In January 2017, Employee was in his early twenties and working in a large distribution warehouse, picking customer orders and loading trucks. The items he lifted ranged from a few ounces to more than 85 pounds, and over half of what he moved each day weighed 25 pounds or more.

His back was already sore from loading a truck when a tote went the wrong way on a conveyor line. He reached for it, and his back popped, with pain shooting down his legs. He reported the injury the same shift. His supervisor handed him a pamphlet of stretches, the stretches popped his back again, and he finished the eight hour shift in pain.

He was in the emergency room the next day. A lumbar MRI a week later showed a herniated disc at L5-S1. The Insurer’s authorized physician treated Employee with a steroid taper, narcotics, and epidural injections, then released him from care in June 2017, still in pain, with 60 days of narcotic refills.

Three years after treating Employee for a work related herniated disc, the authorized physician issued a final report reversing every opinion in his own treatment records. He had reviewed nothing new except a CT scan confirming that the fusion had healed.

That report did not survive the hearing. On cross-examination, the doctor agreed that his treatment records never once mentioned a pre-existing condition, and he withdrew the new opinions. Minutes later, on re-direct, he stood by the opinions he had just withdrawn. Contradictions like that only surface when a case is actually tried.

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

• $114,950.23 in denied medical bills, including the lumbar fusion
• $13,800 in denied temporary total disability, covering 46 weeks Employee could not work
• Permanent partial disability of 30% of the low back and 25% of the body as a whole for depression and anxiety caused by chronic pain
• Future medical care for life for Employee’s low back and mental health
• Sanctions under Section 287.560 RSMo for an unreasonable defense: 25% of all amounts awarded plus the costs of the proceeding, a request of more than $60,000

Sanctions are reserved for defenses without reasonable ground. Asking for them, and building the record to support them, is part of what taking a case to hearing means. 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. A hearing like this one runs on that record: treating physicians, medical experts, depositions, and bills proven page by page.

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.

Insurers make different decisions when they know a firm will finish the fight. That is the argument for a trial firm, and this case is what it looks like in practice.

What is a final hearing in Missouri workers’ comp?

It is a trial before an administrative law judge at the Division of Workers’ Compensation. Both sides present evidence, witnesses testify and are cross-examined, and the judge issues a written award deciding the disputed issues.

What are Section 287.560 sanctions?

The Division can order a party that brings or defends a case without reasonable ground to pay the whole cost of the proceeding, including attorney fees. Here, the firm asked for sanctions because the Insurer offered less than its own doctor’s rating and disputed an injury its own doctor had diagnosed.

Can I get treatment on my own if the Insurer will not authorize it?

You can, and in this case it was the turning point, but do it with guidance. Demands for care should be made in writing first, and self-obtained treatment may be recoverable at a hearing when it flows from the work injury. Protecting an accepted claim along the way matters.

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.