Workers' Compensation and Employer's Liability
The grand bargain
Workers compensation is a statutory no-fault system: the employee gives up the right to sue the employer in tort, and the employer pays benefits regardless of fault for injuries arising out of and in the course and scope of employment. The exclusive remedy doctrine limits employer exposure to the statutory schedule plus Part Two employer's liability coverage for suits outside the comp statute (typically $1,000,000 per accident / $1,000,000 disease-each-employee / $1,000,000 disease-policy limit). Intentional employer acts and third-party suits against non-employers can escape the bar, and the employer may have a lien on a third-party recovery.
Benefits
Four categories: medical (generally unlimited), indemnity (disability income), death (weekly benefits to dependents plus funeral expenses) and rehabilitation. Indemnity tiers: temporary total, temporary partial, permanent total and permanent partial (scheduled and unscheduled). The classic figure is 66 2/3% of average weekly wage, subject to the state maximum and minimum, paid after a statutory waiting period and retroactive if the disability lasts long enough. Louisiana law governs rates and caps - do not import another state's numbers.
Program mechanics
Coverage territory (Part Three), premium audit, classification by job duty, experience modification, and payroll as the rating basis. Sole proprietors, partners, and some corporate officers may elect in or out, and independent contractors must be distinguished from employees - the exam loves a misclassified-worker fact pattern.
Traps
- Workers compensation is not general liability; the CGL excludes the exposure.
- Longshore and Harbor Workers Act and the Defense Base Act cover maritime and overseas federal-contract work.
- Benefits are not payable for injuries from intoxication or horseplay in most statutes.
Rule of thumb: if the injury arises out of and in the course of employment, start with comp and exclusive remedy - not with the CGL.