Frequently Asked Questions

No. The first and most important thing you can do initially after an accident is not call your lawyer, but go get proper treatment. If you need to go to the emergency room, do that immediately. There is time to call your attorney, but first and foremost get treatment for your injuries. Then once you’re checked out by the paramedics or taken to the hospital or whatnot, at that point you need to get advised, once the dust settles a little bit, but and first and foremost get proper medical treatment.

The term treatment gap is used by insurance companies to try to reduce the damages.  For instance, if someone was involved in an accident and they felt okay initially, so they didn’t go to the doctor for a week.  Well, that’s pretty common, but that week is considered a treatment gap.  If you have too many treatment gaps it can be detrimental to your case.

Any Delay in Seeking Medical care after an Accident Is Construed by the Other Party’s Insurance Company as a Sign You Were Not Seriously Injured

Most people don’t like running to the doctor unless they have to.  They may not have health insurance, but that doesn’t mean that they’re not hurt.  You see that a lot of times from insurance companies.  They try to use that gap and they say, “Well, they didn’t go to the doctor right away.  They must not have been hurt.”  See, that’s a common tactic that they use.

Typically, if the gap is less than 30 days, it’s usually not detrimental to your case.  If it is longer than 30 days, we can still make an argument that it’s related, assuming you didn’t have any subsequent injuries.

n Missouri, there’s three hearings, typically the first hearing of workers compensation claim is called a pre-hearing and what a pre-hearing is, it’s just a status conference, you tell the judge where your at with the treatment, whether there are any issues that need to be discussed, the initial stages. Once the claimant or injured worker is released from treatment, and you have a rating report or IME, then you can set the case for mediation. That’s the second level.

Over 90% of Missouri Workers’ Compensation Cases Settle Through Mediation

Mediation is when most of the claims, I would say 90% or higher settle.  Missouri workers compensation claims settle at mediation because most of the administrative law judges are very skilled at making reasonable recommendations that help the parties settle. The judges see these cases, day in and day out, they know the value of the case better than most of the attorneys and make settlement recommendations which are normally followed.  So the judge gives, hopefully a fair recommendation as to what the claim is worth and then that’s usually, when the case settles, the judge would typically give a range, the judge might say, well I think his hand has a 25% – 30% disability, so the parties would typically settle within that range.

Settlement value of a St. Louis workers’ compensation claims can be higher than other jurisdictions.

It is well know that your Missouri workers compensation claim can be worth more or less depending on what jurisdiction you file in.  For instance, workers compensation claims filed in St. Louis Missouri or St. Charles Missouri or often valued higher than more rural counties.

If you’re looking for a personal injury lawyer, you want to find someone that has a lot of experience in that area of the law. You also want to find someone who can give your case the time and attention it needs.  I see many people who go with the big firms that are advertised on TV, but after their initial meeting, nothing happens.  The initial stages of you case are the most important and you want to make sure your lawyer has the time to work on your case from day one.

What Size Firm Would You Feel Comfortable Working with?

Another thing you want to consider is, and people can get a kind of a feel for it themselves, is a personal preference.  Whether you’re looking for a smaller firm who will give you lots of personal attention, knowing who you will be taking to from your first consultation to your settlement, or if you are looking for a larger firm that may have more resources but will treat you more like a number, being passed from attorney to attorney.

Would You Prefer More Personalized Attention from an Attorney?

Typically at the larger firms, a lot of times you’ll meet with the legal assistant or a senior attorney initially then eventually your case gets handed off to somebody else.  I hear complaints from people all the time.  For instance, “I met with this attorney initially and then my file went to somebody else.  Then that attorney left and then somebody else handled my case and I didn’t know who was handling my case anymore and no one returns my calls.”

Sometimes attorneys in any size practice get overwhelmed.  What we try to do here is keep a manageable number of cases so that we can provide a consistent level of service to our clients.  I try to return any phone calls the same day.  I also like to keep my clients regularly updated on their cases so they don’t have to call wondering what’s going on. These simple steps tend to keep people happy.

If you retain an experienced personal injury lawyer, you will more than likely get a much larger settlement.  You’ll receive compensation for all of your injuries and damages.  Most people that are involved in an auto accident have never been through the process before.  They have no idea what their case is worth.  An experienced personal injury lawyer handles these cases all the time.  We know what the value of a case is.

For example, you may have someone that has $20,000 in medical bills a broken arm and a herniated disc in their neck; what’s that case worth?  The insurance company might offer to pay your medical bills plus $10,000 in pain and suffering.  Is that fair?   Most people would have no idea but an experienced personal injury lawyer does.  I recently settled a similar case for $100,000 policy limit.  The insurance company’s original offer was $12,000.

