Tag Archives: Authorized medical treatment

Step by Step Timeline of a Missouri Workers’ Compensation Case

By Steven A. Edelman, Workers’ Compensation Trial Attorney

314-631-6777, Ext. 14

If you suffered a work injury in Missouri, then your Missouri workers’ compensation case will typically follow the below timeline.

  1. Step 1: The injured worker suffers a work injury while in the course and scope of your employment. See Missouri Workers’ Compensation Law RSMo 287.020
  2. Step 2: The injured worker makes a written report of injury to the employer within 30 days of the date of the work injury. See Missouri workers’ compensation law RSMo 287.420
  3. Step 3: Simultaneously with the written report of injury, the injured worker demands that the employer and the employer’s workers’ compensation insurer provide and pay for authorized medical treatment through workers’ compensation. See the law RSMo 287.140
  4. Step 4: The employer/workers’ compensation insurer provides authorized treatment to the injured worker. See Missouri workers’ compensation law RSMo 287.140
  5. Step 5: The injured worker completes authorized medical treatment, and the injured worker is released from all medical treatment at maximum medical improvement (MMI) per the order of the employer’s authorized treating doctor. MMI means that the doctor can not recommend any further medical treatment to the injured worker to relieve the injured worker’s symptoms.
  6. Step 6: Once the employer’s authorized doctor has released the injured worker at MMI, the employer will either have the authorized treating doctor or another doctor of their choice to evaluate the injury worker and provide a disability rating percentage of the injured body part. See Missouri workers’ compensation law RSMo 287.210
  7. Step 7: If the injured worker is represented by an attorney in their workers’ compensation case, then the their attorney will typically obtain their own independent medical evaluation (IME) chosen by the injured workers’ attorney. This IME doctor will then perform an in-person evaluation of the injured worker. The IME doctor will then generate a rating report which includes the doctor’s disability rating percentage of the injured body part. This rating is typically higher than the disability rating provided by the employer’s authorized IME doctor.
  8. Step 8: Mediation: The injured worker and their workers’ compensation attorney along with the employer’s/insurer’s defense attorney will then attend mediation with a judge who is called an administrative law judge (ALJ) or just judge. The mediation judge will then give a recommendation of the value of the case based on doctor’s rating reports, the medical records, and all other relevatnt information. The judge will also potentially resolve any other disputed issues or negotiation brought before the judge. The mediation judge’s recommendation is not binding on any party. If you obtain a high settlement recommendation to settle your case from the judge, the employer does not have offer the high recommendation. Likewise, if you receive a low recommendation from the judge, the the injured worker does not have to agree and accept a settlement for the low recommendation. See Missouri Code of State Regulations 8 CSR 50-2.050 Mediation Services
  9. Step 9: If the both the injured worker and the employer agree on the judge’s mediation recommendation, then the workers’ compensation case can be settled. If the parties do not agree on settlement at the time of the mediation, then the case will proceed to trial.
  10. Step 10: Trial, also known as a Hearing-Final Award If the parties can not settle the worker’s compensation case, then the case will proceed to trial in front of a Judge. There is no jury in a workers’ compensation case. The trial typically last a few hours to one day. Some trials can last more than one day. See Missouri Workers’ Compensation Law RSMo 287.450 and RSMo 287.460

If you’ve been injured at work, then please immediately contact our law firm, and one of our skilled attorneys will be happy to discuss your rights and benefits under Missouri workers’ compensation law. Call us for a free consultation: 314-631-6777, Ext. 14

Steven A. Edelman, Attorney

MISSOURI WORKERS’ COMPENSATION: SETTLEMENTS AND TRIAL AWARDS EXPLAINED

MISSOURI WORKERS’ COMPENSATION

Settlements and Trial Awards

The third major benefit in Missouri Workers’ Compensation cases is typically a lump sum settlement or a lump sum award from a trial judge to compensate the injured worker for permanent disability as a result of the work injury. 

  1. Settlements:

A settlement in a Missouri Workers’ Compensation case is when the injured worker agrees to accept a lump sum amount of money from the employer and workers’ compensation insurer to close their workers’ compensation.  

NOTE: Settlements must be approved by a workers’ compensation judge, who is referred to as an administrative law judge (ALJ). If a settlement contract is not approved by a judge then the settlement agreement is likely unenforceable, and the injured worker can still proceed forward with their workers’ compensation case. 

The law states under RSMo 287.390 in regards to Missouri Workers Compensation Settlements:

“Parties to claims hereunder may enter into voluntary agreements in settlement thereof, but no agreement by an employee or his or her dependents to waive his or her rights under this chapter shall be valid, nor shall any agreement of settlement or compromise of any dispute or claim for compensation under this chapter be valid until approved by an administrative law judge or the commission, nor shall an administrative law judge or the commission approve any settlement which is not in accordance with the rights of the parties as given in this chapter.  No such agreement shall be valid unless made after seven days from the date of the injury or death.  An administrative law judge, or the commission, shall approve a settlement agreement as valid and enforceable as long as the settlement is not the result of undue influence or fraud, the employee fully understands his or her rights and benefits, and voluntarily agrees to accept the terms of the agreement.

