Workers’ Compensation

Work-Comp-Medical-BenefitsThe Law Offices of Kevin J. Roach, L.L.C. handles Missouri workers’ compensation claims throughout the State of Missouri. The firm has successfully represented thousands of injured workers in Missouri. If you or a family member has suffered a work injury in Missouri or has an occupational or repetitive use injury you deserve to have an experienced and dedicated St. Louis Missouri workers’ compensation lawyer on your side. Our firm is experienced in dealing with insurance companies, and we have the resources necessary to take them on and pursue your maximum compensation.

There were many changes to Missouri workers compensation law effective August 28, 2005.  One of the more significant new provisions was a new definition of injury and accident.  In Missouri injured workers must show that work was the prevailing factor (as opposed to substantial factor) in causing the resulting disability of medical condition.  An accident under the new Missouri workers compensation law is defined as an unexpected traumatic event or unusual strain identifiable by the time and place of occurrence caused by a specific event during a single work shift.  The prevailing factor is defined as the primary factor or relation to any other factor, causing both the medical condition and disability.  These changes were not intended to benefit employees filing workers compensations claims and have been used by insurance companies to deny legitimate claims.  Given these changes and the complexities on Missouri workers compensation law it is more important than ever to have a Missouri workers compensation lawyer review your claim and protect your rights.

Do You Have A Case?

If you have been injured, it is possible that you are entitled to workers compensation. The laws passed by the state of Missouri require that your employer, or your employer’s insurance company, compensate you or your family for injuries or death that may occur while you are working. You may be entitled to:

  • Weekly benefits while you are temporarily totally disabled and unable to work.
  • Payment for your medical expenses.
  • Weekly payments or a lump sum payment for partial or total disability resulting from a work related injury.

I was injured at work. What should I do?

If you have been injured at work, the first thing you should do is report your injury to your supervisor. Missouri law requires employees to provide prompt notice of any injury or accident to their employer. You or your attorney needs to file a claim for workers compensation with the Division of Workers’ Compensation. Missouri law provides for specific time limits to file a claim for compensation which can be as short as two years. Your employer generally will not do this for you and will not notify you of any deadlines to file a claim.

How do I get medical treatment for my injury?

Under Missouri law, the employer (and not the insurance company) has the right to select the treating doctor in workers’ compensation cases. If you need to see a doctor for treatment as the result of an injury on the job, you should tell your employer you want to see a doctor. If your employer knows that you need treatment because of a compensable accident, your employer should tell you which doctor to see. If your employer does not refer you to any particular doctor, you should ask your employer which doctor your employer wants you to see. Since your employer has the right to select the treating doctor, your employer (and its insurance company) may not have to pay for your bills if you choose to go to your own doctor rather than to your employer’s authorized treating doctor.

Will I be paid when I am off work?

If the treating doctor certifies that you are unable to work, you should be entitled to “temporary total disability benefits” under the Missouri Workers’ Compensation Law when you are off work. You will not be paid for the first three regularly scheduled work days you are off, but you should be paid for each day missed thereafter and also for the first three days if you are off more than two weeks. The amount of these benefits is two-thirds of your gross average weekly wage, subject to certain maximums which change each year. The law contains a formula for determining your average wage, which usually involves computing the average gross wages you earned over the 13 weeks prior to the accident.

Will I get a settlement?

If you are able to return to work after your injury, you may be entitled to a settlement or payment for your “permanent partial disability” if you have permanent disability as a result of a covered accident or injury. The amount that you will receive for your permanent injury depends on the extent of your disability. Your disability may be evaluated by doctors or other experts. There are formulas in the workers’ compensation statute to determine the amount of permanent partial disability awards. The amount of the settlement will vary depending upon several factors, including the disability ratings from the doctors, your average weekly wage and the date of your accident. Doctors often disagree regarding the percentage of permanent partial disability in any given case. The amount of your permanent partial disability, if any, probably cannot be determined until you have completed your medical treatment.

What if I am unable to return to work because of my injury?

If you are permanently and totally disabled from all types of employment, you may qualify for “permanent total disability benefits” under the Missouri Workers’ Compensation Law. However, in order to qualify for these benefits, you must be unable to work in any line of work in the labor market because of your compensable injury or occupational disease. The weekly rate for these benefits is the same as the temporary total rate. If you are totally disabled, you may also qualify for Social Security disability benefits. You should contact the Social Security office to apply for those benefits. In some cases, but not all, Social Security disability benefits are reduced because of the receipt of workers’ compensation benefits.

What is the second injury fund?

In Missouri, if you had a physical or mental disability before you were hurt at work, you might qualify for additional benefits from the Missouri Second Injury Fund. The purpose of the Second Injury Fund is to encourage employers to hire and retain employees who have disabilities. In some cases, the Second Injury Fund’s liability can be substantial. For example, in permanent total disability cases the Second Injury Fund can be held responsible for an employee’s lifetime weekly benefits when the permanent total disability results from a combination of the employee’s preexisting conditions and those caused by the current injury. Also, in death cases, when the employer failed to obtain workers’ compensation insurance, the Second Injury Fund can be held responsible for death benefits to the employee’s dependents. Claims against the Second Injury Fund must comply with special time limits in the law.

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