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A construction worker is injured on a Louisiana job site. The contractor's workers' compensation carrier has 15 days to investigate. If they don't respond within this period, what happens to the claim?

Correct Answer

C) Claim is automatically accepted

Under Louisiana workers' compensation law, if the carrier fails to respond within 15 days, the claim is deemed accepted.

Answer Options
A
Investigation period extends to 30 days
B
Case goes to immediate hearing
C
Claim is automatically accepted
D
Claim is automatically denied

Why This Is the Correct Answer

Under Louisiana workers' compensation law, carriers have a strict 15-day deadline to investigate and respond to injury claims. This automatic acceptance rule protects injured workers from indefinite delays and ensures prompt medical care and benefits. The law creates a presumption in favor of the worker when carriers fail to meet their statutory obligation to timely investigate claims, making the claim legally accepted by operation of law.

Why the Other Options Are Wrong

Option A: Investigation period extends to 30 days

Louisiana law does not provide for automatic extensions of the investigation period. The 15-day deadline is firm and absolute. Carriers cannot simply extend their investigation time unilaterally - they must either accept, deny, or request additional time through proper legal channels within the initial 15-day period.

Option B: Case goes to immediate hearing

Claims do not automatically proceed to hearing when carriers fail to respond. The hearing process is a separate procedure that occurs after claim acceptance or denial. Since non-response results in automatic acceptance, there would be no dispute requiring an immediate hearing unless other issues arise later.

Option D: Claim is automatically denied

Automatic denial would be contrary to Louisiana's worker-protective approach to workers' compensation. The law favors injured workers when carriers fail to meet their obligations. Automatic denial would create an incentive for carriers to simply ignore claims, which would undermine the entire workers' compensation system.

Memory Technique

Remember '15 Days = YES' - if Louisiana carriers don't respond within 15 days, the answer is automatically YES (accepted). The law protects workers from carrier delays.

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