At its best, work is a place where you can feel productive and fulfilled. Unfortunately, a workplace accident can throw off your entire life. These accidents can range from a slip and fall to vehicle accidents, to exposure to poisonous substances. The employer is responsible for their employees’ on-the-job injuries.
Follow all administrative requirements when seeking recovery after a workplace injury. Failure to comply with required procedures can jeopardize your ability to fully recover. A claim becomes even more complicated if an employer disputes your status as an employee or claims that you didn’t act in the scope of your work duties at the time of the accident.
If a workplace accident in the St. Louis area, including the Metro East, injured you or a loved one, call The Bruning Law Firm at (314) 735-8100 or contact us through our website for your free case consultation with one of our personal injury lawyers. Our team of St. Louis workers’ compensation lawyers is committed to standing up for everyday people who are struggling to secure the recovery they deserve after a workplace injury.
Common St. Louis Workplace Injuries
In 2020, there were more than 90,000 workplace injury accidents in Missouri, with nearly 18,000 of these injuries occurring in St. Louis County. Any injury sustained by an employee while acting within the scope of their job duties is classified as a workplace injury.
The occupations with the highest number of injury incidents in Missouri in 2019 were in the transportation, moving material, and production industries. The most common cause of injury was a fall, slip, or trip, which accounted for 32 percent of injuries that year. Other common causes included overexertion, bodily reaction, and contact with an object or equipment. The most common injuries were sprains, strains, tears, and fractures.
Am I Protected by Workers’ Compensation For My St. Louis Workplace Injury?
The Missouri Division of Workers’ Compensation handles St. Louis work injury claims. Workers’ compensation in St. Louis provides recovery for any employee of a company with five or more employees who is injured while acting in the scope of their job duties, as long as the prevailing cause of the injury or medical condition arises from and in the course of employment. Unlike a lawsuit, recovery under workers’ compensation does not require you to prove that the employer’s or any other party’s negligent or intentional acts caused your injury.
Every St. Louis employer that employs more than five workers is required to either (a) secure workers’ compensation insurance coverage through a carrier authorized by the Missouri Department of Insurance (MDI), Financial Institutions, and Professional Registration; or (b) meet the Division of Workers’ Compensation requirements for self-insurance. The MDI provides an online service for employers to inquire about by workers’ compensation insurers in the state. In the construction industry, any employer with one or more employees must carry coverage.
Certain St. Louis employees are exempt from coverage, including farm laborers, domestic servants, some real estate agents, and direct sellers, and commercial motor-carrier owner-operators. Even if an employer is not required to provide coverage, it can elect to do so by purchasing valid workers’ compensation insurance.
Workers’ compensation only covers St. Louis employees, not independent contractors.
Determining whether an individual was an employee or an independent contractor can be a tricky issue, and requires consideration of several factors, including:
- Whether the worker must follow the employer’s instructions on when, where, and how to work
- If the employer provides the individual with training
- If the business operations integrate the worker's services
- If there is a continuing relationship between the employer and the worker
- If the worker has set work hours and devotes substantially full-time work for the business
If a St. Louis employer must secure workers’ compensation coverage but knowingly fails to do so, they are guilty of a class A misdemeanor. This misdemeanor is punishable by a fine of up to three times the annual insurance premium the employer would have paid or $50,000, whichever is greater. File any claim of employer non-compliance with the Fraud and Noncompliance Unit.
The laws differ somewhat over the river in the Metro East, but we know how Illinois’s workers’ compensation system works, and we can help injured workers there, too.
Our experienced St. Louis workers’ compensation lawyers can analyze your status, determine whether your employer needed to provide workers’ compensation coverage, and seek compensation from the appropriate source.
How Do I Report a St. Louis Workplace Injury and Secure Treatment?
Seek immediate medical treatment as needed for your injury—your health and safety are of the highest importance. Once you have secured any necessary emergency medical treatment, comply with all reporting requirements to ensure that workers’ compensation covers your treatment. In St. Louis, you have 30 days to report your injury. Failure to report promptly might jeopardize your eligibility for workers’ compensation.
You satisfy your reporting obligation once you provide the employer written notice that includes:
- Date, time, and place of the injury
- Nature of the injury
- Name and address of the person injured
Keep a copy of your report for your records in case anyone challenges you on timely reporting. Once you report the injury, the employer must report the injury to the Division of Workers’ Compensation.
