Blog: Workers’ Compensation and Personal Injury

Missouri Workers’ Compensation: Why do you need to hire a lawyer to represent you in your Missouri Workers’ Compensation case?

Why do you need to hire an attorney to represent you in a Missouri Workers’ Compensation case for your work injury?

By Steven Edelman, Attorney

At the Edelman Law Office, we know that injured workers are intelligent, and injured workers want a straight forward answer to their workers’ compensation questions. Everyday, we answer questions, advise and represent injured workers in all areas of work and in all jobs. We successfully recover workers compensation benefits for injured workers against all employers, ranging from small employers to the largest of the largest employers in the state of Missouri. Below is a list of reasons why an injured worker should hire an attorney to represent them for their work injury in a Missouri workers’ compensation case.

  1. The injured worker is unaware of their ability to report their work injury to the employer and the injured worker is not aware if their employer has workers’ compensation insurance to cover their work injury. In Missouri, the law states under section 287.127 that “all employers shall post a notice at their place of employment, in a sufficient number of places on the premises to assure that such notice will reasonably be seen by all employees . . .” The notice shall include primarily: 1. That the employer is operating under and subject to the provisions of the Missouri workers’ compensation law; 2. That employees shall report all injuries within 30 days of the work injury to the employer, and 3. The notice shall provide the name, address, telephone number of workers’ compensation insurer. RSMo 287.127

Often times, the employer will not advise the injured worker of their right under Missouri law to report their work injury to the employer. Employer’s will also not tell the injured worker if they have workers’ compensation insurance coverage for their work injury. If the employer does reveal their workers’ compensation insurance company, the employer often times will not report the work injury to the insurer as a claimed work injury and won’t provide the workers’ compensation insurance companies contact information to the injured worker.

2. The injured worker reports their work injury to a supervisor at the employer, but the employer refuses to make a report of injury for the injured worker. As discussed above, in Missouri, the injured worker is required by law to make a written report of injury to the employer within 30 days of the date of the work injury. See the law under RSMo 287.127 and RSMo 287.420. Often times, the employer will refuse to make a report of injury and or denies that a written report of injury was made.

An attorney at the Edelman Law Office will make sure that you timely make your written report of injury to your work and make sure that you include the necessary information in your report of injury. A written report of injury must be made to the employer including (1) The injured worker’s name, (2) Address, (3) phone number, (4) Date of injury, (5) Brief description of how the work injury occurred, and the body parts injured and (6) A demand for authorized medical treatment from the employer and (7) be signed by the injured worker. The injured worker must make the report of injury to a supervisor and someone in charge at the employer, for example, a foreman, boss, supervisor, human resources, manager. Make sure to keep a copy of the report of injury for your own records in the event the employer denies a report of injury was ever made. Report of injuries can be dropped off in person to the employer, faxed, emailed, but must be made in writing.

A lawyer will also then file your case in the court, which is called a claim for workers’ compensation. Once this workers’ compensation claim is filed with the court, called the Division of Workers’ Compensation, the employer and their workers’ compensation insurance company will be notified by the court of your workers’ compensation claim. The workers’ compensation insurance company will typically then respond to and provide authorized medical treatment to the injured worker.

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

Steven A. Edelman, Attorney

Illinois Workers’ Compensation, Benefits: Temporary Partial Disability (TPD)

Benefits: Temporary Partial Disability (TPD) per the law under 820 ILCS 305/8(a)

Your doctor may return you to work light duty/restricted work, or your doctor may return you to work on a part-time basis reduced number of work hours per day. As a result, you may earn less wages than you were earning prior to your work injury. If this happens, you may be entitled to receive Temporary Partial Disability (TPD) benefits .

The law states that: “When the employee is working light duty on a part-time basis or full-time basis and earns less than he or she would be earning if employed in the full capacity of the job or jobs, then the employee shall be entitled to temporary partial disability benefits. Temporary partial disability benefits shall be equal to 2/3 (two-thirds) (66 2/3%) of the difference between the average amount that the employee would be able to earn in the full performance of his or her duties in the occupation in which he or she was engaged at the time of accident and the gross amount which he or she is earning in the modified job provided to the employee by the employer or in any other job that the employee is working.” See the law 820 ILCS 305/8(a)

It is important that you immediately contact our law office to discuss your temporary partial disability (TPD) benefits. We protect your rights and ensure that the employer pays you your benefits while you recover from your work injury. 

