Get Workers Compensation Claim Help with a St. Louis Workers Compensation Attorney

Common Workers Compensation Claims in St. Louis

The American Chiropractic Association reports back and neck pain as the leading causes of workplace disabilities. Back and neck trauma frequently develop when claimants spend too long using computers, driving/sitting, or performing the same repetitive tasks.

Other injuries and conditions for which injured workers commonly file workers’ compensation claims include:

• Paralysis/Spinal Cord Damage – Elevated falls are the leading cause of construction worker injuries, causing severe damage to the back, neck, and spinal cord, which may result in partial or complete paralysis..

• Traumatic Brain Injuries – Falls, striking accidents, and car crashes can cause mild to severe brain injuries, leading to confusion, difficulty concentrating, memory loss, and irritability.

• Carpal Tunnel Syndrome – This overuse injury can cause nerve damage, resulting in numbness, tingling, and weakness around the wrist and hand that worsen with repetitive use. Claimants may have difficulty performing their regular job functions and may require surgery.

• Broken Wrists and Ankles – Small bones in the wrists and ankles can cause complex injuries. Even minor fractures often require surgery and months of rehabilitation.

• Cancer and Respiratory Illnesses – Hazardous substances in the workplace may cause debilitating diseases, including leukemia, mesothelioma, and related disorders. Employees suffering from these disorders, linked to certain industries through previous litigation, may qualify for enhanced workers’ compensation benefits.

Understanding St. Louis Workers’ Comp Disability Categories and Compensation Entitlements

If you have a potentially disabling injury, it’s essential to consult with a local workers’ compensation attorney. Your disability level categorization determines your entitlement to benefits.

Claimants generally receive one of the following five disability classifications:

• No Disability – No benefits are available because the condition doesn’t interfere with primary work duties or isn’t a result of a workplace injury. You may still be able to recover compensation for negligently inflicted injuries with the help of a personal injury attorney.

• Temporary Partial Disability – You can perform alternative work, including light duty, but your injury interferes with some of your primary work duties. You may recover the net difference between your pre-injury and light-duty average weekly wage if they’re less than your full-duty average weekly wage.

• Temporary Total Disability (TTD) – Your injury completely incapacitates you from normal duties until treated, and you qualify for temporary benefits. You may recover net wage compensation (66% of average weekly wage) during the disability period. TTD injuries generally include minor traumatic brain injuries, leg fractures, curable illnesses, and herniated discs.

• Permanent Partial Disability – Your injury is permanent and incapacitates you from normal duties but doesn’t disable you from all work. The workers’ compensation insurance company may offer you a lump sum settlement award and career training benefits in such cases.

• Permanent Total Disability – Your injury is permanent and incapacitates you from all work, such as such as quadriplegia or severe brain trauma. Most claimants elect to accept a lump sum settlement from insurers in such cases, which an experienced St. Louis workers’ compensation lawyer may negotiate on your behalf.

Appealing Disability Certifications and Benefits Denials

Many insurance-approved doctors do not perform thorough examinations and drastically underestimate your disability level, resulting in a denied workers’ comp claim. Clients frequently contact our workers’ compensation lawyers after receiving surprising benefits denial letters.

If you receive a surprising benefits denial letter, you have the right to appeal the determination. Our workers’ compensation attorneys may appeal the decision by submitting conflicting medical reports, medical records, worker testimony, and challenging the adequacy of the initial workers’ compensation examination.

Filing Compensation Claims Directly With the Missouri Department of Labor

If your employer is unresponsive to your workers’ compensation claim, The Division of Workers’ Compensation can help. Under certain circumstances, injured workers can recover full and fair compensation of their workers comp benefits from unresponsive employers by filing a claim with the state.

The state will handle your claim for compensation if you have informed your employer of your workplace injury and have filed the necessary workers’ compensation paperwork without receiving benefits. This often occurs when employers fail to provide insurers with the official incident reports and wage information necessary to verify claims.

Do not file a state claim for compensation without discussing your options with an experienced workers compensation lawyer. Missouri workers comp lawyers may appeal administrative decisions to a higher administrative board and, if necessary, appeal these denials in court.

Estimating the Value of St. Louis Workers’ Compensation Claims

The amount of financial compensation you receive in your Missouri workers’ compensation claim depends on many factors, from how serious injuries are to which insurance company your employer uses.

For workers compensation cases for most workplace injuries, workers receive set payments that include medical benefits and lost wages. Experienced workers’ compensation lawyers can help you determine your specific workers comp benefits.

Negotiating a Settlement

Lump sum payouts may be available for those with serious injuries suffering from permanent or long-term disabilities. These settlements may be negotiated if the injured worker has reached maximum medical improvement and can comfortably retire. In a workers’ comp case where the insurance company is trying to reduce benefits, it may be worth negotiating for a settlement.

Additional Methods of Financial Compensation

Long-term disabilities may also qualify an injured worker for Social Security Disability Insurance and frequently support a third-party personal injury lawsuit. However, many types of financial compensation for work injury victims can offset one another, so it’s important to discuss options with a dedicated St. Louis workers’ compensation lawyer.

The experienced attorneys at our law firm can help you receive maximum compensation for your personal injury claim avoid costly medical liens and conflicting demands.

