Proving a Work Injury With a Pre-Existing Condition in Missouri

A pre-existing condition doesn’t disqualify your Missouri workers’ comp claim. Learn how aggravation works, what evidence matters, and how we can help.

If you were hurt at work and have a pre-existing condition, there’s a good chance the insurance company will use that history against you. It’s one of the most common tactics in Missouri workers’ compensation disputes — and one of the most misunderstood by injured workers.

Having a prior injury, a chronic condition, or a history of treatment for the same body part doesn’t disqualify you from workers’ compensation benefits. What matters is whether your job duties contributed to your current condition — and whether you can document that connection clearly enough to overcome the insurer’s objections.

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Law Office of James M. Hoffmann4.9

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jim

59 minutes ago

Mr. Hoffmann saved me from loosing my house, and I was able to retire early!
All hope was lost I got into a wreck driving a company vehicle and broke my back. The company was fighting me on workman’s comp. I couldn’t work, couldn’t pay my mortgage. A friend told me about Mr. Hoffmann. I met him hoping he could possibly help with workman’s comp. He not only got me workman’s comp, He asked numerous questions, and reassured me I’d be happy. Later he apparently found the vehicle at a junkyard, went with a mechanic and was able to prove the accident wasn’t my fault. With what I won in court I was able to retire early.
Mr. Hoffmann is extremely personable, down to earth, and really seemed to care about my wellbeing. Not to mention he knows how to control a courtroom. I owe my life to him.

Mark B.

3 months ago

I spent 21 years of my adult life in Law Enforcement. I was a Detective and delt with more attorneys than I can count. James Hoffman is more than an attorney. He cares and he works so very hard for his clients. He spend a lot of time communicating including calling me on a weekend. I also wanna send a special shout out to his para Jamie. She’s awesome and very patient.

Scott M.

5 months ago

This is Barbara Magrew. James Hoffman represented me in a Workmen’s Comp case. I sustained a left wrist fracture and a right knee fracture in a fall. Mr. Hoffmann and his son, Remi, were very professional and represented me very well. They kept me updated and answered all of my questions. I would highly recommend them. My case was settled out of court. His staff was very professional, knowledgeable, and caring. They were always willing to answer my questions.

Owen A.

7 months ago

James Hoffmann is a straight shooter and one of the best lawyers I’ve interacted with in St. Louis. He’s professional, reliable, and has an answer for every question. Communicates clearly and gets things done. Highly recommend!

Response from the owner:Thank you Owen. Fighting for the injured is my passion over the past 30 years. We've represented 1000's of people injured at work and in car accidents. We have deposed over a 1000 doctors regarding injuries such as lumbar and cervical disc herniations, lumbar and cervical fusion surgeries, rotator cuff injuries, concussion and traumatic brain injuries, fracture bones, hip, knee, shoulder, and ankle replacements, paralysis, and wrongful death.

I don't like insurance companies and only represent the injured. I am not a large advertising law firm that settles cheap to meet monthly quotas. We fight hard for every client. The compensation we obtain for the injured is both federal and state tax free. We never ask our clients for a penny as all cases are handled on a contingency fee.

James Hoffmann
314 361 4300
[email protected]

Jaedah B.

7 months ago

Staff is very knowledgeable and caring. Would definitely use Everytime in need and recommend to friends/family.

Response from the owner:Thank you Jaedah. It is my pleasure to represent the injured across the state of Missouri: St. Louis, Kansas City, Kennett, St. Joseph, Rolla, Springfield, Cape Girardeau, Jackson, West Plains, Columbia, Farmington, Poplar Bluff, Sikeston, St. Charles, Kirksville, and more! Work comp and car accidents are my passion.

J R.

9 months ago

I was fighting with workmans compensation for 3½ years with another attorney who did everything WC wanted him to and it had nothing to do with what I hired him for. Mr. Hoffman was on top of my case from the moment I hired him. He didn't really negotiate with WC, he made demands to them. He refused every offer, with my approval, and forced them to compensate me for the injuries that I received. I'm very thankful for Mr. Hoffman and I will recommend him to everyone regardless of whether WC is giving them problems or not. He absolutely knows what he's doing and exactly how to get the job done.