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 Illinois workers’ compensation law. Call us for a free consultation: 314-631-6777

Steven A. Edelman, Attorney

Illinois Workers’ Compensation, Temporary Total Disability (TTD) Explained

Temporary Total Disability (TTD)

Illinois Workers’ Compensation

Temporary Total Disability (TTD) is a check that you receive each week that you miss work because of the work injury either because (1)  The doctor takes you off work completely due to the work injury or (2) The doctor placed you on light duty work work restrictions, and the employer can not accommodate light duty work, and therefore you are off work. 

Your TTD check is equal to 66.67% of your gross average weekly wage. The gross average weekly wage is based on the average of your gross weekly wages for the 52 weeks preceding your date of injury. TTD for  governed by the law under 820 ILCS 305/8(b)

Common Problems with Temporary Total Disability (TTD) payments:

  1. The Employer pays the incorrect amount of temporary total disability (TTD).
  1. The Employer refuses to pay TTD despite the doctor placing you off work.
  1. The injured worker is on light duty work restrictions per the order of treating doctor. The employer then offers light duty work but with unreasonable requirements. For example, the offer of light duty work is at a location that is hours away, or out of state from the employee’s original assigned work location. The employer then refuses to pay TTD based on the offer of light duty work because the employee cannot reasonably travel to the light duty work. 
  1. The injured worker is on light duty restrictions per the order of their treating doctor. The employer then offers light duty work within the doctor’s accommodations but simultaneously tells the injured worker that they must perform additional full duty work outside of the doctor’s light duty restrictions. When the employee cannot do this full duty work, the employer sends the injured worker home. The employer then states that the employee refused light duty work, and therefore denies payment of TTD
  2. The Employer mails your TTD check to the employer’s address instead of mailing TTD directly to the injured worker. Mailing TTD to the employer creates unnecessary burden on the injured worker to travel to the employer to pick up their TTD check.

It is important that you immediately contact our law office to discuss your temporary total disability (TTD) benefits. We protect your rights and ensure that the employer pays you your benefits while you recover from your work injury. 

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 Illinois workers’ compensation law. Call us for a free consultation: 314-631-6777

Steven A. Edelman, Attorney

Illinois Workers’ Compensation; Medical Treatment and Choice of Medical Provider Explained

Illinois Workers’ Compensation

Medical Treatment Explained in Illinois Workers’ Compensation Cases

The First Major Benefit under Illinois Workers’ Compensation Law: The first Major Benefit under the Illinois Workers’ Compensation Act is medical treatment paid for by the employer/workers’ compensation insurance company per the law 820 ILCS 305/8(a). 

Under Illinois workers’ compensation law, an injured worker has the right by law to choose two medical providers and the referrals from each of these two chosen providers are paid for by the employer/workers’ compensation insurer. The law specifically states that:

“[T]he employer’s liability to pay for such medical services selected by the employee shall be limited to:        (1) all first aid and emergency treatment; plus        
(2) all medical, surgical and hospital services

provided by the physician, surgeon or hospital initially chosen by the employee or by any other physician, consultant, expert, institution or other provider of services recommended by said initial service provider or any subsequent provider of medical services in the chain of referrals from said initial service provider; plus
        (3) all medical, surgical and hospital services

 provided by any second physician, surgeon or hospital subsequently chosen by the employee or by any other physician, consultant, expert, institution or other provider of services recommended by said second service provider or any subsequent provider of medical services in the chain of referrals from said second service provider. Thereafter the employer shall select and pay for all necessary medical, surgical and hospital treatment and the employee may not select a provider of medical services at the employer’s expense unless the employer agrees to such selection. At any time the employee may obtain any medical treatment he desires at his own expense.”
820 ILCS 305/8

Example:

The following is one example of facts of how an injured worker can choose his doctor in an Illinois workers’ compensation case. 