You May Be Entitled for Compensation from Lost Wages

Whenever you are involved in an auto accident, lost wages are one of your recoverable damages. Many times lost wages are the most significant portion of the damages. People don’t always realize that they can be reimburses especially if they use sick days, disability or vacation days when out of work.

For example, I represented a teacher after she was involved in a serious auto accident.  She was off work for several months but was able to use disability pay and sick leave until she went back to work. Her sick pay and disability pay was slightly less than her regular wages but, under Missouri law she was still able to claim the total amount of time off as her lost wages.

You Want to Avoid Having the Hospital Asserting a Lien on Your Settlement

I see this in almost every auto accident case.  If you’re taken to the emergency room and it is by ambulance, both the hospital and ambulance will almost always assert liens on your settlement, regardless if you have personal health insurance.  For example, if you are awarded $10,000 for your settlement, but the ambulance has a $1,500 lien and the hospital has a $6,000 lien.  What this means for you is that even though you agreed to $10,000 the ambulance and hospital can come in and rightfully take $7,500 of your settlement leaving you with only $2,500.

The reason they do this is because the health care providers know that they can rightfully receive much more, if not all, of your billed amount from a settlement then from your health insurance.  The insurance company also uses this as a negotiation scheme to resolve this matter for, what you think, $10,000, but later inform you of the liens and your final $2,500.

What we do is correspond with the providers to either submit your bill to your health insurance, per your request, or negotiate a lower lien amount, helping them receive a satisfactory amount and still giving you an entitled settlement.  Liens are always a topic thoroughly discussed between myself and the insurance adjuster prior to any agreement of settlement.

It Is Possible That the Hospital Lien Could Exceed of the Amount of the Settlement

Many times, the liens may be in excess of what the settlement is.  If the injured party did not have an attorney, the hospital and all the medical providers would take the full settlement.  Missouri has a lien statute, which protects people who are in situations like this.

We use the lien statute to get the medical bills reduced, that way our clients receive at least fifty percent of their net recovery.  If there is not an attorney to do this for them, the injured party would not receive a settlement.  They would probably end up owing bills after their case was over.

The insurance company will ask you, for instance, if you had your seatbelt on.  The accident may not have been their fault.  It’s maybe very clear that it wasn’t their fault.  They think, “Oh. I didn’t have my seatbelt on.  It doesn’t matter.  This person rear-ended me and they were going 50 miles an hour.”

People may admit to being on prescription medications.  There is any number of things that could come out that could really be detrimental to their case.

In Missouri, Admitting to Not Wearing Your Seatbelt Can Reduce the Recovery from an Auto Accident

In Missouri, it does matter.  If you did not have your seatbelt on, that’s admissible and that can be used to reduce your recovery.  They can basically admit that in the court of law and they can twist it around to make it look like you wouldn’t have been injured if you did have your seatbelt on.

I think it’s important to retain counsel immediately because I’m seeing the insurance companies being more and more aggressive. They’ll contact the injured parties almost immediately after the accident and in some instances before the victim is even discharged from the hospital.  They do this because they don’t want you to seek advice from a personal injury attorney in St. Louis, for very obvious reasons.  Unfortunately, many people don’t understand that the adjuster’s job is not to give you a fair settlement or compensate you for all your damages.  Their job is to settle the claims quickly for as little as possible.  I see people fall into this trap all the time and it is normally the nice folks who are trusting of others who get shorted the most.

It Is Advisable to Avoid Making Statements to the Other Party’s Insurance Company before You Have Retained an Attorney

Many times, what the insurance company will do is try to get recorded statements from all of the parties involved, which is never a good idea.  You have to make a statement to your own insurance.  The at-fault driver’s insurance, absolutely not.  You never want to make a statement to any other driver’s insurance company.

I see that time and time again, where victims, a day or two after the accident, will be contacted by the at-fault driver’s insurance company.  The victim then makes a statement and will sometimes say things that are detrimental to their case that they unfortunately do not realize.  So it’s just pretty important to speak with an attorney right away, especially if you have serious injuries.  Otherwise, you can really jeopardize your case.  People need to keep in mind that the insurance adjuster has a job and it is to try to get out of paying if they can.

Some accident victims are reluctant to hire an attorney because they think they cannot afford one. However, most personal injury attorneys, including Kevin Roach, are only paid if you receive a settlement or a verdict in your favor. You do not pay anything up front.

Also, remember that the statistics show that people who hire a personal injury attorney usually end up receiving far more accident compensation than if they handled the case on their own – as much as 40% more. The bottom line is – you will most likely receive more for your injuries by hiring an experienced and proven auto accident personal injury attorney.

Kevin Roach is one of those attorneys. He is a highly experienced and well-rated attorney who has practiced personal injury law since 2001. Kevin oversees every personal injury case to ensure that you receive the maximum financial award for your medical bills, lost wages, and pain & suffering.

Every personal injury case is different. The answer to this question always boils down to damages. That is, determining what your injuries cost you mentally, physically and monetarily.

