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WORKERS' COMPENSATION

Missouri Workers' Compensation is for the benefit of the Employee and  the Employer.  It mandates that the Employer take care of its injured employees hurt on the job.   In return the employee cannot sue the Employer or co-workers for acts of negligence.  All disputes over benefits are resolved by a judicial tribunal known as the Division of Workers' Compensation ,by its Administrative Law Judges.

        1.       What do you do if you are injured?

          Always report the injury to your employer as soon as possible.  You must report the injury in writing within thirty (30) days.  Failure to do so may result in a denial of your claim.  Request treatment, if necessary.  Employers will try to deny claims if injuries are not timely reported.  A written report signed by you and tendered to the employer is the best method to report the injury.  You may down load and print a form that you may use to report your injury by clicking here.  You should always keep a copy of that report.  Verbal reporting maybe sufficient, but can lead to disputes as to whether or not the injury was timely reported.  Always report your injury as soon as possible.

2.       What are your benefits?

          The employer must provide three kinds of benefits:

          (a)      Medical care to treat injury:  The employer must pay for all doctor bills, medicines, hospital costs, diagnostic tests, artificial devices, physical therapy or any other medical expenses necessary for your treatment.

          (b)     Sick pay benefits:  If directed off work by the treating physician, the employer must pay two-thirds of your average weekly wage.  This benefit has a minimum and maximum, regardless of your average weekly wage.

          (c)     Compensation for permanent disability:  If the injury results in permanent disability, an employer must pay a cash award.  This benefit is set by the state legislature and its amount is determined by the percentage of disability and two-thirds of your average weekly wage.  This benefit has a minimum and maximum, regardless of your average weekly wage.   If your injury results in permanent and total disability, your benefit will be indefinite and paid weekly for as long as you live or are disabled.  If injury results in death, surviving dependents are entitled to a weekly benefit.

          3.       Are all employers required to pay benefits?

          Employers who have five or more employees are required to provide benefits.  Employers who elect to come under the workers' compensation law or work in the construction industry must also provide benefits.  Employment in farm labor, domestic servants in private homes and a few other types of employment are excluded.

          4.       Can I obtain treatment on my own?

          Do not treat on your own.  Employers under Missouri Workers' Compensation law are required to designate a treating physician and pay for all expenses.  If the employee refuses to accept the treatment or seeks treatment on their own, the employee will be responsible to pay for the same.  If the employer refuses to provide treatment, ignores employee's request for treatment or simply neglects to provide treatment, the employee may seek treatment on their own and the employer will be responsible to pay for the same.

        5.    Will my medical insurance pay for treatment for work related injuries?

        Most medical insurance carriers exclude coverage of treatment for work related injuries.  This explains why it is so important to report the injury and request treatment as soon as possible.

          6.    Who pays the benefits?  Does the employer or his insurance company pay benefits?

          The employer is primarily responsible to pay benefits under Missouri Workers' Compensation law.  Most employers obtain insurance which provides these benefits in the event claims are made.  Insurance companies manage the claim and often determine how treatment will be provided.  The insurance company pays all benefits.  Employees often believe the Division of Workers' compensation pays the bills or provides the benefits.  The Division of Workers' compensation is only a judicial tribunal that resolves disputes between employers/insurers and employees. 

          7.       Must a formal claim be filed?

          Some workers' compensation injuries are handled informally, without a formal claim ever being filed.  But it is always in the best interest of the employee that a formal claim be filed in a timely manner.  If a claim is not timely filed, it can prevent any recovery of any benefits not yet received.  Normally, an employee must file the formal workers' compensation claim within two (2) years after the date of injury.  There are exceptions to this rule.  But it is always best to file your formal claim within this period of time.  A formal claim is made on Form 21 which is provided by the Division of Workers' Compensation.  It must be completed and filed with the Division of Workers' Compensation within the two year period.  The filing of the formal claim is not same as reporting the injury; for that see item # 1.

