Employee was a full-time carpenter building cabinets and retail displays. The displays ranged from 60 to 500 pounds, and carts arrived all day carrying 100 pounds of materials each for him to lift and assemble. In the fall of 2017, the low back soreness that came with the job turned into severe pain with numbness running down his right leg.

He reported a repetitive-use injury to his low back in October 2017. The Employer sent him to an occupational clinic; when severe pain met long delays, he went to urgent care on his own and returned to work with a light duty slip. For months afterward he asked for treatment and kept the Employer informed of the care he was getting on his own. In December 2017 he hand-delivered a written demand for treatment. The Insurer sent authorizations, took his recorded statement, and authorized nothing.

In February 2018, the Employer ended his light duty and sent him home. No wage benefits followed. Employee underwent two back surgeries on his own that year. When he recovered and returned to work in November 2018, the Employer fired him.

Repetitive trauma cases rise or fall on medical causation: whether the job duties were the prevailing factor in causing the condition. Employee’s surgeon related the herniated discs and both surgeries to the work, the firm’s retained medical experts connected the job’s lifting demands to the condition, and the opinions the Insurer hired for trial were challenged piece by piece on cross-examination.

The firm also moved for sanctions under Section 287.560 RSMo for the denial of care and benefits without any supporting medical opinion. The Employer answered with a sanctions motion of its own, arguing Employee should have accepted a settlement offer. That is what trying a case against a total denial looks like.

At the close of the hearing, our firm asked the Division to hold the Employer and Insurer responsible for:

• $248,116.98 in denied medical bills, including both surgeries
• $28,376.01 in denied temporary total disability, covering 39 weeks
• Permanent partial disability of 35% of the low back
• Future medical care for life for Employee’s low back
• Sanctions of 25% of all amounts awarded plus $23,383.41 in the firm’s costs to prosecute the denied claim

In total, the firm asked the Division to award $453,608.64. More of the firm’s tried and settled cases are on our case results page.

In 2025 alone, our firm spent over $700,000 on expert witnesses. Cases like this one are why. When an Insurer pays nothing and explains nothing, the record has to prove everything.

Our firm handled roughly 1 in 4 of recent workers’ compensation trials at the St. Louis Division of Workers’ Compensation, out of hundreds of attorneys representing Missouri workers. Insurers know which firms will actually try a case, and it changes how they negotiate.

A total denial is not the end of a claim. It is the beginning of the record a trial firm builds.

Is repetitive trauma covered by Missouri workers’ comp?

Yes. Repetitive trauma is treated as an occupational disease under Chapter 287. The question is whether the job duties were the prevailing factor in causing the condition, and that is proven with medical opinions.

What if my employer ignores my requests for treatment?

Put the demand in writing and keep a copy, the way Employee did here. A written demand creates a record, and treatment you reasonably obtain on your own after a refusal may be recoverable at a hearing. If the claim is denied outright, there is a process for that.

Can I be fired after a work injury in Missouri?

Missouri law prohibits firing a worker in retaliation for exercising workers’ compensation rights. What happened here, a firing the same month Employee returned from his second surgery, was part of the record presented at the hearing.

Does every case end with numbers like these?

No. These figures are what our firm requested on the facts of this one case, and they are not a prediction for any other. Every case is different; results depend on the facts.