Response from the owner:I've been fighting workers comp and car accident insurance companies for 30 years. Claim adjusters don't want to pay reasonable compensation for any injury whether it's a lumbar fusion, herniated disc, fractured bone, rotator cuff tear, brain injury, or even death. Personal injury attorneys and workers compensation lawyers need to retain medical experts, vocational experts, and life care planners. A trial setting is the only thing that makes an insurance adjuster "see Jesus."

FYI. There are a lot of TV ads and billboards claiming "bigger is better." That is not true. Some of those firms are from out of state and simply hired a few attorneys here in Missouri. And, always remember, quality over quantity. One good trial attorney is way better that 100 average attorneys who only settle cases to meet monthly quotas to pay the millions in advertising fees.

Law Office of James M Hoffmann LLC
Jim Hoffmann
2001 S. Hanley, suite 325
St. Louis, MO 63144
314 361 4300
[email protected]

Shannon B.

11 months ago

After a bad car accident in 2021, I was referred to Jim Hoffman to help with my medical needs. Jim was able to help me get the treatment and surgery I needed to heal & move forward through pain and suffering. I’m extremely grateful to have had a lawyer work hard for me and keep me up to date in the process. We received all of my bills covered and a nice settlement. Thank you, Jim!

Response from the owner:Hello Shannon! Thank you for the kind words. It's my passion to help the injured and I am grateful that you allowed me to represent you. Insurance companies are bullies. As a kid, I never liked a bully and fought them to protect others. Didn't always win those fist fights as a kid, but I sent a message. Glad to continue those fights in the courtroom.

God bless, love and hugs

Jim

Jay L.

1 year ago

Great great lawyer . Perfect execution and preparedness

Response from the owner:Thank you Jay. Recent settlements include over a $1 million for a work comp low back surgery; over $1 million work comp settlement for vision and lung damage due to chemical exposure at work; over $320,000 for a severe ankle injury at work; over $400,000 for a fracture leg due for a pedestrian crossing the street and being struck by a car; and $200,000 for a victim of a dog attack. All of these cases involved years of depositions and expert testimony. Insurance adjusters know that we fight for the injured and will go to trial.

Taylor G.

1 year ago

A relative who does work injury claims said Mr Hoffmann handles all the biggest workers compensation cases in St Louis. I see why. Simply great!

Response from the owner:Thanks Taylor. Big or small cases, my passion is to fight for the injured in Missouri. We represent injured employees under work comp and victims of negligence, such as car accidents, across the state of Missouri. From Kennett to Kansas City, from Cape Girardeau to Joplin, from St. Charles to Columbia, from Kirksville to St. Joseph, we have helped the injured.

Jay G.

1 year ago

This lawyer is on another level for work injury cases. The judges had a lot of respect for this attorney. You just know you are in the best hands.

Response from the owner:Thanks Jay. We just received a favorable decision from the court of appeals reinstating an award of $200,000 in denied medical by the work comp but was taken away when the employer and work comp insurer appealed to the LIRC. The court of appeals ruled that the LIRC made up laws that do not exist and that the hearing judge's award for the denied medical was spot on with Missouri work comp law. The appeals took several years, but thank god my client was willing to fight this battle. The denied bills were for a 2 level lumbar fusion for 2 herniated discs due to lifting heavy items at work. We won wage loss, permanency, and future medical care as well.. and now he gets the denied medical bills too.

Fighting for the injured.

James Hoffmann
Your Missouri car accident and workers comp lawyer
314 361 4300
[email protected]

James W.

1 year ago

In the area of Workers Comp, this lawyer is better than anyone on TV. Thank you!

Response from the owner:Thanks James. From interviewing a few former secretaries of a law firm that advertises a lot, I discovered that the law firm had monthly settlement quotas in order to pay for all of the advertising. The secretaries left the large law firm because they were upset at how cases were being settled cheap to meet the quotas. Bigger is not better. I have gone to trial and taken more depositions than the big firms. It's the quality of the lawyer that counts and not the size of the law firm.

Glenn T.