          8.       How is my cash award for permanent disability determined?

          Your cash award for permanent disability is determined by the extent and nature of your permanent disability and two-thirds of your average weekly wage as of the date of injury.  There is a maximum and minimum weekly benefit rate.  Normally, the average weekly wage of an employee is not disputed.  As a result, the amount of your permanent disability cash award will be determined by the percentage of disability you have sustained.  The exact calculation is complex and cannot be explained without knowing all the facts.

           9.    Who decides what my cash award for permanent disability will be if I and the employer cannot agree?

        If the parties cannot agree, then an administrative law judge for the Division of Workers' Compensation, after a trial, will determine what your award shall be.

        10.  Must I submit to an alcohol and drug test, even if I am not under the influence?

        Unfortunately, Yes.  The changes in the law effective 8-28-05, now force employees to do so.  If you refuse, you could lose all benefits, depending on the circumstances. Even if you do submit, you may lose 50% of all benefits if the test results are positive.  In severe cases of intoxication or drug influence, you may lose all benefits.  But refusing to submit is not a solution.  If asked to submit to testing contact attorney immediately to discuss the consequences of taking the test.  But, in doubt, take the test.

        11.    Can I lose my sick pay benefits, if I am discharged for misconduct after the injury?  Isn't this unfair if  my termination has nothing to do with my injury?

    Yes and Yes.  The change in the law effective 8-28-05 allows Employers and the insurance companies to deny sick pay benefits, if you are terminated for misconduct after the injury.  This language is confusing and the term misconduct is not defined.  An Employer who would terminate and employee for alleged misconduct and then stopped sick pay benefits, exposes itself to civil liability if the employers actions are wrong.  Employers will also be drawn into adversarial proceedings before the Division of Workers' Compensation very quickly.  The Division of Workers' Compensation will have to decide  if the termination is appropriate, if not the Division will order the benefits reinstated.

        12. Why all the changes that hurt Employees, and seem to help only the Employers and the Insurance companies?

        The changes are the direct result of the State legislature (House and Senate) as well as the Governors office coming under control of one party, the Republican party.  The Republican party has a pro business agenda and intends to pass laws that will allow business to make more profits at cost of the Missouri Workers.  Republicans say that Missouri is now open for business but they fail to say it is on the backs of  Missouri Workers.  Unfortunately all the new changes will not save money for Employers either in Insurance premiums or in stream lining the process.  Employers will waste valuable time in learning the new law, implementing its mandates and defending actions taken under the new laws.  The true winners in this political game is the Insurance companies and the lawyers that represent insurance companies.  The losers are Missouri Workers, Missouri Employers and their families. 

          13.       Do I need a lawyer?

          Simple workers' compensation injuries, without complexity, can sometimes be resolved without the assistance of an attorney.  However, complex injuries, problems with medical treatment or problems in obtaining benefits, normally require the assistance of an attorney.  Although employees have the right to represent themselves, they simply do not have the experience or understanding of the law in order to deal with the claims adjusters and the attorneys for the employer and the insurance company.  As of August 28th, 2005, the Missouri Workers' compensation laws will have changed.  It is even more important now to consult with an attorney as soon as possible to avoid problems with your claim.

          14.       What can the Law Office of SEUFERT & DUDLEY, P.C. do for me?

          We offer free initial consultation and we answer all questions without charging any fee.  If you decide to retain the Law Office, you will do so on a contingency fee without payment of any fees up front and with no fees or costs to you unless there is a recovery.  We advance all expenses of litigation.  Missouri Bar Rule 7.2 requires that attorneys who state legal services are available on a no-recovery no-fee basis must also state that the client may be responsible for cost or expenses.  However, our workers' compensation contracts normally provide that you will not be responsible for cost or expenses if no recovery is made. 

For a free initial consultation, contact the Law Office of SEUFERT & DUDLEY, P.C. at 1-800-210-7555.