Springfield Workers' Compensation Lawyer

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).

This protection ensures that employees have access to necessary medical care and financial benefits while reducing the potential for litigation between workers and employers. Familiarizing yourself with the basic workings of Missouri's Workers' Compensation Law can help you make informed decisions if you're injured at work.

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.

This requirement ensures that a broad spectrum of workers, particularly those in potentially hazardous industries like construction, are protected should an accident occur. It's critical for workers to confirm their employer's compliance with these legal requirements.

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 as laws change.

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 the employee’s treating physicians. Employers often defer the choice of treating physician to the insurance carrier handling their workers’ compensation policy.

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, the only option usually is to see the doctors the employer/insurer has selected.

Possibly, depending on how many days you are off work and whether the treating physician specifically took you off work due to the injury.

When the treating physician determines that you cannot work because of a work-related injury, so long as you miss more than 3 regularly scheduled workdays, 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.

Understanding the framework of TTD benefits can not only help prepare for financial planning during recovery but also empower employees to assert their rights if benefits are not being provided on time or correctly.

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. 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 (MMI).

If you are terminated for post-injury misconduct, then the employer and insurer may be able to cancel your TTD benefits. If you are laid off for another reason, like the company is downsizing, then your benefits should continue as if you are still employed.

The workers' compensation law provides that compensation of up to 40 weeks may be awarded for permanent scarring and disfigurement on the:

• Head
• Neck
• Arms
• And hands due to a work injury

The amount of compensation typically is assessed by an Administrative Law Judge (ALJ) and is discretionary. ALJs typically will assess 1 week of compensation for each inch of scarring on the arms or hands, and 2 weeks of scarring for each inch of scarring on the neck or face.

Whether the scar is discolored or raised is also commonly factored into the assessment and may increase the ALJ's assessment. In most cases involving surgery on the head, neck, arms, or hands, there will be some scarring and, therefore, some disfigurement compensation is due.

The evaluation process takes into account both the aesthetic and functional impact of the injury, providing a well-rounded view of how the scarring affects daily life and professional opportunities.

In most workers' compensation cases involving more than the most minor injuries, the treating doctor will provide a permanent partial disability (PPD) rating. This disability rating is expressed as a percentage of disability at a certain level of the body. The PPD rating is used to calculate the amount of compensation due for your permanent partial disability.

If the medical evidence supports a finding of permanent partial disability, then you should be compensated with a lump sum settlement for such disability. The PPD rating provided by the treating physician is not binding on you or the ALJ, and, if you have an attorney, your attorney may have you see another doctor to get a second opinion or to conduct an independent medical examination (IME).

How Can Workers' Compensation Be Utilized for Long-Term Treatment?

Workers' compensation is structured to cover both immediate and ongoing medical treatments necessary for work-related injuries. For injuries requiring long-term care, such as physical therapy or surgery, it's crucial to maintain detailed medical records and continuous communication with your medical providers. Workers should ensure that all treatments are pre-authorized by their employer's insurance to avoid disputes in coverage. The attorneys at Aaron Sachs & Associates, P.C. can offer valuable advice on how to efficiently manage and communicate these needs with insurance providers, ensuring that all necessary treatments are covered under your workers' compensation benefits.

What Should I Do if My Workers' Compensation Claim Is Denied?

Facing a denial of a workers' compensation claim can be daunting, but it's not the end of the road. The first step is to carefully review the denial notice as it will outline the reason for denial. Common reasons include a lack of evidence of the injury or missing filing deadlines. If you believe your claim was wrongfully denied, it's crucial to gather any additional evidence and documentation to support your claim.

Consulting with a knowledgeable attorney from Aaron Sachs & Associates, P.C. can provide insights into appealing the decision. They can help prepare the necessary documentation and represent your interests in hearings or negotiations. It's important to act quickly as there are deadlines for filing appeals. Partnering with seasoned professionals can significantly enhance your chances of a successful appeal.

How Can an Attorney Help with the Workers' Compensation Process?

A knowledgeable attorney plays a vital role in navigating the complexities of the workers' compensation process. At Aaron Sachs & Associates, P.C., our attorneys not only offer legal representation but also serve as advisors and advocates for your rights and interests. Their involvement ensures that all necessary documentation is filed promptly and accurately, significantly reducing the risk of errors that can delay or negatively impact your claim.

They assist in all phases, from initial filings and adherence to deadlines to negotiations and, if necessary, representation in disputes or appeals. This guidance can be particularly valuable in Springfield, where local laws and industrial factors present unique challenges. Leveraging their extensive experience, our attorneys work diligently toward securing the benefits you deserve, providing peace of mind during a challenging time.

Our workers' compensation attorney in Springfield, MO is here to help. Give us a call at (888) 287-1046 or fill out our online contact form today.