1 year ago

Mr Hoffman is an excellent Attorney! So good that we settled out of court and I am Extremely satisfied! Very kind, Mr. Hoffman and his son and I would recommend him to anyone And I already have thanks Mr. Hoffman

Response from the owner:Thanks Glenn. Missouri residents need to contact their state representative about proposed changes to Missouri workers comp laws that only benefit the insurance company and limit the compensation to the injured worker. Jefferson City is full of state representatives and senators who do favors for the insurance companies because they like the donations and high paid lobbying jobs after they leave office. When work comp laws become so favorable to the insurance companies, lawyers stop representing the injured worker because the laws limit what the lawyer can do for the employee and how much he/she gets paid. Write the governor. Write your state rep and state senator. Tell them your story about how the employer, the insurer, or the work comp doctor mistreated you. Tell them you will not vote for any person who passess work comp laws that limit the recovery of the injured worker.

Tonka F.

1 year ago

Mr Hoffmann and is son, Remy, are great work injury attorneys. Definitely recommend hiring their law firm. You will not find better in saint louis.

Response from the owner:Thank you Tonka. Remy and I are preparing for a permanent and total disability trial on Friday. Employee alleges that because of the work injury and two level lumbar fusion, she is unable to return to work. Another issue will be pursuing denied medical for the lumbar fusion surgery. Plus, we are pursuing future medical for life. The work comp adjuster sent my client a doctor who alleged my client suffered no back injury despite work comp sending my client to doctors immediately after the injury who diagnosed herniated discs and radiculopathy... and then did three lumbar steroid injections.
Proud to fight for the injured.

Law Office of James M Hoffmann
2001 S. Hanley suite 325
St. Louis, MO 63144
314 361 4300
[email protected]

Phylicia F.

1 year ago

The reviews and news articles are facts. This workers compensation lawyer is the greatest in St. L. You will notice the difference after you speak to him the 1st time. He knows his business and he's just getting better and better as time goes on.

Response from the owner:Thanks Phylicia. 30 years of representing 1000's of injured workers and car accident victims. Proud to be a Missouri personal injury and workers compensation attorney. We represent the injured across the entire state of Missouri.

James Hoffmann
St. Louis, Mo work comp and car accident lawyer
314 361 4300

Angela H.

1 year ago

Reviews are correct. This is the best works comp lawyer in the state of Missouri. I tell everyone to call jim

Response from the owner:Thanks Angela. Across the state of Missouri from St. Louis to Kansas City, from Cape Girardeau to Kirksville, from Columbia to St. Joseph, from Springfield to St. Charles, we represent and fight for those injured under Missouri workers compensation and in car accidents. Wrongful death, amputation, lumbar fusion, disc replacements, shoulder replacements, knee surgery, fractured bones, carpal tunnel, ankle fusions, and more, we have fought for the injured.

Law Office of James M Hoffmann
314 361 4300
[email protected]

Kendall

1 year ago

Great lawyer. Knowledgeable. Professional. The lawyers on TV were not in the same league as this workers compensation attorney. I tell everyone to hire Jim.

Response from the owner:Very kind of you Kendall. Unlike the tv guys who are either from St. Louis but never step foot in court or are not from St. Louis and have never been in a MIssouri court, I've been taking depositions and trying cases in Missouri for over 30 years. I have deposed orthopedic and neurosurgeons regarding herniated discs, disc extrusions, neck fusions, back fusions, disc replacements, fracture vertebrae's, paralysis, and death. I've deposed doctors about hip fractures, hip replacements, knee replacements, shoulder joint replacements, shoulder fusions, carpal tunnel surgery, cubital tunnel surgery, ankle surgery, ankle fusions, lis franc fracture dislocations, traumatically induced arthritis, and future medical for life. I've depose psychiatrists about depression, anxiety, and PTSD caused by injury and/or chronic pain . I've deposed neurologists regarding TBIs, or traumatic brain injuries, skull fractures, brain bleeds, and post concussion syndrome. We spend money on expert witnesses as the work comp insurer will have experts who will deny your claim. I've taken 1000's of depositions and tried 100's of cases. Those guys on tv have not.

