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Missouri workers' compensation: What you need to know after an on-the-job injury

November 20, 2014

file3291233869663.jpgAs Missouri workers' compensation lawyers, we know the aftermath of a serious workplace injury is often a confusing, overwhelming time for both injury victims and their families. If you or a loved one has been injured on the job, you likely have a lot of questions and concerns. Below, we've provided some basic information about workers' compensation in Missouri.

Facts about the Missouri workers' compensation system:

• It is a no-fault insurance plan for workers who suffer injuries that arise "out of and in the course of [their] employment."

• It provides medical benefits and wage loss compensation. Medical benefits may include coverage for doctor visits, prescriptions, laboratory work, medical supplies, physical therapy and hospitalization.

• Its goal is to help the employee heal and return to his or her job.

• Its laws are outlined in Chapter 287 of the Revised Statutes of Missouri.

• It is administered by the Missouri Division of Workers' Compensation.

• It does not cover your injuries if you were not within the scope of your employment when you were injured (i.e. commuting to work or running a personal errand).

• It covers job related injuries such as burns, amputations, hernias, bone fractures, torn meniscus, stroke, general anxiety disorder, chronic obstructive pulmonary disease, post-traumatic stress disorder, bulging disc, concussion, torn rotator cuff, blindness, neck injury, back injury, fibromyalgia, and carpal tunnel syndrome.

• It authorizes your employer to choose your treating physician.

• It offers disability benefits to injured workers, including temporary total disability benefits, permanent partial disability benefits, and permanent total disability benefits, depending on the nature of your injuries.

• Under certain circumstances, it can cover vocational rehabilitation benefits and death benefits.

Continue reading "Missouri workers' compensation: What you need to know after an on-the-job injury" »

Dealing with a workplace injury? 5 FAQs answered for Missouri workers

hospital-room-449234-m.jpgAs Missouri workers' compensation lawyers, we know the aftermath of an on-the-job injury can be overwhelming and confusing for injury victims and their loved ones. On top of dealing with the physical and emotional trauma of the injury, victims and their families are often dealing with numerous concerns and questions: it can be hard to know where to begin. In this post, we discuss five questions we commonly hear from injured workers.

1. How do I know if I have a workers' compensation claim?

If you've been injured in the course and scope of your employment, you may be entitled to workers' comp benefits. Every Missouri employer with five or more employees is required to carry workers' compensation insurance, and employers in the construction industry are required to carry insurance if they have one or more employees. However, you must report the injury to your employer within 30 days or you could become ineligible for benefits. In addition, Missouri law allows the employer the right to choose the treating physician, so if you need medical treatment, you should tell your employer immediately.

2. What if I have to miss work because of my injury?

If your injury causes you to miss more than three regularly scheduled work days, you may be eligible for temporary total disability (TTD) benefits to compensate you for your lost wages. TTD benefits are based on two-thirds of your average weekly wage prior to your injury. If you're able to return to your job, but at modified duties or reduced pay, you may be eligible for temporary partial disability benefits.

3. What other kinds of benefits are available through workers' comp?

The Missouri workers' compensation system provides benefits that include medical care, lost wages and permanent disability benefits. Permanent partial disability benefits are available to employees who can work in some capacity, but whose injuries limit their ability to perform certain tasks. Permanent total disability benefits are awarded to employees who can no longer work at any job.

4. What if my employer (or the insurance company) wants to settle my case?

Be advised that accepting a settlement will close your case entirely: your employer will not be responsible for any future medical treatment or compensation. If you are still being treated for your injuries - or if you recently had a major surgery - your claim is not yet ready to settle. Before you accept a settlement, your doctor will need to rate your injury and assess the total scope of its impact on your life. Just because you are offered a settlement doesn't mean you have to accept it.

Continue reading "Dealing with a workplace injury? 5 FAQs answered for Missouri workers" »

Injured on the job? 5 FAQs answered for Missouri workers

January 24, 2014

orthopedic-leg-brace-1232546-m.jpgThe aftermath of a workplace injury can be a confusing, overwhelming time for victims and their loved ones. In this post, our Missouri workers' compensation lawyers answer five questions we often hear from injured employees.