A damage award in an auto accident is either agreed upon in a negotiated settlement or it is ordered by a judge or jury after a trial.

The majority of personal injury damages are compensatory. They compensate you for what you lost due to your injuries. Some compensatory damages are simple to quantify, including:

• Medical Costs
• Lost Income
• Property Losses

Others are harder to quantify and a figure is usually arrived at by using a multiplier based upon the above compensatory damages. Your attorney will refer to other similar accident cases in the recent past in your area, which will also provide an idea of how much to demand:

• Pain and Suffering
• Emotional Distress
• Loss of Enjoyment of Life
• Loss of Companionship or Consortium

If the defendant’s actions were truly reckless, you may also be entitled to punitive damages, which are intended to punish the defendant.

It is important to select a highly experienced and successful attorney who is able to fight for the maximum financial award. Attorneys such as Kevin Roach have years of experience in personal injury cases and will have a good idea of how much your case is worth, based upon your injuries and specific case circumstances.

I represent a lot of truckers as well as individuals that have been hit by truckers. For some reason, I see a lot of truck drivers who are injured. Sometimes it’s their fault and sometimes it isn’t.

If it’s not their fault, then you can file a workers’ compensation claim and also pursue a third party claim against the at-fault driver. Trucking cases can be challenging because there are normally many layers of insurance coverage. For instance, the trucking company has coverage and many times the trucker has his own coverage. The at-fault driver may also have coverage and there may also be workers compensation coverage. Often times, finding all the coverage in commercial vehicle cases is very difficult and time consuming. Fortunately, my office has had successful results in obtaining coverage in these matters and has learned the layers of trucking coverage.

Absolutely, you have the right to consult with an attorney at any point in the claims process and if you’re fearful that your employer is going to retaliate against you, absolutely you should consult with an attorney, it’s never a bad idea.

The first thing you should do is report your injury to your supervisor.  If you have reason to believe that they are not reporting it or not providing you treatment, then you need to contact an attorney immediately. What I see over and over again is employers giving injured workers the run around. They don’t report their injuries or they do report their injuries and then they don’t provide proper medical treatments.

Insurance Companies are Notorious for Assigning Conservative Doctors to Workers’ Compensation Claims

In Missouri insurance companies are notorious for sending workers’ compensation claims to conservative doctors. These doctors don’t always provide proper treatment or are very slow to provide it.  People need to realize that these doctors work for the insurance company and are often dependent on this work.  If these doctors are quick to order expensive diagnostic test like an MRI or quick to order a surgery they probably won’t get many referrals.  I am familiar with many of these so called doctors in the St. Louis and can help my clients who have St. Louis workers’ compensations claims

I believe every state has workers comp laws. They were written to protect workers from injuries suffered on the job and to make sure that the injured employee is rightfully compensated for their injuries sustained. It is also utilized to shelter employers to limit their liability.

Missouri Has a Relatively Simple Burden of Proof to File for Workers Comp

In Missouri it’s a really easy burden to prove that you are injured at work. You don’t have to show any kind of negligence or anything. You just basically have to show that you were injured during the course of your employment. You do not need to prove that any misconduct and/or an unsafe working environment caused these injuries.

Employees Do Not Have to Prove Employer Negligence in Order to File for Workers Comp but Must File a Claim within 30 Days of Injury

You don’t have to prove that the employer was doing anything wrong. You do have to comply with the Missouri Workers Compensation Regulations. One of the rules in Missouri is that you have to report your injury to your employer within 30 days of the date of the incident.

Always Document the Reporting of an Injury

If you don’t report your injury, then you could potentially jeopardize your claim. It could be barred and there you would not receive your benefits in which you would ordinarily be entitled. I always tell people to report an injury, if sustained at work, immediately, and to also get it down on paper if possible.  It is always advisable to obtain some sort of documentation that you reported your injury to your employer or your supervisor.

If you’re doing something improperly, that may fall under the violation of a safety code or rule. You can be penalized for not following a safety rule or regulation, but your claim is not barred.

In Missouri, even if you’re engaging in horseplay, it’s been found by the Missouri courts to still be a compensable claim.  If you are at work and you’re doing your job, even if you’re at lunch, you’re not actually working, and you’re punched in on the time clock, technically you’re covered.

In the performance of some jobs, you’re ordered to wear a harness to lift something. That could be a violation if you are not wearing the appropriate safety equipment. But again, your claim would not be barred. You could possibly be penalized.

Illegal Activities and Self-Inflicted Injuries Are Not Compensable under Workers Compensation

There are some exceptions to that. For instance, if you’re engaging in illegal activity or you deliberately injury yourself—that doesn’t happen very often; however, there are certain situations where someone may commit suicide at work.  This would not be covered under the workers comp law in Missouri. As a general rule, if you’re injured at work and you report it, it’s normally a compensable injury.