Law Office of James M Hoffmann
2001 S. Hanley, suite 325
St. Louis, MO 63144
314 361 4300
[email protected]
Your Missouri car accident and workers compensation attorney

Jeffrey C.

1 year ago

Mr.Hoffmann does an amazing job with workers comp cases. Helpful from beginning to end and gets more than you would ever expect. Best lawyer I have ever seen.

Response from the owner:Thanks Jeffrey. My son, Remy Hoffmann, and I only represent those injured whether at work, car accidents, falls, product defects, dog bites or malpractice. Strains, sprains, herniated discs, fusion surgeries, amputations, joint replacements, compound fractures, rotator cuff surgeries, disc replacements, concussions, traumatic brain injuries, loss of vision, hearing loss.. we have successfully obtained compensation for pain and suffering, past medical bills, future medical care, loss of income, and permanent total disability. We are not the big firm advertisers who have monthly settlement quotas. We fight equally hard for every client across Missouri from St. Louis to Kansas City, Springfield, Rolla, Columbia, Jefferson City, Kennett, Cape Girardeau, Branson, Troy, St. Joseph... .
Glad to help. All cases on a contingency fee which means we will never ask a client for a penny.

Law Office of James M Hoffmann
James Hoffmann
Remy Hoffmann
Missouri personal injury attorneys
314 361 4300
[email protected]

Ryan

1 year ago

This attorney gets the highest awards in the division of workers compensation. A lawyer you do not want to pass up when looking to proceed after a workplace injury. I highly recommend.

Response from the owner:Thanks Ryan. We recently went to trial on a denied Missouri workers compensation low back injury that caused two herniated discs, radiculopathy, and eventually required a two level lumbar fusion. Once a case is tried, the attorneys have 30 days to submit proposed awards. The work comp judge has 90 days to issue a final award. We had orthopedic and neurosurgeon experts testify as to causation, permanency, wage loss, the denied medical bills. We also requested sanctions as the employer/insurer denied the injury even before a doctor reviewed the case on behalf of the employer. I cited a prior trial award I obtained for a client where we received an award that included sanctions:
The LIRC in Nouraie v. MO. Baptist Medical Center et al, Injury No.: 10-111746, March 13, 2013, sanctioned the employer for refusing medical care in connection with a repetitive use claim. The Employer obtained an expert long after the wrongful denial of benefits. This did not justify the prior wrongful denial. The LIRC explained:

“In any event, whether an employer has sent a worker for a medical examination prior to denying a claim is a factor for our consideration in determining whether an employer had reasonable grounds for denying a claim.”

The LIRC in Nouraie also explained:

“The courts have instructed us we are only to award such costs “where the issue is clear and the offense egregious.” Landman v. Ice Cream Specialties, Inc., 107 S.W.3d 240, 250-251 (Mo. 2003). We think it is clear that employers have an obligation to investigate the circumstances giving rise to alleged work injuries before denying benefits. And where the worker is available to discuss the injury, we think any reasonable employer conducting an investigation designed to determine whether an injury is work-related would discuss the alleged injury with the worker. In the instant case, Ms. Bequette, as employer's agent, denied evaluation, treatment and benefits to employee without even discussing employee's alleged back condition with employee. We think employer's act of denying workers' compensation benefits to employee before even discussing the alleged injury with employee constituted an egregious offense. Based upon the forgoing, we find employer defended this claim at the outset without reasonable ground.”

Michelle B.

1 year ago

This attorney really helped my nephew, Best lawyer for injured workers in the St Louis area.

Response from the owner:Thank you Michelle. If you are injured while working in Missouri, or if you are hired while in Missouri and injured whether in or out of Missouri, we can pursue a Missouri workers comp claim for you. Workers injured due to another's fault, such as a car accident or machine failure, can also pursue a civil claim for personal injury in addition to a work comp claim.

Merry Christmas.

James Hoffmann, Missouri work comp and auto accident attorney
314 361 4300
[email protected]

Barbara R.

1 year ago

My favorite lawyer. Hire him if a work accident causes you to be injured. Much better than any other workers compensation attorney I have met.

