In the last installment of our 4 part series, "Best Practices for Injured Workers," our Missouri workers' compensation attorneys discuss the different ways that workers' comp claims can be resolved.
Claims for compensation are filed when an injured worker does not ultimately receive all benefits that he or she is entitled to. The workers' comp system gives injured employees the legal right to seek compensation for workplace injuries, but they are not permitted to sue their employers for negligence in civil court: injured workers must seek compensation through the workers' comp system. Workers' comp provides benefits for permanent disability, medical expenses and lost wages, but not for pain and suffering.
Every claim is different. Every case is impacted by numerous factors in varying degrees, including the nature and extent of the injury; the circumstances that caused the injury; and the conditions and environment in which the injury occurred. All of these elements can affect the path a claim takes toward resolution, and the resolution itself. Remember that you're legally entitled to consult a workers' compensation attorney at any point in the process. Missouri workers' compensation law can be complicated: an experienced lawyer can help you navigate your claim through the Missouri workers' comp system, and make sure you understand all the options available.
What happens after a claim is filed?
Again, it depends on the claim. Speaking in general, here are a few possible avenues:
A claimant can ask for a pre-hearing for the following reasons:
• to request approval for a settlement agreement;
• to address any issues that must be resolved so the claim can move forward; or
• to expedite the resolution of the claim, when parties have a "good faith belief" that a pre-hearing will help move the claim towards settlement or final hearing more quickly.
A claimant can request mediation under the following circumstances:
• when specific issues are hindering the claim's progression;
• when parties are unable to resolve a claim after exchanging final disability rating reports, or when one party has not been provided with reasonable, timely access to a final report;
• when the claimant is requesting additional or initial medical treatment, when the claimant has written evidence that demonstrates the need for specific treatment related to the specific workplace injury, and/or when an employer refuses treatment; or
• when parties are unable to resolve a Second Injury Fund claim, and the claimant has official documents that are pertinent to that claim's resolution.
A claimant can request a hardship (or evidentiary) hearing when the following conditions apply:
• claimant is seeking a temporary or partial award; because
• claimant is not at maximum medical improvement, and is in need of benefits or treatment that he or she is not currently receiving.
A final hearing can be requested when:
• a claimant has reached maximum medical improvement; and/or
• parties are prepared for final resolution of the claim.
It's common for insurance companies to offer settlements to injured workers at various times while a claim is being processed. Early offers are notoriously small. We know it can be tempting to accept any funds you're offered, especially when bills are continuing to pile up and you're unable to return to work. Be aware that accepting a settlement completely closes your case. To protect your current and future interests, we advise that you consult with a knowledgeable workers' compensation attorney before you sign anything.
For more information about workers' compensation claims, please visit our website.
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