Can your employer refuse your Missouri workers’ compensation claim?

If you have a difficult employer/boss who is fighting your claim, document all of your conversations by writing a short note to confirm what everyone said. Date it, sign it, and give it to all of your bosses. Keep copies for your attorney.

It’s great to hear a client say that his/her supervisor filled out an incident report and provided the name of a physician for medical care.  But that is not always the case.  Clients have informed us about situations where supervisors have refused to fill out an incident report because the injury was not severe or because you didn’t know the exact date/time your pain started, despite your explaining that the repetitive nature of your job causes your pain every day.

Many employee’s feel intimidated by the supervisor and continue working in pain.  Others believe the supervisor who said you don’t have a claim if you don’t know the exact date and time.  Then you seek treatment from your doctor, but the receptionist won’t schedule an appointment because you said it is a workers’ compensation injury.  Or, you seek treatment from your doctor and tell him that it is not a work comp injury (because you believed your supervisor).

THIS WORKS:

To protect yourself and your claim:  you can put your claim in writing even though your employer refused to do so.  Type a letter or write a note.  Confirm that your conversation with your supervisor: “yesterday, on December 10, 2012, I reported a work injury to you.  You refused to give me an incident report.  I asked for medical care and you refused that too.  As I told you, I hurt my back lifting box after box, day after day.  You said I didn’t have a workers’ compensation claim because I couldn’t tell you the exact date and time of my injury.  I have not hurt my back outside of work.  All of my back pain started at work lifting boxes.  I have told you in the past my back hurts from lifting boxes and asked for breaks.  Again, please send me to a doctor.”  Give a copy to his boss and keep a copy yourself.  Missouri Workers’ Compensation strictly forbids an employer to retaliate in any way against an employee for pursuing a work comp claim.  If you think your supervisor is mad at you for pursuing your claim, type another note:  “John, I have always been a hard worker.  We have gotten along for years. I have great record here.  Recently, and after filing my work comp claim, you and the other bosses are treating me with disrespect.  I feel harassed and put down.  I believe this is due to my work comp claim and ask that you stop this immediately.”  Keep a copy and deliver copies to all of the bosses.

Some injuries can be traumatic, and it is easy to know the exact date and time the incident occurred. Other injuries/pain are caused over time by repetitive work duties: daily sore back from lifting boxes; sore shoulder from overhead work; knee pain from constant squatting.  Both types of injuries are valid claims under Missouri Workers Compensation law.  Missouri Work Comp law mandates the employer to file a report of injury with the Division of Workers Compensation in Jefferson City for every employee who is injured.  For injuries or pain caused by repetitive work conditions, no one knows the exact date.  Missouri only requires that you provide the month and year: for example, you’ve been seeing your doctor for 6 months for a sore back.  You’ve complained that carrying concrete and tools at work is hard on your back.  Finally, in December of 2011, your doctor says for the first time: your work is wearing out your back and causing you pain; yes you have degenerative changes in your back, but your job is making it worse and causing the degenerative changes to be symptomatic.  In that scenario, your claim would be for a repetitive use back injury with a date of injury: December 2011.

Appealing a Denied Work Comp Claim in Missouri

In Missouri, all employers are bound by law to have workers compensation insurance and pay for valid claims made by any employee injured at work. However, it is not uncommon for employers to deny workers compensation benefits as it increases their premium.

Injured workers, who have filed a claim and have been denied compensation, should first seek to understand and investigate why their claim was denied in the first place.

If a clerical error on part of the insurance company or the employer has led to a denial of compensation and benefits claim, then the decision of denial can be reversed by the claimant by the means of a simple phone call.

For any other reason for denial, the first thing that an injured worker should do is to consult a St. Louis workers compensation lawyer. There are certain legal procedures and processes entailing filing an appeal that is best followed with legal assistance.

Filing an Appeal

First, it’s important that the claimant understands the process of filing an appeal. The procedure is as follows in Missouri:

• A written application requesting a review of the claim should be filed with the Missouri Labor Commission within 20 days of receiving the notification of denial of the claim.
• If the Missouri Labor Commission denies the application, the claimant should then send a notice of appeal to the Missouri Court of Appeals within 30 days of receiving the denial notification from the Labor Commission.
• The appeal should provide proof that should counter the reason for denial of the claim. This essentially means that if the claim has been denied because the employer claims that the injury did not occur at work, evidence such as videos from surveillance cameras, original accident reports and even statements from colleagues can work as evidence. Similarly, if the insurance company denies a claim on the grounds that the injury is not serious enough, proof in terms of medical reports, test results, photographs of the injuries, doctors’ statements, etc. are valid proof of evidence.

The Law Office of James M. Hoffmann

Gathering evidence, conducting interviews with employers, co-workers and witnesses should always be conducted by an experienced workers compensation lawyer to ensure that correct accounts are provided and documentation is done accurately to ensure just and fair settlement.

Our St. Louis Workers’ Compensation Attorneys can provide you with the necessary information to make the right choices so that you can receive the best medical care, benefits, and income. Do not let the carrier deny you benefits. Call us at (314) 361-4300 or fill out our online contact form to request a free consultation.