Response from the owner:Thank you Barb.

Dave B.

1 year ago

Attorney is the king of workers compensation. Nobody better!

Response from the owner:Thank you Dave. We recently finished an all day work comp hearing. Below is a summary:

Claimant, a full-time carpenter for Employer, developed low back pain in September of 2017 making cabinets and displays for the Employer. Claimant’s job is physically demanding. Cabinets and displays can range from 60 to 500 lbs. Claimant job duties include lifting displays weighing up to 500 hundred pounds during the assembly process. Carts, each with 100 lbs of materials, are brought to Claimant who must lift the materials from each cart and assemble same. In October 2017, Claimant’s job duties caused his low back soreness to become severe pain with numbness down his right leg. At the final hearing, the Employer/Insurer produced no evidence of non-work activities that could have caused, or did cause, Claimant’s low back pain.

When Claimant’s low back pain became severe in Oct. 2017, he sought treatment with a chiropractor, Dr. Lynch, on 10/17/20217. Claimant then, on 10/23/2017, reported to Employer a repetitive use work injury to his low back. He went sent to Concentra by the Employer but left due to delays in providing immediate treatment as he had severe pain and radiculopathy. He went immediately to an urgent care and returned to work with a light duty slip for 6 weeks for which the Employer complied.

Despite asking the Employer for additional treatment during the next few months, none was offered. He kept the Employer informed of the treatment he was receiving on his own. IN December 2017, Claimant contacted attorney James Hoffmann who instructed Claimant to hand deliver a letter to the Employer making a written demand for treatment. Claimant delivered the letter in December 2017. At the hearing, Employer presented no evidence that it disputed the contents of the letter.

Immediately after receiving the letter, the Employer contacted the Insurer which then sent medical authorizations to Claimant who signed and immediately returned same to the Insurer. The Insurer then obtained a statement from Claimant in Dec. 2017 where Claimant informed the adjuster of a repetitive use low back injury at work and need for treatment.

After 6 weeks of light duty, Employer requested another light duty slip which Claimant provided.

Claimant continued to work light duty until Feb. 15, 2018, when Employer informed Claimant there was no more light duty and sent Claimant home. In the meantime, neither the Employer nor the Insurer offered treatment. The Employer’s attorney was aware of Claimant’s treatment as he was sending copies of Claimant’s medical records to Claimant’s attorney received via the authorizations signed by Claimant.

In Feb. 2018, Claimant’s attorney obtained a medical report from Dr. Armond Levy who related lumbar disc herniations and the necessity of surgery to Claimant’s work for Employer. Several demands were sent IN Feb. 2018 to the Employer for the surgery recommended by Dr. Levy and for TTD. At the hearing, Employer presented no evidence of any response to the demands for treatment and TTD made by Claimant’s attorney in February 2018.

Claimant then underwent 2 surgeries on his own for his low back, the first being in March 2018 and the second in August 2018. During that time, no TTD or treatment was offered. When Claimant returned to work in November 2018, after recovering from the second surgery, he was informed by the Employer that he was fired.

The Employer eventually sent Claimant to a physician, Dr. Bernardi, in November 2018, who is of the opinion that a person cannot suffer a repetitive use herniated disc. It is his opinion that herniated discs can only acute, and that any degenerative changes in the low back are genetic and cannot be caused by repetitive use occupations. In other words, Employer sent Claimant to a doctor who disagrees with Missouri law which specifically recognizes and accepts repetitive use injuries. Claimant had zero chance of a favorable opinion from Dr. Bernardi

Marie H.

1 year ago

⭐️ ⭐️ ⭐️ ⭐️ ⭐️
This is the lawyer you want to hire! Just read the reviews. It is all true. Incredible! He will get you every dollar of lost wages, get you every ounce of medical treatment, and get you the highest possible award from the Division of Workers Compensation.

Response from the owner:Thanks Blair. We are preparing for another trial! Client worked as a carpenter and injured his L4-5 and L5-S1 discs from repetitive heavy lifting. We made several demands for treatment. We obtained an opinion from a neurosurgeon and an orthopedic surgeon that back surgery was necessary. The employer refused treatment so our client had surgery, a lumbar fusion, on his own. We are pursuing the employer/insurer for 6 months of wage loss, denied medical of $245,000, permanency, and future medical for life.