First Choice of Medical Provider:

  1. You suffer injury to your back at work.  (1) You then present to the employer’s recommended doctor, or (2) You choose your own medical provider and receive medical treatment. Whether you receive medical treatment from the employer’s recommended medical provider or from your chosen doctor, this first medical providers is designated as your first choice of medical provider, i.e. “first medical provider” under Illinois law. 
  1. Therefore, the Illinois workers’ compensation insurer will pay for this initial primary care medical provider and any subsequent medical treatment referred by them, which is considered the chain of medical treatment. 
  1. The first medical provider then refers you for a MRI of your back to be performed at a hospital near you. The MRI reveals a herniated disc in your lumbar spine. The workers’ compensation insurer must pay for this MRI as it was recommended by your initial primary care medical provider.
  1. Based on the results of the MRI, the initial primary care doctor then refers you to a specialist orthopedic spine doctor. Again, the workers’ compensation must pay for you to see the orthopedic spine doctor because this specialist was recommended by your first medical provider.
  1. The orthopedic doctor prescribes you an injection in your lower back and some physical therapy that you complete. The injection and physical therapy temporarily relieve your symptoms, but a short time later all your symptoms return. 
  1. The orthopedic doctor then recommends no further medical treatment despite your continuing symptoms and releases you from medical treatment.

Second Choice of Medical Provider:

  1. You then seek another opinion from a second orthopedic spine specialist, i.e. the  “Second medical Provider.” This second orthopedic doctor is then considered your second choice of medical provider. Therefore, the workers’ compensation insurer must pay your medical bills for you to see this second orthopedic doctor. 
  1. The second medical provider reviews your back MRI and prescribes you another three week session of physical therapy at a new physical therapy location. The insurer must pay for this physical therapy because it was recommended by your second chosen medical provider.
  1. After you complete physical therapy, the second medical provider recommends back surgery to fix your back. Again, the insurer must pay for this surgery because it was recommended by your second chosen doctor. 
  1. If you then decide that you do not want the surgery and decide that you want to obtain a second opinion from another doctor, any choice of doctor after the two above choices will then be chosen by the employer/insurer.  

It is important that you immediately contact our law office to discuss your two choices of doctors. We protect your rights and ensure that the employer pays for your medical treatment for the doctor that you have chosen. 

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

Steven A. Edelman, Attorney

Illinois Workers’ Compensation

The Three Major Benefits for Illinois Injured Workers under the Illinois Workers’ Compensation Law

Question: What are the three major benefits for an injured worker under Illinois Workers’ Compensation law?

The First Major Benefit under Illinois Workers’ Compensation Law: The first Major Benefit under the Illinois Workers’ Compensation Act is medical treatment paid for by the employer/workers’ compensation insurance company 820 ILCS 305/8(a). Under Illinois workers’ compensation law, an injured worker has the right by law to choose two medical providers and the referrals from each of these two chosen providers. The law states that:

  1. The employer shall pay for medical services for the employee’s First choice of medical provider and any provider in this chain of referrals from this first choice provider. 820 ILCS 305/8(a)(2)  
  2. The Employer shall pay for medical services for the employee’s Second choice of medical provider and any provider in this chain of referrals from this second choice of provider. 820 ILCS 305/8(a)(3)

The Second Major Benefit under Illinois Workers’ Compensation Law: The second major benefit under the Illinois Workers’ Compensation law is temporary total disability (TTD) 820 ILCS 305/8(b)

The Third Major Benefit under Illinois Workers’ Compensation Law: The third major benefit under Illinois Workers’ Compensation law is typically a lump sum settlement to compensate the injured worker for the permanent disability they suffer from the work injury. 

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

Missouri Workers’ Compensation: Temporary Total Disability (TTD) explained, RSMo 287.170

MISSOURI WORKERS’ COMPENSATION 

TEMPORARY TOTAL DISABILITY

Temporary Total Disability (TTD) is one of the three major benefits that an injured worker receives in a Missouri Workers’ Compensation case. Temporary total disability is referred to as TTD for abbreviation.  

TTD is a check for money which is equal to two-thirds of the gross average weekly wage of the injured worker based on the 13 weeks of gross wages prior to the work injury. The TTD check is typically mailed directly to the injured worker or in some occasions directly deposited to the injured worker’s bank account. Workers’ compensation pays the injured worker TTD for each week of work missed as a result of the work injury either because 

(1) The doctor places the injured worker off work due to the work injury 

OR 

(2) The doctor placed light duty restrictions on the injured worker, and the employer can not provide accommodated light duty work within the doctor’s restrictions; and therefore, the injured worker remains off work. 

Law: (RSMo 287.170) 

Temporary total disability is found in Missouri Law in the Revised Statutes of Missouri, RSMo 287.170 which states, in part, as follows:

“1.  For temporary total disability the employer shall pay compensation for not more than four hundred weeks during the continuance of such disability at the weekly rate of compensation in effect under this section on the date of the injury for which compensation is being made.  The amount of such compensation shall be computed as follows:

. . .