Violations of Safety Rules Are Not Enforceable Unless They Are in Writing and in Easy to Comprehend Language

There needs to be a written rule or safety regulation; the language has to be clear. Sometimes your supervisor or boss might say, “Hey, you’re supposed to wear these safety goggles. Where are your safety goggles?” If it’s not a written rule and maybe nobody wears their goggles, then it’s not necessarily enforceable.

It needs to be clearly enforced and in writing so that it’s clear to the employee that they were supposed to follow that procedure.

In Missouri, most insurance companies, initially after you’re injured, will send you straight over to the doctor. One of the first things the doctor does is they do a drug test on you. If you come back positive for marijuana or any other drug, then your benefits in Missouri are immediately slashed by 50%.

When you automatically have a 50% penalty against your claim it becomes very hard to even find an attorney that will take the case because of that. The judges in Missouri are very prejudicial when they see these positive drug tests. That’s one of the big things that people can do to hurt their case.

You Must Report Any Workplace Injury within the 30 Day Statute of Limitations

Another thing would be not reporting your injury within the 30-day period. Employee’s might injure their back or knee and assume that the pain is going to go away. Therefore, they don’t report it to their employer. That becomes a problem if it goes over the 30 days.

Sometimes you can get around that because maybe the injury didn’t manifest itself or maybe you weren’t aware that you were injured. Maybe you just thought it was a strain and maybe you didn’t know it was injured until you went to the doctor.

Always Document the Reporting of an Injury to the Employer

That is another big thing that people could do to really hurt their case – not reporting and/or not obtaining written proof of your reported claim of injury. A lot of times these matters are conducted verbally. An employee may report their injury to their supervisor, but their supervisor might not do anything further. They might not write anything down and it becomes your word against theirs’ as to whether or not it was reported.

Avoid Confrontations in the Workplace That Could Lead to a Termination for Misconduct during a Workers Comp Claim

Sometimes an employer can become unhappy when an employee is on workers comp. A lot of times it can become a confrontational situation. The employee can be alleged to have engaged in misconduct. Say if you told your boss off because you were sick of him giving you the run around while you were going through your workers comp claim. Your boss can just say, “Okay, you’re fired for misconduct.”

In Missouri, it’s very hard to fire someone when they’re on workers compensation, but if you allegedly engage in misconduct then you can be fired and can miss out on a lot of benefits with your pay. The employer will still have to provide you medical treatment for your work related injuries, but if you’re discharged for misconduct, then they would not have to pay you while you’re off work.

All injuries must meet the standard of accident, accident being the prevailing factor in causing both the resulting medical condition and disability from the injury. It must arise out of the course of your employment.  Most people don’t understand what the “prevailing factor” means so that just highlights the need for hiring an experienced Missouri workers compensation lawyer.

n Missouri, there’s three hearings, typically the first hearing of workers compensation claim is called a pre-hearing and what a pre-hearing is, it’s just a status conference, you tell the judge where your at with the treatment, whether there are any issues that need to be discussed, the initial stages. Once the claimant or injured worker is released from treatment, and you have a rating report or IME, then you can set the case for mediation. That’s the second level.

Over 90% of Missouri Workers’ Compensation Cases Settle Through Mediation

Mediation is when most of the claims, I would say 90% or higher settle.  Missouri workers compensation claims settle at mediation because most of the administrative law judges are very skilled at making reasonable recommendations that help the parties settle. The judges see these cases, day in and day out, they know the value of the case better than most of the attorneys and make settlement recommendations which are normally followed.  So the judge gives, hopefully a fair recommendation as to what the claim is worth and then that’s usually, when the case settles, the judge would typically give a range, the judge might say, well I think his hand has a 25% – 30% disability, so the parties would typically settle within that range.

Settlement value of a St. Louis workers’ compensation claims can be higher than other jurisdictions.

It is well know that your Missouri workers compensation claim can be worth more or less depending on what jurisdiction you file in.  For instance, workers compensation claims filed in St. Louis Missouri or St. Charles Missouri or often valued higher than more rural counties.

Yes, carpal tunnel syndrome is one of the more common injuries that I see. It’s considered what’s known as an occupational disease. Basically it is caused by a condition or illness due to exposure at your work place, repetitive use of your arms and hands typically is, carpal tunnel syndrome is a common injury as a result, but yeah, definitely very common occupational disease claim that I see. I also see a lot of tennis elbow or cubital tunnel syndrome.  Tennis elbow or cubital tunnel syndrome is similar to carpal tunnel for your elbows.  It’s can also be in the form of cubital tunnel. Basically it just moves up your arm, it is kind of a progressive injury if you don’t get your wrist fixed, it may go up to your elbows, it may even go up to your shoulders. I see that a lot. A lot of times people will have carpal tunnel and also cubital tunnel at the same time. They may have trigger finger, it’s similar to carpal tunnel, you just get it in your fingers. Another occupational injury that I see is hearing loss. Sometimes you’ll see this with people who work in loud factories or work at the airport, they may have a hearing loss claim.

