Columbia Workers’ Compensation Appeal Attorneys

Appealing Your Workers’ Compensation Claim in Columbia, Missouri

Navigating the complexities of a workers' compensation claim can be overwhelming, especially when there are disputes, denials, and disagreements that jeopardize your right to receive benefits.

Fortunately, Missouri’s workers’ compensation system allows claimants to file an appeal when claims have been denied or when they disagree with benefit awards. 

Aaron Sachs & Associates, P.C. is a nationally recognized trial practice committed solely to fighting for the injured. Backed by a team of top-rated attorneys and decades of combined experience, we’ve helped countless workers across Boone County and Mid-Missouri navigate the workers’ compensation appeal process – and we are standing by to help you.

If you have questions about a case, our Columbia workers’ compensation appeals lawyers are here to help. Give us a call at (888) 287-1046 or contact us online to request a FREE consultation.

Understanding Missouri’s Workers’ Compensation System & Reasons For Filing an Appeal

Workers’ compensation is a form of no-fault insurance carried by most employers in Missouri. It provides important benefits to workers who suffer job-related injuries or illnesses, including benefits for medical care, wage supplementation, and disability. 

While injured workers have a right to collect workers’ compensation benefits, it’s not guaranteed that they will receive them. Insurance companies that sell workers’ compensation coverage to employers are, at the end of the day, corporations motivated by profits. They aren’t on the side of workers and they meticulously look for ways to deny, dispute, and underpay valid claims.

Fortunately, Missouri law allows workers’ compensation claimants to file an appeal under certain circumstances. For example, you may have an appeal if:

• Your workers’ compensation claim was denied.
• You disagree with your benefit award.
• There are disputes involving important issues in your claim, such as whether your injuries are work related or whether your injury stems from a pre-existing condition. 
• You’ve been denied medical benefits for treatment that was deemed unnecessary or unrelated to your work injury or illness.
• The insurance company has contended that there is a lack of sufficient medical evidence supporting your claim or that there are discrepancies in other claim details. 

As a Missouri-based firm with a regional reputation, Aaron Sachs & Associates, P.C. has extensive experience representing claimants in appealing workers’ compensation denials and disputes over disability ratings, work-relatedness, pre-existing conditions, and benefit amounts. We know how insurers handle cases and we understand the importance of identifying their reasons for denials and disputes so that we can position clients favorably when initiating the appeals process. 

How Does the Workers’ Compensation Appeal Process Work in Columbia, MO?

If you’ve been denied benefits or disagree with an award, you may have grounds to pursue an appeal. Below is a brief overview of how the workers’ compensation appeal process works in Missouri. 

Initial Appeal / Evidentiary Hearing

After a claim denial or unfavorable award, the first phase of the appeal process begins with evidentiary hearings held with the Missouri Department of Workers’ Compensation. Essential steps include:

1. Consulting with experienced legal counsel who can evaluate the reasons for your denial or unfavorable award, formulate a strategy, gather essential evidence (including medical records and witness statements), and prepare for the hearing.
2. Filing an appeal with the Missouri Division of Workers’ Compensation to request an evidentiary hearing before an administrative law judge (ALJ). These hearings are administrative in nature, meaning they are conducted in accordance with rules and procedures established by the Division of Workers’ Compensation and not a court. However, they are still formal and highly consequential proceedings that demand the attention of experienced claimants’ lawyers.
3. Attending the hearing, where both parties will present evidence and make legal arguments. The ALJ presiding over the hearing will rule on what can be admitted as evidence in the case, hear all evidence and testimony, and issue a decision about your benefits award.

Further Levels of Appeal

Evidentiary hearings held by the Division of Workers’ Compensation can have several outcomes. The ALJ may choose to reverse the decision and award a claimant benefits, uphold an initial decision or denial, or remand a case for further review of consideration.

Depending on the outcome of your hearing, you may wish to pursue an appeal. In Missouri, these generally include:

1. Labor Commission Review. If you disagree with the ALJ’s decision, you can file an Application for Review with the Missouri Labor and Industrial Relations Commission (Labor Commission) to review the award. This application must be submitted within 20 days of the date of the ALJ’s award. After filing, you’ll receive confirmation from the Labor Commission and your records will be forwarded to a three-member panel. While the panel generally does not accept additional evidence for this level of appeal, you may be able to file a motion to present newly discovered evidence if necessary. After reviewing your case records, and any new evidence, the Commission will issue a ruling by a 2/3 majority. This decision becomes final 10 days after it is issued.
2. Judicial Reviews. There are two remaining levels of appeal following the Labor Commission review. The first is a Judicial review by the Missouri Court of Appeals. To request this appeal, you must file notice with the Labor Commission within 20 days after the Commission’s decision becomes final and pay the accompanying docket fee. Your request must also first be approved by the Missouri Supreme Court, as these appeals consider only whether there were any legal errors and do not make new findings of fact. While the Missouri Court of Appeals is typically the last stop for most cases, appellants may have the option to request that their case be reviewed by the Missouri Supreme Court after receiving an unfavorable ruling from the Court of Appeals. Generally, however, this is rare and reserved only for cases of great import.

If you have questions about a workers’ compensation appeal in Columbia, we’re available to discus how we can help. Complete an online consultation form or call (888) 287-1046 to request a FREE consultation.