What Are My Worker’s Compensation Benefits

 

If you have been injured while working, including at work and other locations, it is likely that you are entitled to worker’s compensation benefits.  Our firm has abundant experience in handling worker’s compensation claims.  The laws passed long ago by the State of Missouri requires that your employer, usually the employer’s insurance company, compensate you or your family for injuries or death that may occur on the job.  You may be entitled to: Weekly Benefits while you are temporarily totally disabled (TTD) and unable to work, payment for your medical expenses to treat and assist in your healing, weekly payments and a lump sum payment for partial or total disability resulting from a work related injury.

We handle vibration injuries and other repetitive motion injuries.

Filing your Claim/Reporting the Incident

The first thing you should do when injured at work is report your injury to your supervisor.  Missouri law requires employee to give prompt notice of any injury or accident to the employer.

After giving notice an official claim must be filed with the Missouri Division of Workers Compensation.  The statute of limitations on filing a workers compensation claim can be as short as two(2) years from the date of accident or injury.  Do not rely on your employer or insurance company to file a claim on your behalf.  Even if you receive letters from the Division of Worker’s Compensation regarding your injury this does not toll or stop the statute of limitations from running.

Medical Benefits

After notifying your employer of your injury you should request medical treatment.  Under Missouri Law, the employer has the right to select the treating doctor.  You have the right to chose your own doctor however the employer may not have to pay your medical bills incurred. If you are not receiving what you consider to be proper or adequate treatment or if you feel that the appointed physicians are not taking your injury seriously, an attorney can involve the Administrative Law Judges in the process.  Many times the insurer’s physicians are more interested in telling you nothing is wrong or it wasn’t from the accident than in treating your injuries.  We have seen physicians tell women they were too emotional when the employee had an acute ruptured disc in her neck.  See legal consultation immediately.

back and disc work injuries/surgeries are our forte

Payment while off of work

If the treating doctor certifies you are unable to work you are entitled to payment.  Pursuant to the Workers Compensation law there payments are  Temporary Total Disability benefits.  You will received two-thirds (2/3) of your average weekly wage, subject to limits which change each year.  To determine the average weekly wage to the court computes the gross wages you earned over the 13 weeks prior to the accident or injury.  This benefit is applicable when you.  If the employer’s/insurer’s doctor determines that the injured worker can perform light or modified duty work, the employer may offer such work and the employee may not be eligible for TTD benefits. These benefits can be continued until the employee returns to work or when treatment has been concluded because the employee has reached “maximum medical improvement”.  Compensation is not paid for the first three days an employee is unable to work. Unless the employee is unable to work for more than 14 consecutive days, then the “three-day waiting period” is also paid. All of these payments and medical bills are paid by and typically through the employer’s workers’ compensation insurance.

What will my lump settlement be?

Construction Mishaps, injuries and death claims

Permanent Partial Disability If you have a permanent disability as a result of an accident or injury you may be entitled to a settlement for your permanent partial disability.  The amount of disability will be based on the evidence presented.  Part of the evidence presented will be in the form of medical reports and ratings by medical doctors or other experts.  The doctors we will have you evaluated by will have a different opinion on the permanency of permanent partial disability.  Other factors in determining your settlement will be your average weekly wage and the date of your injury. If injuries to different parts of the body increase the overall disability beyond the sum of the separate disabilities, then there is a load factor added to increase the award.  There are many other issue that arise in evaluating a final settlement that an experienced attorney would identify.   These benefits are calculated at 66 2/3% of the employee’s average weekly earnings as of the date of the injury. However, if the employee suffers from a permanent partial disability, they may receive a lump-sum payment based upon the amount of disability.

repetitive trauma/motion injuries

Permanent Total Disability  If you cannot return to work because of your work injury or your work injury combined with your preexisting injury you may qualify for Permanent Total Disability (PTD) benefits.  An employee will have to prove that because of his or her injuries they are unable to work in any line of work in the open labor market.  When an employee is permanently and totally disabled, they are entitled to receive weekly payments for their lifetime, or they may negotiate a favorable lump-sum settlement.  Legal advise should be sought for entering into any such settlement.  The amount of the weekly payment is based upon 66 2/3% of employee’s average weekly earnings at the time of the injury, not to exceed a maximum amount set by law.  This amount is much higher than the maximum amount for regular partial disability settlements.

The Second Injury Fund

The Fund provides five different kinds of benefits. One or more may be available to you. They are:  disability benefits (permanent partial benefits and permanent total benefits); death benefits where employer is uninsured; rehabilitation benefits, second job wage loss benefits; and medical expenses  for injured workers of uninsured employers.

The permanent total and permanent partial disability benefit is set up to compensate an injured employee for the additional disability caused by pre-existing medical condition(s) that, prior to the primary injury date, are either a hindrance or an obstacle to the employees work or to reemployment in another job.

An example of permanent total disability benefit would be a past client of Pedroli & Gauthier who received life time benefits payments award after hearing and appeals because her permanent total disability resulted from a contributing factor of her preexisting knee injuries combined her primary injury.  Both disabilities required surgery because of the contribution of the injury and the severe restrictions on her ability to move and lift.  She was awarded benefits against the Second Injury Fund.  It was a long fight complicated by the inability of the Second Injury Fund to fund the payments my client was owed by the State of Missouri due to the political grid lock in Jefferson City.  Eventually we succeeded though the appellate courts and obtained funding and my client received all of the due payment plus interest.  She was very appreciative for our efforts over the years long fight for her justice.  She wrote:

“Thank you for all of your hard work, It was a long journey…but long journeys are brief to God.  I’ll never forget you!”  D.J

Recent developments in the Missouri General Assembly may help to revamp and repair Missouri’s troubled Second Injury Fund.  Read more below.

https://www.stlbeacon.org/#!/content/30948/moleg_second_injury_051613

Additional Case for same injury

In some types of cases a claim can be brought against third parties and companies in addition to and outside of the worker’s compensation system allowing you to obtain a jury trial and an additional award for your injuries.   The evaluation should be made by an attorney.

 

Call us for a free consultation regarding your worker’s compensation claim.

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