Once you have reported your injury, your employer or their insurance provider is responsible for coordinating and paying for medical care. The employer, through their insurance policy, must pay for necessary treatments for the injured employee, including authorized medical treatment, prescriptions, and medical devices.
To receive this coverage, you must know:
- The employer has the right to choose your healthcare provider or treating physician
- You may be required to exhaust accumulated paid or sick leave to attend medical treatment
- You must submit to reasonable medical examinations at the request of your employer
- The employer can require vocational testing and assessment, which are commonly required if you are claiming permanent or total disability
- Your medical records related to the injury must be made available to the Division of Workers’ Compensation and your employer
Failure to comply with any of the above requirements could jeopardize your ability to secure coverage for your medical treatment. If you believe your employer, the Division, or the insurance provider is making unreasonable demands or wrongfully denying coverage, contact a workers’ compensation lawyer.
What Benefits Will I Receive?
In addition to covering the costs of your medical treatment, St. Louis workers’ compensation provides additional benefits when the employee is partially or permanently disabled either temporarily or permanently.
The below wages are subject to a maximum payout, which the State Average Weekly Wage calculates.
- Lost Wages: Receipt of payment for lost wages will depend on your doctor’s assessment of your ability to work. If you can't return to work due to your injuries or need to take time off to recover from surgery, you should recover lost wages. If you can perform light work or modified work duties, you can only recover for the difference between your normal wages and the pay you receive for modified duty. Once a doctor approves you to return to work, you will not receive further payments for missed work.
- For temporary partial disability, a worker receives two-thirds of the difference between their average earnings before the accident and the amount the worker can earn during the period of disability.
- For temporary total disability, a worker receives two-thirds of their average weekly wage.
- Disability Benefits: Some injuries are so catastrophic that the worker is declared permanently disabled. A permanent partial disability means that the worker can't perform certain jobs or tasks but can work in some capacity. A worker who has suffered a permanent total disability is no longer able to work any job. Permanently disabled employees are entitled to additional benefits for the rest of their life.
- For permanent partial disability, your benefits will depend on a rating assigned by a doctor, which will correlate to how much the disability affects the injured body part. You will also receive a numerical value based on a schedule of losses. This formula will determine the benefit.
- For permanent total disability, the calculation is the same as a temporary total disability but will last for your lifetime.
- Survivor Benefits: If your loved one died in a workplace accident, the survivor (normally a spouse or child) should receive two-thirds of the victim’s average weekly wage from the immediately preceding year. The employer must also pay up to $5,000 in funeral expenses. The status of the survivor will determine how long workers' compensation pays the benefit.
There is no doubt that calculating workers’ compensation benefits is complicated. Don’t trust that the Division or your employer has managed the calculation correctly. Work with an experienced workers’ compensation lawyer to make sure you recover everything you deserve.
What if I Disagree With a Benefits Determination, Should I Contact a Work Comp Lawyer?
If you disagree with the benefits you are afforded, you may:
- Appeal dispute management services through the Missouri Workers’ Compensation Division. A neutral mediator facilitates this process with the goal of all parties agreeing upon a resolution.
- Conference with an administrative law judge. If mediation before the Division fails, you can opt to have a Conference with an administrative law judge (ALJ). Unlike dispute management, this does not involve a mediator. Instead, the employee can meet with the employer’s or insurer’s attorney under the oversight of a judge. The parties will attempt to settle the case.
- File a Claim for Compensation. This is a more adversarial process to modify your benefit award. It includes a series of hearings in which the employee fights to have their employer compelled to pay. Employees may argue that they have not reached maximum medical improvement, require additional treatment, or are entitled to additional benefits.
- Appeal an Award: Even if an ALJ issues an award, you still have the right to appeal the decision. You must file an appeal with the Missouri Labor and Industrial Relations Commission within twenty days of the award. After a decision by the Commission, you can file a second appeal with the Missouri Court of Appeals. If your case presents unique legal issues, it is possible (but extremely rare) that the Missouri Supreme Court will accept the case for review. You cannot appeal a settlement.
A St. Louis worker is not required to have a lawyer to pursue any of the above challenges, but a lawyer is a valuable partner. Any final decision or acceptance of benefits will be a decision you are committed to. The law and administrative requirements are complicated and often change. Additionally, most employers and insurance companies are counseled and represented by a lawyer—you balance the scales by having legal representation.
An experienced workers’ compensation lawyer will ensure that you are advocated for throughout the claim process to give you the best chance of receiving the maximum benefits possible.