1. How do I know if I'm covered by the Missouri workers' compensation system?

Under state law, the majority of Missouri employers are required to carry workers' compensation insurance to cover their employees. If a business employs five or more workers, the employer must carry workers' comp insurance. Businesses in the construction industry must carry insurance if they employ one or more workers. (To find out more about what kind of businesses are considered part of the construction industry, click here.) Missouri law does provide exemptions for farm laborers, domestic servants and occasional laborers in private residences, real estate agents and direct sellers, certain inmates, certain volunteers, and certain individuals who serve amateur youth programs.

2. I've been injured at work: what are the first steps I should take?

First and foremost, be sure to report your injury to your employer (in writing) as soon as possible. Failing to report an injury within 30 days following its occurrence can jeopardize your right to workers' compensation benefits. You'll need to include the following information: your name and address; where the injury occurred; the date it occurred; and the nature of the injury. Keep a dated copy for your own records. It's also paramount that you seek immediate medical attention so your injuries can be assessed and documented by a physician.

3. How long do I have to file a workers' compensation claim?

First, please note that filing a workers' comp claim is completely different than reporting the injury to your employer. If you wish to file a claim, you must do so directly with the Missouri Division of Workers' Compensation. Claims must be filed within two years of the date of your injury, or, if you received workers' comp benefits following your injury, within two years following the date of the last payment you received. (If your employer failed to report your injury to the division in a "timely fashion," the time period is extended to three years.)

Continue reading "Injured on the job? 5 FAQs answered for Missouri workers" »

Dealing with a workplace injury: Tips and info for Missouri workers

1123374_industrial_-_factory_2.jpgIf you or a loved one has been injured on the job in Missouri, you may be hesitant about taking legal action because you're concerned about the impact it could have on your employment. Many injured workers worry that litigation will ruin their working relationship, while others are reluctant to deal with the stress of what can be a lengthy process.

However, under state law, the Missouri workers' compensation system is the exclusive remedy for damages and losses associated with workplace injuries. This means you do not need to sue your employer to recover financial compensation for your injuries and lost wages - in fact, in the vast majority of cases, you legally can't sue your employer. Any damages you suffer will be remedied through the worker's compensation system, not by filing a personal injury claim in civil court.

Workers' compensation involves a tradeoff for both employers and employees.
When you suffer an on-the-job injury, you're entitled to workers' compensation benefits regardless of who was at fault for your accident, but you are not permitted to sue your employer for negligence. In turn, your employer can't be subjected to a lawsuit, but your employer cannot assert any legal defenses to your claim for workers' compensation.

To be eligible for workers' compensation, your injury must have occurred within the course and scope of your employment.
So long as you were acting within the scope of your employment when your injury occurred, you are covered by workers' compensation. In other words, you're covered if you were injured in the course of performing your job duties. Be aware, however, that workers' compensation benefits are usually not available to employees who are injured while commuting to or from their workplace, under what is known as the "going and coming" rule.

Workers' compensation insurance is required for most employers.
Employers who have five or more employees are required by law to carry workers' compensation insurance. Employers in the construction industry must have workers' comp insurance if they have one or more employees. The law does provide exemptions for certain kinds of employees (section 287.090 RSMo), including farm laborers, domestic servants, certain real estate agents and direct sellers, and commercial motor-carrier owner operations

Workers compensation benefits are designed to cover your medical expenses, lost wages and permanent disability following a workplace injury.
Workers' comp benefits should cover your doctor visits, physical therapy appointments, hospitalization, and all other medical expenses medically necessary to diagnose and treat your work injury. If your injury prevents you from returning to work or from performing certain tasks, you may also be entitled to disability benefits.

Continue reading "Dealing with a workplace injury: Tips and info for Missouri workers" »

Workplace Injury Plus Medical Malpractice Equals a Complicated Case

391481_knee_x-ray_2.jpgNormally, workers' compensation claims are very different from medical malpractice cases. But what happens when medical malpractice results from treatment for an injury covered by workers' compensation?

