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How Do Missouri Workers’ Compensation Settlements Work?

A Missouri worker who suffers an injury or illness at work is entitled to receive a workers’ compensation settlement after filing a legitimate injury claim. However, getting a compensation claim approved often depends on the type of injury you suffered and how long the injury leaves you unable to work. Furthermore, the paperwork, deadlines involved, and evidence required can be confusing and stressful.

It’s important to contact an experienced Missouri workers’ compensation attorney who can help you navigate the workers’ compensation claim process. They can help prove your claim is legitimate and help you get an amount that can support you and your family as you recover from your injury.

WORKERS’ COMPENSATION BENEFITS IN MISSOURI

Workers’ compensation includes covering the cost of all authorized medical treatments, prescriptions, and medical devices required to treat your injury or occupational illness. You may also qualify for temporary total disability benefits or permanent partial or permanent total disability benefits.

These weekly benefits can cover up to two-thirds of your average weekly wage starting three days after your injury leaves you unable to work. If you miss over 14 days of work, you can also retroactively receive payment for those first 3 days of time off.

It is important to note that workers’ compensation does not provide compensation for pain and suffering resulting from your injury.

Temporary Disability

Temporary total disability (TTD) benefits are available if a doctor determines that you cannot work because of an injury or while recovering from treatment for an injury (such as surgery). Workers’ compensation still pays temporary partial disability benefits if you eventually return to light or modified duty work that pays less than your usual total wages. These weekly benefits cover up to 66% of your average weekly wages before taxes and deductions.

You should continue receiving these TTD benefits until your doctor confirms you can return to work fully or if your condition reaches maximum medical improvement (MMI). If your doctor gives you an MMI rating, it means they believe your injury will no longer improve significantly with or without medical care.

Permanent Disability

The Missouri Department of Labor considers a permanent partial disability a work-related injury that limits your ability to perform specific tasks but lets you work in some capacity. A permanent total disability means you can no longer work in any occupation.

HOW DO WORKERS’ COMPENSATION CASES SETTLE FOR LUMP-SUM BENEFITS?

Instead of weekly benefits for your permanent partial or total disability, you may choose to receive a lump-sum settlement from your employer. A lump-sum settlement is a one-time payment for all your medical costs and workers’ compensation benefits.

The Missouri workers’ compensation resolution process involves several steps after filing a workers’ compensation claim:

  • You may request a pre-hearing to discuss legal issues between you and your employer before an administrative law judge at the Division of Workers’ Compensation. The pre-hearing also serves as an opportunity for presenting a settlement agreement to the judge for approval.
  • If neither you nor your employer can reach a settlement agreement, ask for mediation with the administrative law judge. Mediation identifies areas of contention and enables negotiations for a settlement without going to court.
  • Once you reach your MMI or your case is ready for a final hearing, you can file for a final hearing. The administrative law judge will review and approve your final settlement at this stage.

Upon approval from the judge and depending on your injuries, the insurance company will offer you a lump-sum settlement, if that is how you wish to be paid.

SHOULD YOU ACCEPT A LUMP SUM SETTLEMENT OFFER?

Before you agree to a lump-sum settlement offer, you must evaluate all your medical expenses and outlook. A settlement must also consider other government benefits such as Social Security and Medicare, if you are eligible for them.

  • Medical Expenses: Consider all medical bills from your doctor visits, prescriptions, and other out-of-pocket costs. You can negotiate required medical devices and medications for your injury with your employer as part of your settlement.
  • Government Benefits: You can receive Medicare benefits with prior approval from the Centers for Medicare & Medicaid Services (CMS) before you go forward with your lump-sum settlement. However, if you have already applied or are a recipient of Social Security disability benefits, your workers’ comp payment may reduce your Social Security disability benefits.
  • Liability Insurance Claim: Missouri’s right of subrogation allows your employer to take part of your settlement when you have a liability claim against a third party (someone other than your employer) for your work-related injury. In this case, you may need to pay back some of your compensation to your employer for whatever medical costs or lost wages they already paid through workers’ compensation benefits that you then later also received compensation for from the third party via a personal injury lawsuit.

WHAT TO DO IF YOUR CLAIM IS DENIED

If you find yourself facing a denial of your workers’ compensation claim in Missouri, it’s important to know that you have options. A denial is not the end of the road—there is a structured process to appeal the decision. Understanding this process and knowing how to navigate it can significantly impact the outcome of your claim.

When a workers’ compensation claim is denied, it can be due to a variety of reasons, from concerns about the injury being unrelated to work to inadequate documentation. Whatever the reason, this process begins with filing an application for review by the Labor and Industrial Relations Commission. If the decision remains against you after this review, further appeals can be made to the Missouri Court of Appeals.

However, navigating the appeals process can be complex and challenging, especially when you’re still mentally and physically recovering from an injury. This is where having an experienced workers’ compensation lawyer becomes invaluable. A skilled attorney can review the reasons for the denial to determine the best course of action, gather additional evidence, represent you in hearings, and guide you through every step of the appeals process.

By enlisting the help of a dedicated attorney, you enhance your chances of overturning a denial.

CALL THE EXPERIENCED WORKERS’ COMP LAWYERS AT COFMAN TOWNSLEY

A workers’ compensation lawyer from Cofman Townsley can help you assess your options, file a claim so you are approved for benefits the first time around, and negotiate a settlement. They can also help you appeal if your claim is initially denied.

Call our office today for a free case evaluation and learn how we can help you get the workers’ compensation benefits you and your family deserve.

Originally published October 17, 2022. Updated July 10, 2024.