Back Injuries Are Also Commonly Cited Injuries for Workers’ Compensation

Those are two of the more common ones that I see. Back injuries can be considered occupational claims as well.  If you are lifting, bending, lifting, stooping on a regular basis, you develop disability in your back that can be considered occupational disease. Basically with occupational disease, there is no specific incident like where you just fell and it started hurting or you bent over and picked something up and it started hurting. It’s something that just develops over time just from the daily wear and tear of your job.

Another common way to have your claim denied is if you can’t prove that you were injured at work. You may be working by yourself and no one witnessed it, you didn’t report it, you may report it within 30 days, two or three weeks later and there is no medical documentation so it can be very hard to prove these up. The documentation is very important so I always encourage people to, if your employer is dragging their feet, not providing you treatment, get over there and see your own doctor.

The Biggest Way that People Get Denied Workers Compensation is By Failing to Report an Injury

You might have to pay out of your pocket initially but we could probably get you reimbursed for that later on. If you have an emergency situation, you need treatment, they are not providing it, then you have every right to go get treatment on your own. Probably one of the biggest ways that people get denied is not reporting their injury, getting their treatment right away, just because there is hesitation, they are hesitant to push the issue, they don’t want to jeopardize their job, they are worried about losing their job and their future I guess.

Absolutely, if you don’t like the findings that the administrative judge came down with, then yes, you can absolutely, you can file an appeal.

The range is according to whether the judge followed the law or not. Most of the time judges follow the law, but if the judge was totally off base with the ruling, then your chances would be much greater, as far as what the percentage of cases that have won an appeal, I have no idea.

One of the most difficult things a lot of times with workers compensation claims is getting the initial treatment process started, getting them medical care. Under Missouri law, the employer is required to provide medical care from the effects of the injury. However, a lot of times, they may be providing care which might not be proper care and if they have a doctor, even though he’s a work comp doctors, he may say, ‘Well, he doesn’t need surgery, he just needs physical therapy’, it’s kind of hard sometimes to prove otherwise because you don’t have control of treatment.

Getting The Right Amount of Compensation for an Injured Client is one of the Most Difficult Aspects in a Workers’ Compensation Suit

So there are a number of things you can do to counteract that, but that’s one of the more difficult aspects of these claims. Another one is getting a settlement, or getting the person the right amount of compensation for their injuries. There are hundreds if not thousands of different types of injuries, and body parts and strains and sprains and different types of amputations and eye injuries, ear injuries, finger injuries, all sorts of different types of injuries that someone can receive and it’s difficult for someone that, all the times to get them a fair amount of compensation for their particular injury. That’s where having an experienced St. Louis workers compensation attorney comes in, because most people, they have never dealt with this before in their life and they may have an operated shoulder, you know, how much is that worth?

Insurance companies take advantage of unrepresented workers

The state of Missouri puts out this disability chart which says the shoulder’s worth 232 weeks, and your rate of compensation may be $245 a week and your disability level may be 20% of that shoulder, well, what’s that worth? Most people have no clue, most attorneys have no clue unless they know how to do the math on that, and defense attorneys will use that to their advantage. They’ll typically try to low ball these cases, they may offer a fraction of what the case is worth initially. But what we do is, we send all of our clients for an independent medical evaluation, we get them rated by our doctor, and our doctor, he renders an opinion on what the permanent part of disability is for that particular injury and then we use that report to get a mediation setting and once we get the mediation setting, we get in front of the administrative law judge and we hash out all the different disputes there may be with lost wages, unpaid medical expenses, permanent parts disability, we try to come up with, get a good recommendation from the administrative law judges to what benefits the claimant or injured worker is entitled to.

If hurt your back when lifting something at work and you are out and have to miss work, the employer is not required to pay you for the first three days you’re out.

If You Miss More Than 3 Days of Work, Your Employer Must Pay Temporary Total Disability (TTD) Wages, Which Are Two-Thirds of Your Gross Pay

In Missouri the wages are called Temporary Total Disability or TTD benefits. If you’re out longer than three days, your employer’s workers compensation insurance will have to pay you that owed TTD. The TTD is 2/3 or 66% of your gross wages.

If You Are Temporarily Re-Assigned to a Lower-Paying position, TTD Will Cover the Reduction

In certain situations you may only miss a half day. Then they only have to pay you Temporary Total Disability for that half day that you missed. Sometimes people are released from the doctor to go back for light duty. Maybe there’s a light-duty job available but the light-duty available pays $5 an hour less than what they were being paid prior to getting hurt. Workers Comp in Missouri has to pay you that TTD for that reduction in wages while you’re on light duty.