  2.  A compromise settlement approved by an administrative law judge or the commission during the employee’s lifetime shall extinguish and bar all claims for compensation for the employee’s death if the settlement compromises a dispute on any question or issue other than the extent of disability or the rate of compensation.”

  1. Trial Awards:

While many Missouri workers’ compensation cases settle with the employer/insurer, there are still many workers’ compensation cases that proceed to trial. A workers’ compensation case will proceed to trial if the injured worker and the employer and insurer can not agree on settlement terms to settle the workers’ compensation case.  In Missouri workers’ compensation cases trials are referred to as Hearings for a Final Award.

In Missouri workers’ compensation trials, there is no jury. There is only an administrative law judge (ALJ) that awards you money to compensate you for your work injury. 

If you have been hurt on the job and suffered a work injury, please call our office immediately to discuss your rights under Missouri workers’ compensation law. We work to obtain the largest settlement for you. We do not hesitate to proceed to trial if the employer and workers’ compensation insurer are unwilling to settle your case for what is fair and reasonable. 

Please call us if you have been injured on the job and have any questions about potential settlement of your Missouri workers’ compensation case. (314) 631-6777

Steven A. Edelman, Attorney

314-631-6777, Ext. 14

Authorized Medical Treatment Explained in Missouri Workers’ Compensation Cases

MISSOURI WORKERS’ COMPENSATION LAW

Authorized Medical Treatment Explained

Missouri Workers’ Compensation Law in section RSMo 287.140 states:

  1. “In addition to all other compensation paid to the employee under this section, the employee shall receive and the employer shall provide such medical, surgical, chiropractic, and hospital treatment, including nursing, custodial, ambulance and medicines, as may reasonably be required after the injury or disability, to cure and relieve from the effects of the injury. If the employee desires, he shall have the right to select his own physician, surgeon, or other such requirement at his own expense.”

As cited in the above Missouri law, authorized medical treatment under Missouri Workers’ Compensation Law is defined as medical treatment provided to the injured worker at no cost to the injured worker. Under Missouri law, The employer and workers’ compensation insurer get to the choose the doctor and medical providers to provide medical treatment to the injured worker.

The employer’s workers’ compensation insurance company is responsible by law to pay for and provide all types of medical treatment to cure and relieve the effects of your work injury. Medical treatment provided by the employer includes, but is not limited to, x-rays, CT scans, prescription medication, MRI, physical therapy, injections, surgery, EMG Nerve Conduction Studies, psychiatric and medical treatment for mental injuries, pain management, emergency medical treatment, ambulance, prosthetic replacement of injured body parts, canes, walkers, and even in home health care where applicable.

NOTE: The injured worker does not get to choose his own doctor or medical provider. If the injured worker goes to his own doctor or medical provider, then the injured worker is likely solely responsible to pay the medical bills for his own chosen doctor.

MOST COMMON PROBLEMS FOR INJURED WORKERS:

  1. At any time during your workers’ compensation case, the employer and workers’ compensation insurer will unnecessarily delay in providing you medical treatment.
  2. The employer and the workers’ compensation insurer will deny you medical treatment based upon the employer’s workers’ compensation doctor stating that you are released from medical treatment despite the fact that you have continuing, severe symptoms that need further medical treatment.
  3. The employer and the workers’ compensation insurer will deny you medical treatment in contradiction to a doctor’s recommendation for additional medical care.
  4. It is extremely important that you contact our law office immediately to discuss your case with an experienced attorney. One of our top priorities is to get you the medical treatment which you are entitled to by law.

If you’ve been injured at work and the employer is not providing you with authorized medical treatment or the employer and workers’ compensation have unjustifiably denied you medical treatment, please immediately contact our law firm at 314-631-6777.

Steven A. Edelman, Attorney

314-631-6777

Three Major Workers’ Compensation Benefits under Missouri Workers’ Compensation Law

Missouri Workers’ Compensation Benefits:

The Three Major Benefits under Missouri Workers’ Compensation are the following:

  1. Authorized medical treatment paid for by the employer/insurer. In Missouri, the medical provider is chosen by employer/insurer, which is called authorized medical treatment. Authorized medical treatment is explained in Missouri law in the Revised Statutes of Missouri (RSMo) Section 287.140
  2. Temporary Total Disability (TTD): This is a check that you get each week you are off work because of the work injury. TTD checks are equal to two-thirds of your gross average weekly wage (AWW). Temporary total disability is explained in RSMo Section 287.170
  3. Typically a lump sum settlement or a lump sum awarded to you by the trial judge to compensate you for the permanent disability you suffered due to the work injury. See Code of State Regulations (CSR) under 8 CSR 50-1.010 et seq.

Common Problems and Issues for Injured Workers in Missouri Workers’ Compensation Cases:

Employers and workers’ compensation insurance companies often pay injured workers a lower, incorrect amount of temporary total disability (TTD) and under settle cases with injured workers who are not represented by a workers’ compensation attorney. Employers will often terminate medical treatment when it become too expensive despite the fact that you are not finished with medical treatment and require further surgery or evaluation.

Please call our office immediately to discuss your rights and benefits under Missouri law and to protect you from these common Missouri workers’ compensation issues.

Steven A. Edelman, Attorney