim, or issues arising out of
provisions of present law, the employer or payor, or their authorized agent or attorney, to do
all of the following:
(1) Prepare a "Notice of Payment, Modification, Suspension, Termination, or
Controversion of Compensation or Medical Benefits" on a LWC-WC 1002 form or
any other form promulgated by the assistant secretary.
(2) Send the notice to the injured employee within three business days after the effective
date of the modification, suspension, termination, or controversion.
(3) Send a copy of the notice to the OWCA on the same date the original notice was sent
to the employee.
Proposed law requires the employee to provide a mailing address and an email address upon
the employer's or payor's request. Proposed law also provides that any notice required to be
sent shall be sent and delivered in any of the following ways:
(1) The address where the injured employee receives payment of indemnity benefits.
(2) The employee's email address.
(3) Hand delivered to the employee.
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Present law provides notice requirements for when the injured employee is represented by
an attorney. Proposed law adds additional delivery options and otherwise retains present
law.
Present law provides that if there is a dispute between the parties and upon a rule to show
cause held prior to the preliminary determination or any other hearing, the workers'
compensation judge shall determine whether the employer is in compliance.
Proposed law repeals present law and instead requires an employee who objects to a request
for a preliminary determination to file a motion to strike the request within 10 business days
of receiving the required documentation.
Proposed law requires the motion to contain factual and legal bases for the objection.
Proposed law also requires the workers' compensation judge to consider the motion by a rule
to show cause prior to any preliminary determination hearing.
Proposed law states that failure to file the motion to strike within the prescribed time period
shall be considered a waiver of any objection to the preliminary determination hearing.
Present law imposes a penalty plus reasonable attorney fees on an employer or insurer who
discontinues payment of claim and if it is determined that such discontinuance is arbitrary,
capricious, or without probable cause. Present law provides that such penalty shall not
exceed $8,000.
Proposed law repeals present law.
Present law provides that the provisions set forth in present law (R.S. 22:1892(C)), which
address how payment of workers' compensation claims is dispensed, shall be applicable to
claims arising under present law (R.S. 23:1020 et seq.).
Proposed law repeals present law.
(Amends R.S. 23:1201(F)(intro. para.) and (2) and 1201.1(A), (B), (D), (E), (G)-(I), (J)(2)-
(4), and (K)(1)(intro. para.) and (2)-(5); Adds R.S. 23:1201(F)(6); Repeals R.S. 23:1201(I)
and 1201.1(A)(4) and (5))
Summary of Amendments Adopted by House
The Committee Amendments Proposed by House Committee on Labor and Industrial
Relations to the original bill:
1. Allow the employer's or payor's authorized agent or attorney to prepare a notice
as required by present law and proposed law and send such notice to all
necessary parties upon the first payment of compensation.
2. Allow the employer's or payor's authorized agent or attorney to prepare a notice
as required by proposed law and send such notice to all necessary parties upon
any modification, termination, or controversion of compensation or medical
benefits.
3. Delete the definition of "arbitrary, capricious, and without probable cause".
4. Make technical changes.
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