Once you’re injured, and it’s reported to the employer, they are supposed to file a Report of Injury with the Missouri Division of Workman’s Compensation. The employer is also supposed to set you up with medical treatment.

The Employer May Choose the Doctor

The employer has the right to choose a doctor and/or medical facility; but they still required to provide doctors and/or facilities to properly treat and care for the employee’s injuries sustained. That includes payment of all the costs for the authorized medical treatment including prescriptions and any medical devices.

The Employee Should Have No Out-of-Pocket Expenses in Seeking Medical Treatment

There are no deductibles or any costs that are paid by the employee. Again, the employer has the right to choose the health care provider or treating physician.

Yes, in Missouri, if you have five or more employees, you are required to carry workers comp coverage for your business. If you have less than five employees, then you are not required to have workers comp coverage.

If you’re killed while at work, there are benefits available to your spouse or children. Generally there’s a $25,000 death benefit awarded to the estate of the individual that is killed. The surviving family members can also be entitled to other benefits under Section 287.243 of the RSMO. Basically, your family is entitled to death benefits if you are killed while at work.

Employers with 5 or More Employees Must Carry Workers Compensation in Missouri

I frequently see people whose claims were initially denied; and majority of the time, there’s no legitimate reason. Unfortunately, the system is Missouri is set up to where the insurance company gets to pick the doctors. A lot of times these doctors, they are really dependent on receiving all this business from the insurance companies so they want to keep the insurance companies happy.

This is especially common when employees are unrepresented. Dr. Smith might treat the injured worker, take him off work for a couple of days, and then out of the blue release the employee back to full duties.  I see a lot of employees come in to my office with unresolved injury complaints that were released far too early and by this point the employee’s injuries have only worsened, ultimately making a bigger mess for both the employee and the employer.

Some Doctors Chosen by the Insurance Company May Not Attribute the Injury to a Duty Performed at Work

A doctor may say such scenarios as: “Well, this isn’t a compensable claim. Maybe you have carpal tunnel” or “This is because you’re overweight, or because you have diabetes. That’s what caused your carpal tunnel.” They will deny your claim for any reason they can find; ultimately stating that your work was not the prevailing factor.

Lack of Notice Can Result in a Claim Being Denied

In Missouri, that’s what they have to show. They have to show that your work injury was the prevailing factor. That means it wasn’t caused by something else that you did outside of work. I see frequently in occupational disease claims where the claim is denied and there’s really not a legitimate reason for it. Another reason they are denied is the lack of notice. Maybe several months went by before they notified their employer of their injury so they are denied as well.

I always ask my clients to bring any documentation they have that they feel may be related. If the claim has already been filed, they have an injury number from the Missouri Division of Workers Compensation. I ask for any correspondence from an insurance company and/or employer, as well as any medical records they have. They may have copies of x-rays or MRIs. I also ask for the names and numbers of any doctors you may have treated with.

Witness Statements from Co-Workers Can Be Helpful If the Claim Is Disputed

If there’s a dispute as to whether or not the injury happened at work, we like to get any witnesses that may have seen the injury or accident, or anybody that may have knowledge of it shortly after it happened. Anything that you can bring in related to your claim is always helpful.

There has actually been a study done in Missouri. It is proven that represented injured workers, or claimants as they are commonly called, receive substantially more benefits than unrepresented workers or claimants. In Missouri, there was tort reform in 2005 which really changed things.

In Missouri, Judges Can No Longer Recommend What Amount a Claimant Should Receive

Prior to 2005 a lot of the pro se or unrepresented claimants could go to the Division and could attend the mediation, just the same as when they would be represented by an attorney and the judge would give a recommendation. The judge would say, “Well, I think your case is worth X amount.” After the 2005 tort reform, the law changed. Actually, the administrative law judges in Missouri are bound from making any kind of recommendation on your claim if you’re not represented.

The judge’s hands are really tied. Let’s assume you receive your treatment and you’ve been released from treatment, and you go into mediation unrepresented. You are at the defense attorney’s mercy.  Not having the background knowledge of what you’re entitled to can only hurt you.

Experienced Workers Compensation Attorneys Are Better Suited to Judge the Value a Case

The judges, if they are following the rules, cannot make a recommendation. They can’t say, “I think your case is worth X amount” to an unrepresented claimant. As you can imagine, that is an extreme disadvantage because the way that cases are valued in Missouri, it’s confusing. Most attorneys, unless he or she has extensive experience in handling workers compensation as I do, do not know the value of the case.

You only know the value of the case after you’ve reviewed the medical records and after you’ve had years of experience handling these claims over and over again. Most people when they’re injured at work, it’s the first time in their life that they have sustained a major injury. They’ve never been through this experience before.