(4)  For all injuries occurring on or after August 28, 1991, the weekly compensation shall be an amount equal to sixty-six and two-thirds percent of the injured employee’s average weekly earnings as of the date of the injury; provided that the weekly compensation paid under this subdivision shall not exceed an amount equal to one hundred five percent of the state average weekly wage;

. . .

Temporary total disability payments shall be made to the claimant by check or other negotiable instruments approved by the director which will not result in delay in payment and shall be forwarded directly to the claimant without intervention, or, when requested, to claimant’s attorney if represented, except as provided in section 454.517, by any other party except by order of the division of workers’ compensation.

  3.  An employee is disqualified from receiving temporary total disability during any period of time in which the claimant applies for and receives unemployment compensation. RSMo 287.170.3

  4.  If the employee is terminated from post-injury employment based upon the employee’s post-injury misconduct, neither temporary total disability nor temporary partial disability benefits under this section or section 287.180 are payable.  As used in this section, the phrase “post-injury misconduct” shall not include absence from the workplace due to an injury unless the employee is capable of working with restrictions, as certified by a physician.

  5.  If an employee voluntarily separates from employment with an employer at a time when the employer had work available for the employee that was in compliance with any medical restriction imposed upon the employee within a reasonable degree of medical certainty as a result of the injury that is the subject of a claim for benefits under this chapter, neither temporary total disability nor temporary partial disability benefits available under this section or section 287.180 shall be payable.”

Common Problems that Injured Workers have with the Employer and Workers’ Compensation regarding payment of Temporary Total Disability (TTD)

Injured workers regularly have problems with the employer and workers’ compensation insurer paying temporary total disability (TTD). 

Common problems include:

  1. The doctor places an injured worker off work, and workers’ compensation never pays temporary total disability.
  2. The employer/workers’ compensation insurer pay the wrong amount of temporary total disability, which is usually much lower than what you are entitled to receive. 
  3. Workers’ compensation unnecessarily delays payment of TTD.
  4. Workers’ compensation sends TTD checks at sporadic intervals, which cause financial difficulty for the injured worker. 
  5. An injured worker is released to work light duty work, and the employer instructs the injured worker to return to work full duty in contradiction to the doctor’s order of light duty restrictive work. The employer makes the injured worker work full duty instead of sending the injured worker home. In this situation, the injured worker exposes themselves to potential additional injury when they should be receiving TTD because the employer can not provide light duty work. 
  6. The employer fires an injured work for alleged“misconduct,” and therefore stops paying TTD
  7. The employer stops paying the injured worker TTD because they allege the injured worker declined light duty work. 

If you’ve suffered a work injury on the job in Missouri, and you are not receiving temporary total disability (TTD) then call our law office immediately for a free consultation. We pride ourselves on fighting for your rights and getting you the benefits you are entitled to by law.  Please call us immediately at 314-631-6777

Steven A. Edelman, Attorney

314-631-6777

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

Illinois Workers’ Compensation: When do I have a workers’ compensation case in Illinois?

820 ILCS 305. Sec. 1 (b)

You have an Illinois workers’ compensation case if one of the following situations applies to you:

  1. The work injury occurred in Illinois regardless of the state you were hired.
  2. The work injury occurred outside the state of Illinois and your contract for hire was made within Illinois NOTE: If the last act of hiring you occurred in Illinois, then Illinois has jurisdiction, for example- you signed your employment contract in Illinois or completed your work training in Illinois.
  3. Workers whose employment is principally localized within the State of Illinois, regardless of the place of the accident or the place where the contract of hire was made, including non-citizens and minors.

It is very important that you recognize your ability to file your workers’ compensation case in Illinois if one of the above situations applies to you because there are important benefits under Illinois law that you are entitled to. One of these benefits under Illinois law is that you have the right to choose your medical provider to provide you with medical treatment for your work injury. The employer will then have to pay for your chosen medical provider.

If you’ve suffered a work injury in Illinois or you were injured outside the state of Illinois but you were hired in Illinois, call our law office immediately to discuss your rights under Illinois workers’ compensation law. One of our skilled attorneys will be happy to discuss your rights and benefits under Illinois workers’ compensation law. Call us for a free consultation: 314-631-6777

Steven A. Edelman, Attorney