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How Workers’ Compensation Claims Are Processed

Each workers’ compensation case is unique; however, there are rules and deadlines that apply to all cases.

work injury

While workers’ compensation cases normally do not require a full-blown trial, employees and their lawyers should not rule out this possibility and should prepare well for any possible outcome. It is important to understand the chronology and process of a workers’ compensation claim.

Role of an Arbitrator

Once a workers’ compensation claim is filed, it is normally assigned to a particular location where an arbitrator will act as the judge, supervise all developments, and deal with all disputes between the two parties. A routine hearing will be scheduled for the case every three months. The Missouri workers’ compensation lawyer of the employee and representative of the insurance company will meet with the arbitrator during the hearing to provide updates about the case. A trial can be formally requested by either of the parties during this hearing.

It is possible for hearings to continue for several years before a resolution is reached by the arbitrator. In the mean time, the lawyer of the employee and the insurance company will continue to handle the case. The health of the injured employee would determine as to when the claim will end. The claim cannot end until the employee has fully recovered. Maximum medical improvement is a legal term which indicates that the employee has fully recovered from the injury, and once the employee has reached maximum medical improvement the claim can be ended.

Settlements Paid By the Insurance Company

Many workers’ compensation cases normally end with a settlement wherein a lump sum is paid to compensate for any permanent injuries suffered by the employee at work. However, if the employee agrees to the settlement offer, the injured employee may not receive any medical coverage for that particular injury in the future. However, if the two parties cannot reach an agreement, it may go to trial. Whenever the injured employee finds something wrong with the treatment and recovery, the employee can request for an administrative hearing. The Missouri workers’ compensation attorney will make a request for a trial when any of the benefits are withheld or discontinued.

Timeline for a Settlement

It is not easy to determine the time needed for a trial or settlement to resolve the claim of the injured employee. It is mainly determined by the injury and recovery period of the employee, which may take a number of years. So, it is extremely important to have an experienced Missouri workers’ compensation lawyer by your side that can fight for your rights and, if required, take your case for a trial.

Contact The Law Office of James M. Hoffmann at (314) 361-4300 to assist you with your workers’ compensation claim.

Updated: November 20, 2014