This predicament can be unbelievably frustrating. It's upsetting enough to be injured and unable to work: when you feel you have an unsympathetic doctor who isn't treating you effectively, a tough time becomes even tougher. Seeing an injury worsen when you're expecting it to improve can be disheartening and even alarming - particularly when medical bills are continuing to pile up.

So, can an injured employee sue a workers' comp doctor (who is typically selected by the employer) for medical malpractice? It's a complicated question. In fact, it is nearly impossible to give a conclusive answer without reviewing the exact circumstances and medical records connected to a specific case. As our workers' compensation lawyers know, there are multiple factors that must be considered.

It's worth noting that in some states, workers' comp doctors cannot be sued for medical malpractice because the doctors are considered "co-employers." In other words, the doctors are covered by the same laws as the employer, meaning the workers' compensation system is the only way to address the malpractice.

In Missouri, however, a workers' comp doctor is considered a third party who can be subject to a lawsuit. And it's common for injured employees to question the methods of workers' compensation treating physicians, particularly when the recovery process is painful, expensive and time-consuming.

While it's true that there have been occurrences of medical malpractice in workers' comp cases, it's important to remember that malpractice has a very specific legal definition. For example, if your injury does not heal (or if it worsens over time), that is not necessarily a sign of medical malpractice. To win a malpractice suit, a plaintiff must prove 4 separate elements:

1. A duty of care was owed by the physician; 2. the physician violated the applicable standard of care; 3. the person suffered a compensable injury; and 4. the injury was caused in fact and proximately caused by the substandard conduct.

Continue reading "Workplace Injury Plus Medical Malpractice Equals a Complicated Case" »

Best Practices for Injured Missouri Workers: Part 3 of 4

February 17, 2012

Meldodi2_hospbed_100_2857.jpgIn Part 3 of our 4 part series, "Best Practices for Injured Workers," our Missouri workers' compensation attorneys provide information about the different kinds of benefits available to workers' compensation claimants.

If you are unable to return to your job as the result of workplace injuries, you are most likely entitled to disability benefits. There are several factors that affect what kind of benefits you are eligible for:

Temporary Total Disability

• If you have to take time away from work to recover from your injuries and/or any medical procedures associated with those injuries; or your doctor says you cannot return to work because of your injuries, you may be eligible for Temporary Total Disability benefits to compensate you for your lost wages.

• If your employer has offered you "light or modified [duties]," and your doctor says that you are capable of performing those tasks, you may not be able to collect Temporary Total Disability benefits.

• However, if you accept "light or modified" duties, but at less than full pay, the law allows you to collect Temporary Partial Disability benefits.

• Temporary Total Disability benefits should continue until your doctor releases you to return to work, either because your "treatment is concluded" or because you have "maximum medical improvement," whichever comes first.

Permanent Partial Disability and Permanent Total Disability

• Permanent Partial Disability benefits are designed to assist injured workers whose injury impacts the tasks they can perform, but who can still work (even if the job isn't exactly the same one that they had before the injury).

• Permanent Total Disability benefits are awarded to employees who are no longer able to work, in any capacity, at any job. Depending on the circumstances - in particular, the nature and extent of the injury - these benefits may be paid out in lifetime weekly installments, or as a lump sum payment.

Continue reading "Best Practices for Injured Missouri Workers: Part 3 of 4" »

Best Practices for Injured Missouri Workers: Part 2 of 4

February 10, 2012

In Part 2 of our 4 part series, "Best Practices for Injured Workers," our Missouri workers' compensation attorneys offer some guidelines related to medical care.

PIC108543992297.jpgReceiving appropriate medical treatment is crucial. Many workplace injuries cause are extremely debilitating, causing physical limitations and serious pain, and they require extensive and continuous treatment. If you are eligible for workers' comp, and you have reported the injury to your employer (see Part 1 of our series), then your benefits should cover your medical expenses. According to the Missouri Department of Labor, "The employer or insurer is required to provide the medical treatment and care to cure and relieve the employee from the effects of the injury. This includes all costs for authorized medical treatment, prescriptions, and medical devices."

