Nearly 92,000 workers were hurt in Missouri on-the-job accidents in 2022. These accidents cause a range of injuries, from fatal brain or spinal cord injuries to bone fractures and soft tissue injuries.
Your rights after suffering a work-related injury come primarily through your employer’s workers’ compensation policy. This policy pays medical and wage replacement benefits until you recover.
Workers’ Compensation Rights in Missouri
According to state law, Missouri employers must carry workers’ compensation insurance if they:
- Have five or more employees
- Have at least one employee in the construction industry
Smaller businesses can elect to participate in the workers’ comp system and buy insurance.
Missouri law exempts some types of employees from counting toward the threshold for workers’ comp, including:
- Railroad, postal, and maritime workers who are covered by federal laws
- Farm labor
- Domestic servants
- Real estate agents
- Unpaid volunteers for charities
- Unpaid sports referees for interscholastic or amateur youth sports leagues
Although these may seem like significant exemptions, most Missouri employers must carry workers’ comp insurance.
What is workers’ compensation insurance?
Workers’ comp insurance is a policy bought by your employer. You do not need to buy the policy. It will cover you from the day you start working without any waiting period.
This insurance policy pays benefits to you if you get injured in the course and scope of your employment. It only covers injuries caused or worsened by your job. Some factors that insurers use to determine whether an injury is work-related include:
- Did the injury happen at work?
- Did you get hurt during working hours?
- Was your employer directing your activities when you were injured?
- Were you performing job duties when you were injured?
- For whose benefit were you working at the time of your injury?
For example, suppose your boss sent you to pick up printer paper, and you got run over in the parking lot of the office supply store. You have a strong argument that you suffered an on-the-job injury. But if you got hit in the same parking lot during your lunch break, you probably did not suffer an on-the-job injury.
Workers’ comp insurance represents a tradeoff. You get guaranteed medical and disability benefits for your on-the-job injury. But you lose the right to sue your employer for your injuries. Instead, your workers’ comp benefits are the exclusive remedy for your injury.
Rights and Options Under Workers’ Comp Insurance
Workers’ comp pays two types of benefits. First, medical benefits cover all reasonable and necessary medical treatment, therapy, and medication for your injury. In Missouri, your employer or its workers’ comp insurer can choose the doctor to provide your medical treatment benefits. You can choose your own doctor, but you must pay them.
Second, disability benefits replace up to two-thirds of your average weekly wages while you recover from your injuries. If you suffer permanent disabilities, the insurer can negotiate with you and your injury lawyer to pay a lump sum settlement.
To claim these benefits, you must notify your employer of your injury within 30 days of the incident that caused them or the diagnosis that connected your job to your injury.
The workers’ comp insurer will investigate the claim and accept or deny it. Some common grounds for denial include:
- Your job did not cause your injury
- Your injury did not require treatment or missed work
- You did not go to the right physician
If the insurer denies your claim, you must choose whether to drop the claim or pursue it with the Missouri Department of Labor and Industrial Relations. You can choose informal dispute resolution, such as mediation or a settlement hearing.
You can also file a claim for compensation. The statute of limitations for this claim is two years after your injury. If the case does not settle, you will have a hearing with an administrative law judge (ALJ). You can appeal if the ALJ does not rule in your favor.
Get Compensation with the Help of a Lawyer
To discuss your on-the-job injury and the benefits you can seek, contact Privette Law Office, a workers’ compensation law firm in Southern Missouri.