Reasons to Hire a Saint Louis Workers’ Comp Lawyer
Several reasons exist for injured workers to hire a workers’ compensation lawyer near you. They include:
1. Denial of Your Claim
Workers’ comp insurance providers deny plenty of legitimate claims, forcing injured workers to hire an attorney to get benefits. Sometimes they deny claims for valid reasons, too.
Some common reasons they deny workers’ compensation claims include:
- No one witnessed the injury, so the insurance provider assumes the worker made up their story.
- The injured worker did not immediately report their accident to their employer.
- The injury did not occur at work or while performing job duties.
- The worker was under the influence of drugs and alcohol.
- The injured worker did not receive treatment from an approved medical provider.
- The injured worker did not receive medical treatment at all.
- The injured worker did not meet deadlines related to filing the necessary paperwork.
- The injury occurred because of a practical joke or horseplay.
- The injury comes from a preexisting condition.
- The employer disputes the claim.
Regardless of the reason for your workers’ compensation claim denial, it’s in your best interest to contact a workers’ comp lawyer near you as soon as possible.
2. Inadequate Medical Treatment
Under Missouri law, employers or their workers’ comp insurance providers must provide medical treatment to injured workers to care for their injuries. The state requires them to pay for all authorized medical treatment, prescription medication, and necessary medical devices without any deductible. However, the employer or their insurer has the right to choose the medical treatment provider and/or physician when an injured employee receives treatment.
If you’re not receiving the care you need, your employer and their insurer can authorize you to see your regular doctor. However, this is not always the case. You deserve to receive any medically necessary treatment. If you are not receiving adequate medical treatment, an experienced St. Louis workers’ compensation attorney can help communicate with the insurance provider and fight for you to get the medical care you need.
3. Employer Retaliation
Employees can be demoted or fired after an injury because of poor conduct, but Missouri law prohibits employers from retaliating against employees who fire a workers’ compensation claim. Retaliation can include a wide range of actions, including termination, demotion, or any other adverse change in your conditions of employment.
If your employer has retaliated against you after filing a worker’s comp claim, you have the right to bring a lawsuit against them for compensation. Hiring a workers’ comp attorney ensures you have someone in your corner who knows how to apply the law to your situation and can protect your rights.
4. Unpaid Medical Bills
As previously mentioned, workers’ compensation benefits should pay for necessary medical treatment costs. If they are not paying, you might have a massive amount of medical bills rolling in. You may not be able to pay, especially if you cannot work because of your illness or injury. Injured workers must prioritize paying for housing and food before worrying about paying their medical providers.
However, the failure to pay your medical bills can ruin your credit if your medical providers send your accounts to a collection agency. A St. Louis workers’ comp lawyer near you can communicate with your medical providers and fight for the workers’ comp insurance provider to provide the benefits you deserve.
5. Employer Has No Coverage
Missouri requires businesses with five or more employees to carry workers’ compensation insurance. Construction companies and other businesses related to the construction industry must carry workers’ comp if they have one or more employees.
Employers who choose not to buy coverage must self-insure. However, they open themselves to employee lawsuits when a workplace injury occurs.
If you suffered an on-the-job injury or illness, and your employer does not have workers’ comp coverage, it’s in your best interest to consult with a workers’ comp lawyer near you to learn about the best way to recover economic and non-economic losses related to your injury.
6. Excluded Profession
Most Missouri employers must carry workers’ comp insurance for their employees. However, the law contains some exceptions for workers who do not qualify for workers’ compensation benefits. An attorney can review your case and evaluate how you might be able to recover losses related to your injury.
Missouri workers’ compensation benefits do not apply to:
- Farm laborers and agricultural workers
- Domestic workers in a private home
- Occasional labor for a private home
- Real estate agents and direct salespeople
- Non-profit volunteers
- Some inmates, patients, and residents of the state, county, or city
- Those who judge sports, contests, or other interscholastic activities for adults and youth
7. Third-Party Liability
Third-party liability in workplace injury or illness cases is one of the most crucial reasons you need to consult with a workers’ comp lawyer near you. Workers’ compensation benefits provide medical and permanent or temporary disability benefits.
Still, they do not compensate employees for non-economic losses such as pain and suffering or reduced quality of life. The workers’ compensation insurance system exists to protect employers from lawsuits and prevent them from having to pay for non-economic losses.