Law Office of James M. Hoffmann
2001 S. Hanley, suite 325
St. Louis, MO 63144
314 361 4300
[email protected]
Your Missouri workers comp and car accident attorney.

J G.

1 year ago

This laywer rocks!

Response from the owner:Thanks Justin. Happy to report another win a trial. Client injured his knee at work. He underwent a meniscus surgery. The doctor also "cleaned up" other degenerative changes in the knee. This is called a chondroplasty. After the surgery, client's knee go worse. The doctor blamed prior arthritis even though my client had no prior knee issues and no prior pain. Yes, at his age he had prior natural degenerative changes. We retained experts who testified that chondroplasty caused those areas top become inflamed and painful, thus causing the "arthritis." We argued that prior to the injury, there was no "itis", which means inflammation and pain. We argued that all of the "itis", and thus arthritis, was due to the surgery. The judge agreed and also awarded future medical for life which includes knee replacements.

So, why did the doctor shave areas in the knee that were not symptomatic? Look at the bill: a meniscus surgery is onl $3000; but for every other area he "cleaned up", he gets $3000 for each area.

Law Office of James Hoffmann
314 361 4300
[email protected]
Your Missouri workers comp and car accident lawyer

Katie B.

1 year ago

Best you will find! This law firm is great for work injury claims. Tons of union members use him to file claims.

Response from the owner:Thanks Katie. We also help families through car accidents and slip/falls. We recently recovered $500,000 for a client who fell at service station!

James Hoffmann
314 361 4300
[email protected]

Zach B.

2 years ago

Several of the big TV law firms advertised for workers compensation. Called them but was not impressed. Then I called attorney Hoffman because of his reviews and am so glad we did. Night and day difference. Extremely competent lawyer!

Response from the owner:Thank you Zach. I represent injured Missouri workers from St. Louis to Kansas City and all throughout Missouri: Springfield, Cage Girardeau, Hannibal, Rolla, Columbia. Ozarks. Kennett, Poplar Bluff, etc. We fight hard for every client and do not have monthly settlement quotas like the big advertisers do to pay for all of their advertising!

Law Office of James Hoffmann
314 361 4300
[email protected]

Jacob P.

2 years ago

Love my workers compensation law firm. Highest work injury awards in St Louis. The reviews are 100% correct.

Response from the owner:Falls at work are not compensable under Missouri work comp unless it is shown that something specific at work caused the fall. Just walking and stumbling for no reason is not work comp. Walking, and carrying a box, which causes you to stumble because you can't see your feet is work comp. Falling down stairs because you missed your step is not compensable unless you missed the step because you were in a hurry for a work issue; or you were carrying work items and that affected your line of sight. Having to wear certain shoes is work specific if the shoes are awkward and contributed to your fall.

James Hoffmann
attorney
St. Louis workers comp and car accident lawyer
314 361 4300
[email protected]

Jerry H.

2 years ago

And used Mr Hoffman's Law Firm for a workers compensation claim. All the firefighters use him said he gets the highest work in injury Awards.

Response from the owner:Thanks Jerry

I have represented numerous first responders in Missouri workers comp and car accidents. Heavy ambulance doors have caused severe post concussion syndrome and TBI's. Lifting victims has caused herniated discs requiring cervical and lumbar fusion surgeries. Glad to help our hero's.

Law Office of James Hoffmann
2001 S. Hanley, Suite 325
St. Louis, MO 63144
314 361 4300
[email protected]

Jessica B.

2 years ago

Exceeded our expectation. Incredible lawyer for work injury claims he will file and litigate the workers compensation claim walk you through the process and fight for treatment and the final award gold medal effort.