They may have a lumbar fusion or carpal tunnel. They have no idea what their case is worth. The only way to know the value of their case is to retain an attorney who regularly practices in that area of law.

Unrepresented Claimants Are More Likely to Not Receive the Full Extent of Appropriate Medical Treatment

Also, unrepresented claimants or injured workers in Missouri don’t typically receive proper medical benefits and/or treatment. In almost every case, the workers comp adjuster tries to send people back to work when they’re not ready.  What we do is file a hardship motion with the Division and/or demand additional treatment be authorized and provided by the insurance company.

Represented Claimants Have the Benefit of an Attorney to Advocate for Their Medical Care

That’s usually a large portion of what we do, is trying to get people the treatment that they are entitled to. When you’re unrepresented, you have no way of really doing this. You can’t go in and talk to the judge. You can’t file a motion with the court. As you can imagine, you’re not going to receive the benefits that someone that is represented would receive.

Whenever I call someone in, whenever I schedule an initial consultation with someone for workers compensation, what I like for them to bring would be, first of all if they have their report of injury, that’s always good to have. If there has been a claim filed, we’d like to get any correspondence they have received from the claims adjuster and / or the Missouri division of workers compensation.

The more information you have regarding your work injury the better

Any medical records, X-rays, MRI reports that they have related to their treatment, names of any witnesses that may have witnessed their injury, any pictures they may have related to, documenting their injuries, condition of the workplace that may have resulted in the accidents, names of any doctors, health care providers, just basically any information they have related to their claim as to date, they bring it with them. If they don’t have that information, then we can generally get it all together, but it just helps speed the process along if they have documentation, that’s always a good thing.

Absolutely, yes, I see that all the time where people have hesitations about filing a workers compensation claim and what I try to do is educate them in the process. People tend to think that they have to sue their boss, but really that’s not the case. Most of the time when you have a work injury the claim process has already started because you file your report of injury, your report of injury goes to the Missouri division of workers compensation, department of labor, and then that claim is sent on its way.

Most Employers Understand the Process and Know That Work Injuries are Bound to Happen

Once your injured a work a claim is filed with your employers insurance. When the claim is filed the damage to your employers insurance is already done. So whether you choose to exercise all of your rights under that claim, that’s up to you but it does not affect your employers insurance, it does not count as an additional claim if you decide to receive your benefits, it doesn’t really work that way. People don’t understand it, but once it’s explained to them, typically they decide they want to go forward because there’s already a claim going anyway.  Most employers understand that it’s just a cost of business…people are going to get hurt on occasion…that’s why you have insurance.

The number 1 thing that can ruin your claim is not reporting it within 30 day.  One thing that I’m seeing more and more of lately is post-injury misconduct under the changes to the Missouri workers compensation law back in ’05, there was a change regarding post-injury misconduct, basically it states that if an injured worker returns to work and is terminated from employment due to “post-injury misconduct”, the employee is not eligible to receive any temporary total disability or total disability benefits following the post-injury misconducts.

Post Injury Misconduct is a Commonly Committed Mistake By the Injured Party

So that’s one mistake that I see people make because sometimes they may get injured and maybe they are out of work for a couple of days and they might go back on light duty or limited duty.  Sometimes there are hard feelings between them and their employer which can lead to an argument which can be considered “post Injury Misconduct” and result in a termination.  When an employee is fired under these circumstances, the employer and the insurance company, they are not entitled to pay them any benefits after that misconduct. So, they could be out of work for a substantial amount of time and they would not be entitled to any weekly benefits and they would still be entitled to their medical care, and their permanent parts disability settlement but they could lose out on a substantial amount of weekly benefits, or temporary total disability benefits.

Refusal to Take a Drug Test Following an Injury is Another Mistake

Another mistake I see people make is refusing to take a drug test following an injury. It is pretty routine in Missouri, and probably in every other state, whenever someone is injured at work, one of the first things they do is they send you over to the medical clinic, and one of the first things they do over there is they drug test you and some people are taken aback by that and they may refuse to do it. Well, if you refuse that drug test, all of your benefits are forfeited in Missouri, that’s a huge mistake that I see people make.

Testing Positive for Drug or Alcohol Abuse after Being Injured is Another Vital Mistake

Another mistake or just a related issue is you can get your injured workers who test positive for drugs, marijuana or any sort of non-prescription drug, alcohol, they test positive post-accident, then their benefits can be reduced up to 50%, so for instance, if someone was injured at work not because they were high or drunk but just because they may have tested positive for marijuana, that maybe they smoked 2 weeks prior, they could still have their benefits reduced to 50%. So that’s a huge mistake, I don’t know if that’s a mistake, but that’s a huge barrier in getting the amount they want.