Can I choose my own doctors?
No - not unless you plan to pay your own expenses out of pocket. Workers' comp law affords the employer (or the insurer, on the employer's behalf) the legal right to select any and all health care providers. Be sure that you check with your employer and/or the insurer regarding physicians who treat your injury. If you're not satisfied with the medical care that you're receiving, it might be in your best interests to consult the attorney.

What if I have to travel to receive treatment?
If you are required to see a doctor whose office is located outside the local/metropolitan area of your principal place of employment, your employer is required to pay the "necessary and reasonable expenses" associated with that travel. However, employers will not cover the cost of travel "over 250 miles each way from the place of treatment." If you are not a Missouri resident, your employer can choose a treatment facility within 100 miles of your residence, the location of your injury, or your place of hire.

Do I have to agree to medical examinations and evaluations at my employer's request?
The law does permit your employer (or insurer) to request that you "submit to reasonable medical examinations" while you are on disability. Your employer can request multiple exams if you require long-term treatment, or if you have more than one injury. Similarly, you can be compelled to "submit to appropriate vocational testing and a vocational assessment scheduled by an employer or its insurer." Typically, these assessments are only administered when an injured worker is claiming to be permanently and totally disabled.

Continue reading "Best Practices for Injured Missouri Workers: Part 2 of 4" »

Best Practices for Injured Missouri Workers: Part 1 of 4

February 3, 2012

If you are injured on the job in Missouri, it's essential that you take certain actions as soon as possible following your injury. In this 4 part series, our workers' compensation attorneys will outline the best practices for an injured worker, from reporting your injury to making sure your claim is resolved. Following certain procedures in a timely fashion is one of the best ways to ensure your rights and benefits are protected.

Paper_Stack.jpgHow do I know if I'm eligible for workers' compensation benefits?

In Missouri, businesses are required to carry workers' compensation coverage when they employee 5 people or more. (NOTE: "Construction industry employers that erect, demolish, alter, or repair improvements" must carry work comp, even if they only have one employee.) Missouri workers' compensation law does not apply to railroad, postal or maritime workers, as these employees are covered by federal law.

Additionally, the Missouri Department of Labor outlines other kinds of employees who are not eligible for workers' compensation benefits:

• Farm labor employees
• Domestic servants in private households (both full time and part time)
• Direct sellers and real estate agents (as defined in Title 26 United States Code, Section 3508)
• Unpaid volunteers of a tax-exempt organization (as defined in the Internal Revenue Code, Section 501(c)3
• Adjudicators, referees, or contest workers for school activities, youth sports, etc.
• Certain inmates, patients, or residents of Missouri, or one of its counties or municipalities

If an employer has fewer than the required number of employees, or falls into one of the above categories, that employer can elect to carry workers' compensation coverage, but it is purely voluntary.

Continue reading "Best Practices for Injured Missouri Workers: Part 1 of 4" »

Kansas City Missouri, Workers' Compensation Attorneys Address Frequently Asked Questions About Missouri Workers' Compensation--Part Three

November 15, 2011

133320_woman_at_the_hospital.jpgIn this third post on frequently asked questions about Missouri Workers' Compensation Law, Kansas City, Missouri, workers' compensation lawyers address the types of disability benefits available to injured Missouri workers to compensate them while they are off work and in medical treatment due to their injury, and other issues involving off-time benefits.

If I am off work due to an injury, am I entitled to compensation for lost wages?

Possibly, depending on how many days you are off work and whether the treating physician specifically took you off work due to the injury. Where the treating physician determines that you cannot work because of a work-related injury, so long as you miss more than 3 regularly scheduled work days, you are entitled to temporary total disability benefits (TTD) to compensate you for your lost wages. You will not be paid wages or TTD for the 3 day waiting period unless your time off extends past 14 days, at which time the insurance company should pay TTD for the initial 3 days missed.

TTD benefits are paid as 2/3 of your average weekly wage in the 13 weeks prior to your injury up to a statutory maximum benefit. The current maximum TTD rate for injuries sustained after July 1, 2011, is $811.73. TTD benefits should be continued to be paid in the same manner as your ordinary income (but at least every 2 weeks) until your doctor releases you to return to work, or your treatment is finished because you have reached maximum medical improvement.