Response from the owner:Thanks Jessica. Missouri injury claims are a battleground. Whether its a wrongful death claim, herniated disc, lumbar or cervical fusion, strain/sprain, shoulder surgery, knee surgery, amputation, concussion, dog bite, workers comp, and other injuries, the bottom line is that insurance companies don't want to pay fair and reasonable damages, they want to as little as possible and delay the case so payment is delayed. Attorneys from across Missouri from St. Louis to Kansas City to Springfield, Columbia, Cape Girardeau, etc. need to ready for a fight. Money needs to be spent on experts and the attorney needs to go to trial when the offer is too low. The big law firm advertisers settle everything they can for cheap to meet advertising budgets and attorney quotas.

Law Office of James Hoffmann
St. Louis personal injury and work comp lawyer.
314 361 4300
[email protected]

T. H.

2 years ago

You are a great attorney! Thank you.

Response from the owner:Worsening of prior conditions are a valid Missouri work comp claim:
Per Tillotson v. St. Joseph Med. Ctr., 347 S.W. 3d 511 (Mo. App. W.D. 2011) to determine need for treatment, surgery, and treatment after surgery. Treatment need only be reasonably required to cure and relieve the effects of the injury. Id. Section 287.140.1 RSMo states in pertinent part that the Employer shall provide such medical as may “reasonably be required.

To be entitled to future medical care the employee must establish that there is a reasonable probability that he will need future medical care. Forshee v. Landmark Exc. & Equip., 165 S.W. 3d 533 (Mo.App. E.D. 2005) An [Employee] does not have to provide evidence of specific medical treatments or procedures which will be necessary in the future in order to receive an award of future medical care. See Chatmon v. St. Charles County Ambulance, 55 S.W.3d 451, 459 (Mo.App. E.D. 2001).

Employee has already satisfied the burden of proving a compensable injury. Here, defense's authorized Dr. Spears on 4/26/2010 opined "if she doesn't get improvement in her radicular pain, then the next step is going to be a microscopic transforaminal lumbar interbody fusion to remove the foraminal stenosis." He went on to state the January 2010 incident was a "fall (that) aggravated significantly a pre-existing condition". This is enough under Tillotson, Forshee, and, Chatmon (supra) to award further treatment.

Please also see Maness v. City of De Soto, 421 S.W.3d 532 (Mo. App. 2014). The court rejects Employer's contention that the mere existence of degenerative disc disease in the cervical spine and neck symptoms prior to the work accident requires a determination that Claimant's injury is not compensable.

See also the following in support:

If the evidence establishes that an accident caused a
disability or aggravated a preexisting condition or infirmity of an employee,
which produces a condition that would not have resulted in a normal, healthy
individual, an award is authorized. Fogelsong v. Banquet Foods Corp. 526
S.W.2d 886 (Mo. App., K.C.D. 1975)

An aggravation of an existing infirmity caused by an accident or occupational
exposure arising out of and in the course of employment is compensable under
Chapter 287, RSMo, even if the particular accident (occupational injury) would
not have produced such result in a normal and healthy individual. Mashburn v.
Chevrolet-Kansas City Division, General Motors Corp., 397 S.W.2d 23 (Mo.
App., K.C.D. 1965)

Steven Mitchell J.

2 years ago

Bunch of Ford employees recommended Mr Hoffmann for workers compensation claims. Said he handles all the union workers who get injured at the plant.

Response from the owner:Thank you Steve. I wish I handled all of the work comp claims, but I do represent many. Whether it's large employers like Boeing, Ford, Emerson, Anheuser Busch, BJC, or smaller employers, we fight hard for injured workers in Missouri. 30 years of experience. 1000's represented. Over $100,000,000 recovered and the battles rage on. We also had personal injury claims as well. We recently recovered $450,000 for an injured worker who was bit by a dog.

Law Office of James M. Hoffmann
2001 S. Hanley
St. Louis, MO 63144
314 361 4300
[email protected]

James V.

2 years ago

My cousin was injured in a work accident so we had to interview all the “top workers compensation lawyers” in Saint Louis. This lawyer was clearly on another level.

Response from the owner:Thanks James. Workers' comp, or workman's comp as some say, lawyers need to hire experts such as pain management doctors, or orthopedic doctors who specialize in back surgery, shoulder surgery, knee surgery, neurologists, concussion specialists, and psychiatrists. The political environment in Missouri now favors insurance companies. Work comp claim are no longer simple and informal. They are a jury trial but without a jury. Lawyers need to know how to depose doctors and try a case. Every day we fight for our clients injured at work, injured in car accidents, injured by dog bites, injured medical negligence, and more.

