Frequently Asked Questions About Missouri Workers' Comp
Dec. 7, 2024
Missouri workers' compensation law provides vital protection to employees who are injured or become ill due to their work. If you're an employee or an employer in Missouri, reviewing the basics of workers' compensation can help with potential claims and maintain compliance with the law.
For over 15 years, Attorney Joe Phillips has been representing workers in St. Louis, Missouri, and throughout St. Charles County, St. Louis County, and Jefferson County. If you've been injured on the job, the following questions may be helpful in determining your next steps.
1. What Is Missouri Workers' Compensation?
Missouri workers' compensation is a system designed to provide financial and medical benefits to employees who suffer work-related injuries or illnesses. The goal of workers' compensation is to make sure that injured workers receive prompt medical care and income replacement while also protecting employers from lawsuits related to workplace injuries.
In Missouri, the workers' compensation system is primarily governed by the Missouri Workers' Compensation Law (Chapter 287 of the Missouri Revised Statutes). The law mandates that most employers with five or more employees carry workers' compensation insurance or be self-insured.
2. Who Is Covered by Missouri Workers' Compensation?
Missouri workers' compensation covers most employees, but there are some exceptions. The following groups are typically covered:
Full-time and part-time employees: Both are covered if the injury occurs during the course of employment.
Temporary workers: Workers employed by staffing agencies are generally covered under the staffing agency's workers' compensation policy.
Seasonal workers: Seasonal employees are also eligible for coverage if they're injured during their work period.
However, certain workers are not covered, including:
Independent contractors (unless they're working in construction)
Sole proprietors and partners, unless they elect to carry coverage for themselves
Certain agricultural workers
3. What Types of Injuries Are Covered by Workers' Compensation?
Workers' compensation in Missouri covers a broad range of work-related injuries and illnesses, including but not limited to:
Physical injuries: Such as broken bones, sprains, strains, and lacerations caused by workplace accidents.
Repetitive stress injuries: Conditions like carpal tunnel syndrome or tendonitis that develop over time due to repetitive motions or activities.
Occupational diseases: Illnesses that develop due to long-term exposure to harmful conditions or substances, such as lung disease from inhaling toxic chemicals or asbestos exposure leading to mesothelioma.
Mental health conditions: In certain cases, psychological injuries caused by the workplace, such as post-traumatic stress disorder (PTSD), may also be covered if the mental health condition is tied directly to work-related stress or trauma.
4. What Should I Do If I Get Injured at Work?
Whether you've been struck by a work vehicle at a construction site or have had equipment fall on you in an office environment, it’s important to take the following steps if you've been injured at work:
Report the injury: Notify your employer immediately. Failing to report the injury within 30 days may result in losing your right to workers' compensation benefits.
Seek medical treatment: In Missouri, you're typically required to see an employer-approved doctor for an injury unless it's an emergency situation. The employer must provide a list of approved healthcare providers.
File a claim: Your employer will then initiate the workers' compensation process by filing a claim with their insurance carrier. If the claim is denied or delayed, you may need to file a claim directly with the Missouri Division of Workers’ Compensation.
5. What Benefits Are Available Under Missouri Workers' Compensation?
Workers' compensation in Missouri provides several types of coverage for injured workers:
Medical benefits: Coverage for necessary medical treatment related to the injury, including doctor visits, hospital stays, surgeries, medications, and rehabilitation.
Temporary total disability (TTD): Wage replacement benefits if the injury prevents you from working. Typically, this benefit is 66 2/3% of your average weekly wage, subject to state maximums and minimums.
Permanent partial disability (PPD): If you have a permanent impairment but can still work, you may be entitled to compensation based on the degree of disability.
Permanent total disability (PTD): If the injury leaves you unable to work in any capacity permanently, you may be entitled to lifelong wage replacement benefits.
Death benefits: If a worker dies as a result of a work-related injury, the surviving spouse and dependents may be eligible for death benefits, which include compensation for lost wages and burial expenses.
Benefits are generally paid by the employer’s workers' compensation insurance carrier, and payments may be subject to state-set limits.
6. How Long Do I Have to File a Workers' Compensation Claim in Missouri?
According to Missouri State Law, the statute of limitations for workers' compensation claims is two years from the date of the accident or the last payment of compensation, whichever is later. However, you must report the injury to your employer within 30 days to avoid losing your right to file a claim. If you wait too long to report the injury or file a claim, your benefits could be denied.
For occupational diseases or repetitive stress injuries, the time limit is different. You must file a claim within two years from the date you knew or should have known the injury was related to your work.
7. Can I Be Fired for Filing a Workers' Compensation Claim?
It's illegal in Missouri for an employer to fire, retaliate, or discriminate against an employee for filing a workers' compensation claim. If you believe your employer is retaliating against you for filing a claim, you may file a retaliation complaint with the Missouri Division of Workers' Compensation or seek legal counsel to explore your options.
However, if your termination is unrelated to the injury or workers' compensation claim—such as due to performance issues or downsizing—your employer may still have a legitimate reason to terminate you.
8. Can I Choose My Own Doctor?
In Missouri, you generally must see a doctor from your employer’s approved list of healthcare providers. If the employer has not provided a list of doctors, you may have more flexibility in choosing your provider. However, if you want to change doctors, you may need to get approval from your employer or the workers' compensation insurance carrier.
In an emergency situation, you can seek immediate care at any medical facility, but your employer may direct you to a specific doctor or treatment plan after the emergency is stabilized.
9. What Happens If My Workers' Compensation Claim Is Denied?
You have the right to appeal a denial. The process involves filing a claim with the Missouri Division of Workers' Compensation and may include a hearing before an administrative law judge (ALJ).
During the appeal, you can present evidence to prove that your injury is work-related and that you qualify for benefits. If the ALJ rules in your favor, you may be awarded compensation. If the ALJ rules against you, you can further appeal to the Labor and Industrial Relations Commission.
In some cases, injured workers seek the help of an attorney experienced in workers' compensation to assist with the appeal process.
10. Do I Need a Lawyer for My Workers' Compensation Case?
You aren't required to hire a lawyer for a Missouri workers' compensation case. However, it can be beneficial to work with someone like Attorney Joe Phillips, especially if:
Your claim has been denied.
You have a complicated injury or illness (e.g., occupational disease).
You're dealing with disputes about your disability rating or benefits.
You need assistance with appeals or hearings.
Attorney Joe Phillips can help to protect your rights and work through the legal and procedural challenges of the workers' compensation system.
11. Can I Sue My Employer for a Work Injury?
In most cases, Missouri workers' compensation laws prevent employees from suing their employer for injuries sustained on the job. Workers' compensation is generally the exclusive remedy for workplace injuries, meaning that in exchange for benefits, employees give up the right to file a traditional lawsuit against their employer.
However, there are exceptions, such as:
If the employer intentionally caused the injury.
If the injury is caused by a third party (e.g., a contractor or another company), you may still have the right to pursue a personal injury lawsuit against that third party.
Knowing how workers' compensation works, your rights and the process for filing a claim can help protect your interests in the event of a workplace injury. Whether you're an employee or an employer, being informed about the workers' compensation system in Missouri can make working through the process much easier.
Contact a Workers' Comp Attorney Today
If you've suffered an injury or illness at work, or if your workers' compensation claim has been denied, be sure to reach out to the Law Offices of Joe Phillips today.