Will being terminated affect my eligibility for TTD compensation?

IF you are terminated for post-injury misconduct, than the employer and insurer may have a valid defense to paying you TTD benefits.

If I am on modified duty and earning less than before the injury, am I entitled to compensation?

Continue reading "Kansas City Missouri, Workers' Compensation Attorneys Address Frequently Asked Questions About Missouri Workers' Compensation--Part Three" »

Kansas City Missouri, Workers' Compensation Attorneys Address Frequently Asked Questions About Missouri Workers' Compensation--Part Two

November 8, 2011

565431_chewing_asphalt.jpgThis is the second post in our Q & A series about Missouri workers' compensation law regarding the rights of injured workers in Lee Summit, Kansas City, and across Missouri. Questions about medical treatment often arise, and are addressed in this article.

Can I Pick My Own Doctor and Still Have My Treatment Covered by Workers' Compensation?

No. In Missouri, the employer must pay for reasonable and necessary medical treatment related to a work injury, and in exchange the employer has the right to select your physicians. The right to choose the physician belongs to the employer by statute, however, the employer typically delegates such right to the their workers' compensation insurance carrier. It is not uncommon for an insurance adjuster to contact an injured employee and notify them of the name of the doctor they must see under workers' compensation.

The employer/insurer chooses the physician, and must authorize treatment before it will be covered by workers' compensation.

Just because employers have the right to choose physicians and direct the medical care, does not mean employees are forbidden from choosing their own doctors. Indeed, employees are free to choose their own physician and direct their own medical care, but such treatment will typically be at their own expense if the employer/insurer accepted the case and offered treatment. Therefore, unless an employee wants to pay for treatment out of their own pocket (because their health insurance likely won't pay either, as discussed below), the only option usually is to see the doctors the employer/insurer directs the employee to.

Can I Get a Second Opinion or Change Doctors?

Sometimes injured workers are unhappy with the care they receive from the doctor the employer/insurer directed them to. An injured worker may not be making any progress towards healing and believes he or she needs a different type of treatment, tests, a specialist, or surgery that the employer/insurer's authorized treating physician doesn't approve.

Continue reading " Kansas City Missouri, Workers' Compensation Attorneys Address Frequently Asked Questions About Missouri Workers' Compensation--Part Two" »

Kansas City Missouri Workers' Compensation Lawyers Address Frequently Asked Questions About Missouri Workers' Compensation--Part One

November 5, 2011

375464_workers_of_construction_2.jpgAs workers' compensation lawyers, we frequently encounter similar questions about Missouri workers' compensation law from the Kansas City area and across Missouri. In order to answer some of the frequently asked questions, we will cover some common questions and answers in a series of articles on this blog.

Let's start with the basics:

What is Workers' Compensation?

The Missouri Workers' Compensation Law (Chapter 287 of the Missouri Revised Statutes) governs the rights and obligations of both employers and employees when an employee suffers an on-the-job injury. Workers' compensation covers both injuries by accident (such as a fracture from a slip and fall) and injuries due to occupational disease (such as carpal tunnel syndrome from repetitive occupational exposure).

Who is Covered Under Missouri's Workers' Compensation Law?

All Missouri employers with five or more employees are legally required to carry workers' compensation insurance. All employers in the construction industry, even if they have only one employee, are also required to carry this coverage.

Does Missouri's Workers' Compensation System Benefit the Employer, or the Employee?

The workers' compensation system was initially designed to be a win-win for both employer and employee, with the employer having limited liability and the employee no longer having to prove negligence to receive compensation for a workplace injury. The system has grown more complicated over time, and recent legislative changes pursued by employers have sought to limit compensation available for employees. Recent appellate decisions, on the other hand, have been pushing back in favor of employees. Overall, there are benefits and downfalls for both sides, with the balance constantly pushing one way or the other with the ebb and flow of the changes to the statutes and the development of case law. Who the system benefits more is a matter of opinion and constantly changing.

Continue reading "Kansas City Missouri Workers' Compensation Lawyers Address Frequently Asked Questions About Missouri Workers' Compensation--Part One" »