What are my rights under the Workers’ Compensation Law?

What do I do if I have been injured at work?
If you have been injured at work, you need to immediately report the injury to your supervisor. Missouri law requires employees to provide prompt notice of any injury or accident to their employer.

How do I get medical treatment?
Under Missouri law, the employer (not the insurance company) has the right to select the treating doctor in workers’ compensation cases. If you need to see a doctor for treatment, your employer should tell you which doctor to see. If your employer does not refer you to any particular doctor, you should ask your employer which doctor they want you to see. Since your employer has the right to select the treating doctor, your employer (and its insurance company) may not have to pay for your bills if you choose to go to your own doctor, rather than to your employer’s authorized treating doctor.

Will I be paid when I am off work?
If the treating doctor certifies that you are unable to work, you should be entitled to “temporary total disability benefits”. You will not be paid benefits for the first three regularly scheduled work days you are off, but you should be paid for each day missed thereafter, and also for the first three days if you are off more than two weeks. The amount of these benefits is two-thirds of your gross average weekly wage, subject to certain maximums, which change every year. The law contains a formula for determining your average wage, which usually involves computing the average gross wages you earned over the 13 weeks prior to the accident.

Will I be paid mileage for my trips to the doctor?
Under Missouri law, you are entitled to be paid mileage for driving for medical treatment, but only if you are required to be treated “outside of the local or metropolitan area from the place of injury or the place of your residence”. This is subject to a 500-mile round trip limit.

Will I get a settlement?
If you are able to return to work after your injury, you may be entitled to a settlement or payment for your “permanent partial disability” if you have permanent disability as a result of a covered accident or injury. The amount you will receive depends on the extent of your disability. Doctors, or other experts, may have to evaluate your disability before an amount can be determined.

Are occupational diseases covered?
Under Missouri law, occupational diseases (as well as accidents) are covered. If you develop a disease or illness, which is directly caused by your employment, you may file a claim for benefits under the law.

Will I be paid anything for scarring or disfigurement?
In Missouri you can be paid for scarring or other disfigurement, but only if the disfigurement is to your head, neck, arms or hands. The disfigurement payment is determined by the administrative law judge or legal advisor at the Division of Workers’ Compensation and is in addition to all other benefits due. There are limits in the law regarding the amount you can receive for disfigurement.

What if I am unable to return to work because of my injury?
If you are permanently and totally disabled from all types of employment, you may qualify for “permanent total disability benefits”. However, you must be unable to work in any line of work in the labor market because of your compensable injury or occupational disease. The weekly rate for these benefits is the same as the temporary total rate. If you are totally disabled, you may also qualify for Social Security disability benefits. You should contact the Social Security office to apply for those benefits.

What is the Second Injury Fund?
In Missouri, if you had a physical or mental disability before you were hurt at work, you might qualify for additional benefits from the Missouri Second Injury Fund. The purpose of this fund is to encourage employers to hire and retain employees who have disabilities. In some cases, the Second Injury Fund’s liability can be substantial. For example, in permanent total disability cases the Second Injury Fund can be held responsible for an employee’s lifetime weekly benefits when the permanent total disability results from a combination of the employee’s preexisting conditions and those caused by the current injury. Also, in death cases, when the employer failed to obtain workers’ compensation insurance, the Second Injury Fund can be held responsible for death benefits to the employee’s dependents. Claims against the Second Injury Fund must comply with special time limits in the law.

When should I file a claim?
The Missouri Workers’ Compensation Law contains time limits for the filing of claims. Generally, a claim must be filed within two years of the last to occur of the following: date of the accident, last payment of workers’ compensation benefits or the last medical treatment provided: or, within three years of the last of those dates if the employer failed to file the Report of Injury with the Division of Workers’ Compensation within the time allowed by law.

Remember, simply notifying your employer or its insurance carrier about your injury does not constitute filing a claim. A claim is “filed” by filling out the claim form with the Division of Workers’ Compensation.

Do I need a lawyer for my workers’ compensation case?
Not everyone who suffers an injury or illness at work needs a lawyer. However, a lawyer can answer your questions and represent your interests in your workers’ compensation case. If necessary, your lawyer can take your case to trial before an administrative law judge.