St. Louis Workers Compensation & Work Injury Lawyer - Law Office of James M. Hoffmann

St. Louis Workers Compensation & Work Injury Lawyer - Law Office of James M. Hoffmann

Work Injury Attorney

Workers Compensation Lawyer Blog

Can I Get Workers Compensation If I Am Injured at a Company Event?

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Though these events are designed to help bring workers together, socialize and unwind, in some cases, the event may lead to an injury.

Workers’ compensation benefits may not apply to all injuries or illnesses a worker gets. The laws explicitly say that the health conditions must directly arise from the worker’s job, whether it’s the activities they perform, or simply the environment.

This, in practice, has led to a lot of workers not being compensated for an injury based on a technicality, which could also be the case of injuries sustained during a company event.

work injury at company event

Work Events: Are You Required to Be There?

Work events can take on many different forms, from launch parties, team-building retreats, or the classic Christmas party. Though these events are designed to help bring workers together, socialize and unwind, in some cases, the event may lead to an injury.

The question is: does worker’s comp cover these types of injuries?

In most cases, employers will make any event they organize optional, meaning the workers are not obligated in any way to attend. Workers’ compensation provides benefits to injured workers because of the notion that their job required them to be present at a specific location, or perform a specific activity. If not for these requirements, the worker may not have gotten injured.

As a result, a case can be made that injuring yourself during a work event does not fall under workers’ compensation eligibility. You did not have to attend the event, and you were likely off the clock and not performing any work activities at that time.

Your Employer May Still Be Liable

Workers’ compensation may not apply to work events (unless you are required to be present as part of your job), but it doesn’t mean you don’t have options for compensation.

Your employer still has a responsibility to ensure the safety of all their workers, even during these events. So, under some circumstances, you may have the option of filing a personal injury claim against your employer if they did not ensure your safety during the event.

In other cases, if the event takes place at a restaurant or another location, you may be able to hold a third party liable. However, when it comes to personal injury cases, your role in the accident becomes relevant.

In short, to get compensated you’d have to show the accident was not, in any way, your fault, but the result of someone’s negligence. In worker’s comp, you have a no-fault system where the question of who is liable doesn’t really matter.

In personal injury claims, proving fault is the entire point.

What Are Your Options?

Before you do anything, you should get in touch with an experienced St. Louis worker’s compensation lawyer for a free consultation. It may be difficult for you to determine if you have a shot at a worker’s comp claim, or need to go the personal injury route, but an experienced lawyer can definitely help you figure this out. 

Speak With a Workers Comp Attorney

Give us a call 24/7 for a FREE Case Evaluation

Call (314) 361-4300

How Diagnostic Tests Can Affect Your Workers Compensation Claim

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Diagnostic testing may be requested by the insurance company in order to confirm an injured worker’s diagnosis.

Diagnostic testing is a process of evaluating a person’s medical status to either reach or confirm a diagnosis.

Testing takes on many forms, from X-rays, MRIs, blood tests, or even CAT scans. A medical professional will choose which tests to perform on a patient based on the symptoms they are showing, which will also help them determine the treatment needed.

However, diagnostic testing may also be requested by the insurance company in order to confirm an injured worker’s diagnosis.

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Why Would They Require It?

Virtually the only real reason the insurance company can ask for diagnostic testing in a workers’ compensation case is to confirm a worker’s diagnosis.

Usually, whenever a worker’s comp case reaches the insurance company, an adjuster will analyze the claim and first see if it has merit, by determining if, in fact, the worker’s injury or illness is a result of employment. Under Missouri’s worker’s compensation laws, workers can only access these benefits if their condition is a direct result of their job.

For common injuries like slip and falls, chances are rather low for anyone to doubt your claim (though it does happen). But for more complicated conditions, it’s likely for the insurance company to ask for additional tests, usually ones done by doctors they have worked within the past.

How Diagnostic Tests Can Affect Your Worker’s Compensation Claim

Your entire claim could very well depend on the diagnostics test. Consider this scenario: you file a claim with your employer to receive treatment for asthma. You work on a construction site and often inhale many chemicals and particles, which over time has led to asthma.

However, the insurance company may not be that convinced this is true. It could be that you haven’t worked on the site that long, so they question if the job itself leads to the condition. Or, they had another doctor look at your file, and the doctor believes you don’t have asthma, just another, maybe smaller issue.

In either case, the insurance company can take their doubts and ask for another diagnostic test. If the test they run comes with a different result, your entire claim can be dismissed, or you may end up seeking treatment for a different condition.

What Are Your Options?

The diagnostic testing won’t necessarily break your case since it will be done by a medical professional, but there is a chance it could.

Medical testing isn’t a perfected science as people would like to assume, and sometimes the results can be interpreted differently by different doctors. To protect your rights, and your benefits, get in touch with an experienced workers comp attorney.

They can step in and make sure the insurance company does not take advantage of your situation.

