Anything here from the readme.txt file help?
== Installation ==
1. Upload the lca.php file into your wp-content/plugins/ folder.
1. Navigate to the Plugins menu within your WordPress admin area and activate the plugin.
1. Click “Manage” and then “LCA Management” and adjust the settings as necessary.
1. Place the tag <?php lca_form(); ?>
within your template in the place where you wish the upload form to appear.
1. Place the tag <?php lca_avatar( $comment ); ?>
within your template in the place where you wish each commenter’s avatar to appear. This must be placed within the comment loop on the Comments page.
The upload directory must be writable by the PHP script. The script will warn you if this is not the case and ask you to take action before using the plugin. This usually means setting the permissions to 666 or such like.
The upload directory must be specified twice – once from the server’s perspective (for example, */home/username/public_html/wordpress/uploads*) and once from the outsider’s view (for example, *https://www.domainname.co.uk/wordpress/uploads*). They must both point to the same place and if either are wrong then the script will not function properly.