If the Injury is Determined to Be Caused Due to Intoxication, the Benefits are Totally Forfeited in Missouri

Another related issue, related to drugs and alcohol, if you’re in Missouri, if your injury was a result of you being drunk or on drugs, then your benefits are totally forfeited. So if you were, for instance you work at a bar or you were drinking alcohol and you fell on the steps because you were drunk, you don’t get any benefits for that obviously, but that’s another thing that I don’t see very often but that’s one thing that can really mess up your benefits.

No and I’ll see this. That’s another misconception that people have. Say they injured their hand or their shoulder or their back previously. Maybe there was a previous workers comp claim for that injury. If they injure that same body part again, they think that maybe they’re barred from filing a claim, but in Missouri you’re not.

It can be something that can be taken into consideration when it comes time to settle your case, resolve a dispute over causation, or determining whether it’s the prevailing factor or not. It absolutely does not bar your case if it’s the same body part that you previously received a settlement on.

If the employer has less than five employees, they don’t have to have coverage in Missouri. It would depend on whether that sole proprietor has five or more employees. If they have more than five employees and you don’t have coverage then that employer can be sued civilly for any damages that may have resulted to the injured worker.

Yes, absolutely. The law says an unborn child is still considered a wrongful death claim.I personally have not handled one involving the loss of an unborn child, but I would imagine they can happen any number of ways. Auto accident would probably be the most common, someone involved in a serious auto accident, it’s a trauma, and they could possibly lose their child. I have had a couple cases recently; female clients of mine who were pregnant were involved in auto accidents.

It’s a very traumatic thing whenever you’re carrying an unborn child, whenever you’re in an accident you can imagine all the emotions going through your mind. You’re worried about the health of your child, you’re worried about your own health. It’s not a good situation to be in. Fortunately, my clients, their children were fine. Yeah, that’s not something I see on a regular basis, it’s not something I want to see honestly. It’s a very horrific situation.

No, they’re not. Money recovered from wrongful death or just a regular negligence case in Missouri is not taxable. The only money taxable would be those recovered as punitive damages. Those are taxed in Missouri, but other damages are not taxable.

I think it’s the same as any other area of law. There is no substitute for experience; you want to find someone that has significant experience handling wrongful death cases in Missouri. People just need to feel it out, I always recommend that people talk to several attorneys; find someone that you’re comfortable in dealing with. That you can talk to, that you feel comfortable with.

It is Important that You are Able to work with your Attorney in a Wrongful Death Case

This is an important decision and you want to make sure that you’re going to be able to work with the attorney. When you’re picking an attorney, one of the questions you should always ask him is, “Are you going to be the one that goes to court with me? Are you going to be sitting next to me if we go to court? Who’s going to be working on my file?” Because a lot of firms … We have a smaller firm here, I have one-on-one relationship with my clients, a lot of firms they’re not like that.

I hear this complaint from a lot of people, where they may meet with a medium or larger firm, at some point in time it becomes unclear as to who’s representing them, they may meet with one attorney initially and the person may assume that’s who that’s going to be representing them, but that’s not always the case.

People Generally are Not Comfortable with their Wrongful Death Cases Being Handed to Junior Associates

A lot of times the case is handed off to a junior associate. You want to feel comfortable who you’re dealing with, you want to make sure, you want to confirm who’s actually going to court with you and make sure they have sufficient experience in that area of law. Those are probably the most important things I can think of when picking an attorney to handle your wrongful death case in Missouri.

If you’re killed while at work, there are benefits available to your spouse or children. Generally there’s a $25,000 death benefit awarded to the estate of the individual that is killed. The surviving family members can also be entitled to other benefits under Section 287.243 of the RSMO. Basically, your family is entitled to death benefits if you are killed while at work.

Employers with 5 or More Employees Must Carry Workers Compensation in Missouri

Yeah, wrongful death cases are similar to other personal injury cases. Typically your attorney would get paid on a contingent fee, which means we don’t charge anything up front. We take a percentage of what’s recovered, typically that percentage is thirty-three and a third percent.

Then if there is no recovery, then you’re not indebted to us for any attorney’s fees or costs. It’s a standard contingence fee contract, it’s exactly the same contingent fee contract that we use for other personal injury cases.

The wrongful death law in Missouri is very specific to Missouri, and you need to hire a lawyer that is familiar with the wrongful death law and all the damages that can be recovered. It’s a very complicated area of law, even for seasoned attorneys.

Someone that’s maybe trying to handle it themselves is at a severe disadvantage. People need to know in wrongful death cases there always has to be court approval. You’re always going to have to file a lawsuit with the circuit court where the accident occurred and you have to get court approval in all wrongful death cases. You’re going to have to have a lawyer one way or another, it’s always a good idea to have a lawyer on your side, that way they can ensure you get what you’re entitled to and try to make the process as pain free as possible. People have already been through a traumatic event in their life and we try to deal with the legal aspects of the case, so they can try to get on with their life, and try to move forward.