Workers’ Compensation FAQs

Our prospective clients frequently ask us the following questions about their St. Louis workers’ compensation rights:

HOW CAN I TELL IF MY EMPLOYER HAS WORKERS’ COMPENSATION INSURANCE?

A. Most employers in St. Louis and Missouri carry workers’ comp insurance. The law requires all construction industry employers and any employer with five or more employees to maintain workers’ comp insurance.

Employers must generally post workers’ right notices that contain claims information and inform new hires of available coverage. Employers who aren’t legally obligated to carry workers’ comp insurance often purchase coverage anyway, so if you’re unsure of your benefits, ask your employer.

The Missouri Division of Workers’ Compensation maintains an online Employer Coverage Verification tool that you can use to verify your employer’s insurance coverage. If your employer does not have workers’ compensation insurance, they may be in violation of Missouri law (Mo. Rev. Stat. § 287.030).

Q. AM I ELIGIBLE FOR WORKERS’ COMPENSATION BENEFITS IN ST. LOUIS OR THE METRO EAST?

A. If you have been injured while performing work-related duties, you are likely eligible for workers’ compensation benefits in St. Louis and the Metro East.

Eligibility for workers’ compensation benefits is not dependent on fault or negligence, meaning that you can receive benefits regardless of who was at fault for the injury. Adjusters do not base eligibility on accident liability unless evidence indicates the claimant inflicted the injury intentionally and committed fraud to recover benefits or violated employer drug and alcohol policies.

To recover initial benefits, employees must show that they suffered injuries at work, such as in a car accident while making deliveries or neck pain from computer overuse, and this injury prevents them from performing essential job functions. Insurers generally request the initial accident/injury report filled with the employer, wage information, and corroborating medical documents.

Q. WHAT KIND OF LOST WAGES BENEFITS DOES WORKERS’ COMP INSURANCE OFFER?

A. St. Louis claimants entitled to WC payments receive wage, medical, and death benefits. Generally, injured employees recover two-thirds (66.6 percent) of their gross weekly salary (or average weekly earnings). Because these benefits are tax-free, this normally equates to the claimant’s net wages.

Certain factors increase or decrease these benefits. For example, claimants diagnosed with certain medical conditions related to workplace toxicity, such as mesothelioma, myelodysplastic syndrome, and silicosos, might recover enhanced weekly benefits. National litigation has already linked these serious conditions to certain workplace hazards, such as asbestos and silica dust.

Q. WHAT SHOULD I DO TO GET WORKERS’ COMPENSATION BENEFITS?

A. If you have been injured while performing work-related duties, you should first seek medical care immediately.

As soon as you’re able, report your injuries verbally to a supervisor and complete incident report forms. If your employer does not ask you to review, sign, and/or complete paperwork, you should follow up with supervisors or human resources in writing (generally via email).

It’s important to have written documentation that you reported the injury/illnesses and provided details of the event shortly after developing symptoms. Many injuries, especially back pain, worsen overnight or in the weeks following the workplace accident. You must report any incident to employers, including general contractors, as necessary, within thirty days or risk losing benefits.

If your employer fails to take immediate action after you’ve reported a potential workplace injury or illness, you should contact Missouri workers compensation attorneys and file a claim with the Missouri Department of Labor.

Q. WHAT IS A WORKERS’ COMPENSATION IME, AND HOW SHOULD I PREPARE?

A.  An independent medical exam (IME) is necessary to obtain and maintain workers’ compensation benefits in St. Louis. Unfortunately, IME doctors may try to minimize your injuries to reduce the insurer’s financial liability. Additionally, many claimants don’t fully express their pain and discomfort during exams.

It’s crucial to contact a workers’ compensation lawyer before your IME to ensure the doctor receives all relevant medical records and to learn how to accurately express your concerns.

Claimants can receive denials of needed workers’ compensation benefits simply because they walked into the examination room without support. And be sure to attend — if you cancel or skip your IME, this gives WC insurers grounds to deny you benefits even with reports from private physicians.

Q. HOW LONG DO I HAVE TO FILE A WORKERS’ COMPENSATION CLAIM IN ST. LOUIS?

A. Missouri law requires injured workers to report any qualifying work injury or illness within 30 days.

A Missouri workers’ compensation claim report must include the date, time, and circumstances to enter the workers’ compensation system. Your employer should then send the claim to the workers’ compensation insurance within five days. Most employers are prompt, but if you don’t hear back within a week, contact a St. Louis, MO workers’ comp attorney.

You have two years to file disputes with the Department of Labor.

Q. WHAT SHOULD I DO IF MY WORKERS’ COMP CARRIER DENIES OR REDUCES MY BENEFITS?

A. If the insurance carrier denies or reduces your injury claim benefits, it’s recommended to hire a lawyer. The Department of Labor also strongly advises workers’ comp claimants to obtain private legal counsel if:

• you’re not receiving proper medical treatment

• the workers’ comp insurance company denies or reduces your benefits

• the insurance company accuses you of drug or alcohol violations

• you’re eligible for SSDI, Social Security, Medicare, or Medicaid

• you’ve suffered total or partial permanent disabilities