Workers' Compensation

Facts about Missouri Workers' Compensation

Fault - You are entitled to workers' compensation benefits even if your employer was not at fault and did not cause your injury, if your injury is job related. This is true even if the injury was your fault.

Medical Treatment - Your employer's workers' compensation insurance company is required to provide all necessary medical treatment to cure and relieve your injury. You are not required to use your own medical insurance for this treatment and are not required to pay any deductible or co-pay.

You may be entitled to future medical treatment after your trial or settlement but, to protect that right, it must be provided for in the settlement or award.

In many cases the employer and/or its insurance company refuses to provide adequate medical treatment. They sometimes refuse to provide any treatment at all. Other times they may insist that you see the company doctor and unreasonably refuse to authorize a specialist.

Your attorney can help you obtain the medical treatment you are entitled to.

Weekly Disability Payments - Your employer's insurance company is required to pay you weekly benefits while you are unable to work because of a work accident or occupational disease. You are not required to use your vacation pay or sick leave.

Often the insurance company refuses to pay the weekly benefits or terminates them before you are able to return to work. Sometimes they pay the wrong amount.

Your attorney can help you obtain your weekly disability benefits.

Settlement or Recovery - After you have received your medical treatment and weekly benefits, you are entitled to an additional award to compensate you for any permanent disability.

If you have some remaining pain, weakness, limitation or other disability but you are able to return to work, you are entitled to compensation for the permanent partial disability. The amount you are entitled to receive depends upon your compensation rate and the degree of disability. That can vary from a few hundred dollars to tens of thousands of dollars.

If, after your medical treatment, you are still unable to work because of disability from the work injury or disease or because of a combination of problems, some of which are from the work injury and some from pre-existing disabilities, you may be entitled to permanent total disability benefits. In that event you are entitled to receive your weekly compensation benefit for the rest of your life. This benefit does not stop when you reach age 65. Depending upon your compensation rate and your life expectancy, this benefit may be worth as much as several hundred thousand dollars. Your claim can sometimes be compromised for a lump sum settlement, if you prefer.

Your attorney can help you maximize your settlement or award.

Second Injury Fund Claim - If you have had a previous injury or disability, you may be eligible for money from the Second Injury Fund in addition to your workers' compensation claim against your employer's insurance company. The preexisting disability does not have to be from an injury to qualify. It can be a heart condition, diabetes, c.o.p.d., arthritis, emphysema or other disease or impairment. Of course, preexisting carpel tunnel syndrome, back injuries and knee injuries usually also qualify. The Second Injury Fund recoveries usually range from a few hundred dollars to several thousand dollars.

It is essential that you be represented by an experienced workers' compensation attorney that knows and understands Second Injury Fund law and procedure.

Your attorney can help you determine whether you have a valid Second Injury Fund claim and help you obtain a reasonable recovery, if you do qualify.

Social Security offset - If you are going to be eligible for social security disability benefits, it is important that you choose an attorney who is familiar with the social security offset rules and one who has experience solving offset problems.

If you are receiving, or are entitled to receive, social security disability benefits, the social security administration may attempt to reduce your social security benefits by offsetting part or all of your workers' compensation benefits. Your attorney can help you determine if there will be an offset and, if so, the amount of the offset, and protect your social security benefits.

Your attorney can also help you structure your settlement to partially or totally avoid the offset.

Disability Rating - Your attorney can help you make sure that your disability rating is appropriate. Almost always when the "company doctor" selected by your employer releases you he will give you a disability rating for your injury. That rating is often unreasonably low. You are not required to accept that rating. Your attorney can help you get a fair rating.

Compensation Rate - Your attorney can help you make sure that the correct compensation rate is used in determining your benefits. The amount of your weekly benefit checks and the amount you are entitled to receive as a settlement for disability depends, in part, on your compensation rate. Your compensation rate is usually computed from your average weekly wage. In many cases your employer or the insurance company, either intentionally or mistakenly, miscalculates that rate. We believe the employer misstates the rate in more than 25% of our cases. The miscalculation is usually to the disadvantage of the injured employee. This can make a significant difference in the amount of your benefits/settlement.

Work related injury or disease - The employer and its insurance company sometimes deny that there was an accident or that the injury or disease is work related. That is usual for heart attack and heat stroke cases but it also happens with lifting injuries and repetitive motion injuries such as carpal tunnel. The "company doctor" often supports the employer's denial of the claim. You do not have to accept the employer's determination or the company doctor's determination that your injury is not work related. Your attorney can help you prove that your injury is work related.

Parking area injuries, etc. - Injuries on the employer's premises, including the parking area are normally covered and you are entitled to benefits for those injuries. Injuries that occur on the way to or from work are normally not covered by workers' compensation but there are exceptions and you should talk to a lawyer to determine whether you are entitled to benefits.

On-the-job travel - If your job requires you to travel, you may be entitled to benefits for injuries that occur at any time while you are away from home. This would include injuries that occur while you are going to and from your hotel, going out to eat, or even while you are in your hotel room.

Injuries in other states - You are entitled to benefits and your case can be filed in Missouri even if the injury occurs in another state, if you were originally hired in Missouri or if your employment is normally centered in Missouri.

Time limit - There is a time limit for filing a workers' compensation "claim". A formal claim should be filed with the Division of Workers' Compensation within two years of the injury. That time may be extended if the employer or its insurance company provides benefits. The fact that a report of injury has been filed or that you have received correspondence from the Division of Workers' Compensation does not mean that a "claim" has been filed. You should consult with an attorney to make sure your "claim" is filed within two years after your injury. If the required "claim" is not filed within the time limits, you will lose all rights to further benefits including any settlement for your injury.

Retaliatory firing - Missouri law prohibits your employer from terminating your employment or discriminating against you because you file a workers' compensation claim.