Speak With a Workers Comp Attorney

Give us a call 24/7 for a FREE Case Evaluation

Call (314) 361-4300

Does it Matter What is in the Work Injury Report? Yes – Here’s Why

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It is important to ensure that as many details regarding your injuries are recorded in the work injury report, regardless of how minor they may seem at the time.

Picture this: you were carrying some work tools when you tripped and hurt your knee. You filed a report with your employer and went to the doctor to get checked for your knee injury. A few days later, you start noticing intense pain and discomfort in your arm. As it turns out, you used your arms to ease the impact of your fall. You had a tingly sensation in your shoulder, but ignored it and focused on the part that was clearly affected by the injury: your knee. 

What can you do now? 

work injury report

The Human Body Is a Complex Mechanism 

Everything in the human body is interconnected. A lower back injury can cause pain in your hips and legs as well. An injury in your left leg can affect your gait as well. This may cause you to move quicker than usual on your left foot, lurching frequently onto the right one. As a result, you may start noticing bursitis and pain in your right hip.

You may not feel any pain or discomfort at first, but you may start noticing the symptoms a few days later. That may be problematic if you neglected to include these pains in your work injury report.

Don’t Ignore Any Injury, No Matter How Small or Insignificant

One common mistake employees make when filing a work injury report is focusing on the big and evident pains and ignoring other parts of the body. However, if you want your workers’ compensation to account for all your medical expenses, then you need to include every bruise, pain, and swollen body part in the work injury report, no matter how small it may seem. 

As you’ve seen, different parts of the body are connected in ways you wouldn’t expect and an injury to your left ankle can eventually cause pain in your right leg. 

Of course, foreseeing how an injury may affect your body can be impossible for a person with no medical training. However, by describing the accident in detail and including every pain and bruise in the report, your doctor may make the connections and prescribe you the treatment that accounts for future conditions too. 

What If I Left Something Out?

It can be difficult to persuade the insurance company to pay for an injury that wasn’t documented. A medical report can show that your condition is related to the work injury, but you should expect some push back from the insurance company. 

If you’ve already agreed on a settlement and only now you start noticing new pains that you suspect may be related to your work injury, then you may be able to reopen your workers’ compensation case. 

If you’ve signed a full and final release of all claims, then you have waived your right to reopen your case. That’s why you should always speak with an experineced St. Louis workers compensation attorney before you accept any type of settlement.  In fact, it is a good idea to get in touch with them as soon as possible after you are injured.

A lawyer can help protect your legal right to compensation and help you ensure important details are not left out of your settlement agreement.

Speak With a Workers Comp Attorney

Give us a call 24/7 for a FREE Case Evaluation

Call (314) 361-4300

Here’s What to Expect at Your Workers Compensation Hearing

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If you suffer an injury at your workplace, but your workers’ compensation claim was denied, legally you have the right to appeal that decision.

However, it’s important to know what this process looks like, so you can be prepared. You will likely have to attend several meetings, negotiations, even mediation sessions.

If you still cannot reach common ground with the insurance company, then an administrative judge will typically schedule a formal hearing, after which they will provide a ruling.

Here’s what the hearing process often looks like.

Filing Work Injury Claim

How the Process Unfolds

The hearing process may look rather similar to a trial. Here, you will present your case to an administrative judge, and essentially explain why your worker’s compensation claim should not have been denied by the insurance company. The company will then make a case to justify their actions.

Most of these hearings can be resolved on the same day, but more complicated cases can take longer than that if there is a lot of evidence to go through. Here are the main things you need to about these hearings:

1. Who Will Be There?

Though these aren’t public as is the case with many trials, you can expect multiple people to be present:

  • Lawyers
  • The judge
  • Court reporter
  • Witnesses
  • Your employer or a representative
  • Someone from the insurance company

2. What Evidence Do You Need to Present?

First, you have the documents relevant to your claim:

You may also have witness testimony or other evidence (such as surveillance videos, for instance) which you can present in front of the judge.

3. Will You Testify?

In most cases yes. The judge will likely want to hear your story, so you will be asked to testify and provide information on:

  • Your accident
  • Your injuries or illness
  • How it affected your life
  • Your job description, etc.

Additionally, the other side has the right to cross-examine you, meaning they will ask you questions. You will be under oath the entire time. 

This is usually the step most injured workers are concerned about since they fear their answers may lead to the judge dismissing their case altogether. It’s important to remain calm when you testify, and always stick to what you know to be true. When you don’t know, or don’t remember something, it’s best to be honest, rather than try to guess. This is usually the mistake most people make when they testify.

Benefit From the Experience of a Workers Compensation Attorney

A St. Louis worker’s compensation lawyer can help you fight the insurance company’s decision. It’s your right to speak with an attorney and have them represent you. They will help you prepare for the hearing, gather all evidence, and make your case in front of the judge. You can be sure that the insurance company has a team of lawyers working to minimize or deny your claim. Gain even footing by speaking with an experineced attorney as soon as possible!