However, situations exist when a third party, who is not protected from a civil lawsuit by workers’ comp insurance, holds some or all financial responsibility for a worker’s injuries. In these cases, a workers’ comp lawyer can help an injured worker bring a lawsuit against a third party to recover damages related to their injury or illness.
Examples of workplace illness or injury scenarios that could give rise to a civil lawsuit against a third party include:
Toxic Substance Exposure
Regardless of the type of job, an employee could come in contact with toxic chemicals or substances that cause disease or illness. In severe cases, where exposure causes a permanent condition or leads to terminal illness, you can hold the product manufacturer financially liable. Production or manufacturing jobs use many toxic substances.
Some employees need to use heavy machinery or equipment to do their jobs. If the equipment or machinery is defective and leads to a workplace accident, a court may hold the manufacturer liable for injuries. Defects fall under three categories: design defects, manufacturing defects, and information defects. Design defects occur when the machinery is designed poorly.
Manufacturing defects occur during the production or assembly of machinery and stem from poor materials and human error. Information defects occur when companies do not provide proper instruction about proper use or warn users about the most dangerous aspects of their machinery or equipment.
Many job sectors involve employee roles that require them to work at a client’s or customer’s job site. They might be a sales representative for a large business that travels to client locations, or they might be a construction worker remodeling a home.
Workplace injuries at an off-site job leave property owners, business owners, and others open to liability in some situations. Your workers’ comp attorney can review your claim and identify any third parties that might be liable for your workplace injuries.
Accidents in Company Vehicles
The most common third-party liability scenario with on-the-job injuries is traffic accidents when an employee is driving a company vehicle. If you cause the accident, this creates a slew of issues that your employer and their insurance carrier will have to sort out, and consulting with a lawyer is in your best interest. If another motorist causes an accident that leads to your injuries, you have the right to take legal action against that driver, even if you were driving a company vehicle.
8. Communication With Insurance Companies
As mentioned above, workers’ comp providers frequently deny legitimate claims. Injured workers can appeal their case to Missouri’s Labor and Industrial Relations Commission, and if they have a negative outcome, they can appeal it to the Missouri Court of Appeals.
During the appeal, the Department of Labor and Industrial Relations assigns a specialist to each claim. Unfortunately, some assume the specialist substitutes for legal representation. However, this is not the case. The specialist cannot act as legal counsel or give legal advice.
The appeals process comes with an abundance of paperwork and deadlines. Also, sometimes workers’ comp insurance providers offer a settlement during the process.
An experienced workers’ comp lawyer near you can help you meet all the appeals requirements and communicate with the insurance company during the process. Insurance companies, including workers’ comp providers, often take claimants with legal counsel more seriously than those without, and your attorney may negotiate a better settlement than what they offer.
9. Refusal of Recorded Statements and Medical Authorizations
After a workplace injury, the workers’ comp insurance provider typically asks an injured employee to give a recorded statement and sign medical authorizations, especially if they have an issue with the case.
It’s not in a worker’s best interest, and they are not legally required to provide a recorded statement. If an injured employee gives a statement, their claim is still likely to get denied. If they do not give a statement, the workers’ comp provider has grounds to deny the claim.
A similar thing occurs with medical authorizations. It’s best to provide an insurance company with medical records related to a workplace injury or illness instead of signing a blanket authorization.
Signing an authorization often helps workers’ comp providers access a person’s entire medical history. They use unrelated medical records to find pre-existing injuries or anything else that can help them avoid paying a claim.
Work with an Experienced St. Louis Workers’ Compensation Attorney
At The Bruning Law Firm, we are committed to providing injured workers with the support and expertise they need to navigate the complicated workers’ compensation recovery process. We can provide precise advice and the quality representation and attentive service you need. We take the time to get to know each of our clients and their needs.
With years of experience winning cases, our firm isn’t shy about standing up to employers or insurance companies who treat injured employees unfairly in the workers’ compensation process. We have the resources and know-how to secure full and fair compensation for our clients. We understand that each client is unique, and we take the time to understand your stresses and concerns and incorporate this into our strategy for recovery.
If you or a loved one was injured at work in St. Louis, call The Bruning Law Firm today at (314) 735-8100. One of our attorneys will contact you within 24 hours to discuss your case. You can also reach out to us online.
"When other law firms failed me. Bruning Law Firm came through for me. They did a great job and were able to get me more compensation than I expected. Couldn't be more pleased. Truly glad these folks were there for me. Took care of everything. Truly pleased. Tthank you Ryan and Alice." - Joseph F.
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