Speak With a Workers Comp Attorney

Give us a call 24/7 for a FREE Case Evaluation

Call (314) 361-4300

Will Workers Compensation Cover My EMDR Treatment?

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New procedures or treatment may encounter some push back in workers’ compensation claims.

People with all sorts of conditions will routinely be prescribed what is sometimes deemed as “non-traditional” treatment. These are procedures or medications that are roughly new to the world of medicine.

It’s an essential component that allows the entire industry to improve, and offer better care for the patient. However, when it comes to the insurance companies carrying the health coverage, especially in a workers’ compensation claim, new procedures or treatment may encounter some push back.

Let’s discuss for example: EMDR treatments.

EMDR therapy workers comp

What’s EMDR?

EMDR stands for “eye movement desensitization and reprocessing” and it’s a psychotherapy treatment originally designed to help people with distress caused by trauma.

Its goal is to help people heal from emotional distress onset by disturbing life experiences, and multiple studies have claimed that it is an effective treatment. One study, in particular, found that 70% of its participants experienced drastic improvements after three sessions, compared to 29% of participants who underwent other forms of therapy.

It’s an 8 phase treatment, which also decreases the chance of patient dropout, which is quite common in traditional therapy.

Does Missouri Worker’s compensation Cover EMDR?

EMDR is an approved treatment for PTSD, however, workers’ compensation laws don’t specifically accept or deny it.

In many cases, it may come down to the insurance company that carries the insurance, and whether they will accept this form of treatment or not. Based on the benefits EMDR brings to the insurance company, specifically that it takes less time for a patient to go through it than therapy, there should be no reason not to, though this may not always be the case.

Even if the company has no issues with the type of treatment, injured workers may still face difficulties in getting their claim approved. PTSD is a very complex condition, and the worker’s comp golden rule is that a worker may only receive compensation if their injury or condition is a direct result of their work.

What Does That Mean?

It likely means you will have to prove legal causation. PTSD is a mental health disorder, and these types of conditions generally have multiple, complex causes, so an argument can be made that your work environment would not have been enough to lead to it.

Many American workers can come face to face with traumatic experiences at their job, which result in PTSD, such as:

Speak With an Experienced Workers’ Comp Attorney

The insurance company is a big business with a goal to make money, not give out its money. So, of course, they will fight against difficult claims, like the ones where workers suffer from PTSD. Don’t give up! Speak with an experienced attorney today to ensure your legal rights are protected.

Speak With a Workers Comp Attorney

Give us a call 24/7 for a FREE Case Evaluation

Call (314) 361-4300

Settling Your Workers Compensation Case During the COVID-19 Pandemic

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This global pandemic has uprooted the lives of many American citizens, but those with an open workers’ compensation case may face a unique problem.

Many injured workers are now being pressured into settling their cases in the midst of the COVID-19 pandemic. However, if you’re also under home isolation, you may be wondering if it’s possible to settle your case remotely.

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First Thing’s First: You May Not Need to Settle

This pandemic has created a lot of financial uncertainty for people, so injured workers may feel tempted to take the insurance company’s settlement offer without considering if that’s really the best move for them.

Settling your case most often means that yes, you receive a lump sum which can solve your immediate problems, but may also cut all future benefits you may be entitled to. Most often, insurance companies will add a line in the settlement in which you agree to waive your right to any future medical reimbursements you could be entitled to. So, if over time your work injuries present with further complications, you may not be able to receive financial support from the insurance company anymore.

Before you sign anything, it is a good idea to speak with an experienced St. Louis worker’s compensation lawyer and have them review the details of your case.

How the Settlement Process Works During a Pandemic

The process itself is virtually identical, the only difference is that now instead of having face to face meetings, you will likely need to discuss with the insurance company via phone calls, Skype, or other conferencing software.

The settlement process involves negotiating a lump sum (or weekly payments, though insurance companies usually prefer lump sums), where both sides will make an argument for either a higher amount (you) or lower amount (the insurance company).

Once both parties agree on a settlement, you will need to sign a document for it to come into effect. You will likely receive the contract via email, and be asked to sign and mail it to the insurance company later on.

Then, the settlement agreement will be sent to an administrative judge for consideration using the local office docketing email. If needed, the Division will request a teleconference with both parties.

In some cases, however, the parties involved cannot reach common ground, which is usually when the Division steps in and tries to resolve it either through mediation, or having an administrative judge weigh in on the case. 

Missouri has announced that both these processes are still available to injured workers during the pandemic, but that they will be done remotely, using teleconferencing software.

Have You Been Injured on the Job in Missouri?

This pandemic does not mean you need to accept any settlement the insurance company is offering. Please reach out to our law office for a free case evaluation and help to negotiate a fair deal with the insurer.

Speak With a Workers Comp Attorney

Give us a call 24/7 for a FREE Case Evaluation

Call (314) 361-4300