James M Hoffmann, attorney
2001 S. Hanley, suite 325
St. Louis, MO 63144
314 361 4300
[email protected]

Eric A.

2 years ago

This workers compensation lawyer gets a perfect 10. Fights hard for injured workers and he wins. Walks you through the entire process. He is also a great person.

Response from the owner:Thanks Eric. Workers comp insurance doctors love to blame ongoing pain on pre-existing arthritis even though all of the employee's pain started with the work injury and prior to the work injury the employer had no pain and had never been diagnosed with arthritis. The insurance doctors always refer to prior, non-symptomatic degenerative changes in a joint as being "arthritis." "Itis" means inflammation and pain. The itis is usually due to the joint becoming inflamed and painful from the work injury and surgery. Thus, the "arthritis" is due to the injury and not because a person has prior naturally occurring non-symptomatic degenerative changes. Ask the work comp doc: "you agree that 60 year old tonsils probably have degenerative changes. Would you call 60 year old non-symptomatic tonsils "tonsilitis": NO!; would you call a 60 year old non-symptomatic appendix "appendicitis":NO!; would you call a 60 year non-symptomatic bursa "bursitis": NO!.. that's because the "itis" means inflammation and pain, non of which I had until the work injury!!!
I see this all the time with neck injuries, low back injuries, disc herniations, rotator cuff tears, meniscus tears: doctors do surgery under workmans comp and then blame ongoing pain on a made up pre-existing condition.

James Hoffmann
Your Missouri workers comp and car accident attorney
314 361 4300
[email protected]

Jennifer A.

2 years ago

I agree with the reviews. This lawyer is in a different league from other workman’s compensation lawyers. He does all the massive injury cases in Missouri.

Response from the owner:Thank you Jennifer. We just went to trial for a disputed total knee replacement. The work comp doctors always allege the knee replacement is due to pre-existing arthritis yet my client has no prior knee pain, no prior limitations, no prior treatment. He had a 60 year old knee that had natural degenerative changes, but he was pain free. In the word "arthritis", itis means inflammation and pain, neither of which my client had before the injury. The itis started with the work injury. It takes 90 days for a ruling.
Law Office of James M. Hoffmann
St. Louis, MO car accident and workers compensation lawyer
314 361 4300

Payton G.

2 years ago

Phenomenal experience with the Law Office of James Hoffmann. He is know as the best in workman’s compensation and I can tell you he is. Great team. Answered all questions, was available and is brilliant.

Response from the owner:Thanks Payton. Call it work comp, or workers comp, or workman's compensation, it's all the same. A current battle with a work comp insurer concerns "natural consequences." My client had a L5-S1 fusion under work comp. She has at home transitioning from a walker to a cane, per doctor's orders, when she fell fracturing her elbow and damaging her lumbar fusion. The injuries from the fall are part of the work injury as someone falling, due to balance issues from the surgery, while rehabbing is a known and accepted consequence. Of course the work comp insurer is fighting us arguing that her home rehab should only have been indoors and not outdoors where she fell...absurd! The doctor placer no restrictions on where to practice transitioning. She now has a three level lumbar fusion from L3-4. L4-5. and L5-S1. We'll go to trial if not accepted.

Glad to fight for the injured worker in Missouri.

Law Office of James M. Hoffmann
St. Louis, Missouri workers comp, car accident, injury attorney.
314 361 4300
[email protected]

James H.

2 years ago

5 Stars

These reviews are correct. This attorney is incredible. He knows workmans compensation, fights for denied treatment and wages, and gets your on the job injury rated by the best doctors. I will be using him from here on our great experience.

Response from the owner:Thanks Joshua. Unlike the big firms that advertise on TV which have monthly settlement quotas for their attorneys, I spend my money on experts such as orthopedic surgeons, neurosurgeons, pain management doctors, vocational experts, and life care plans. These experts are necessary to prove the permanent damage and wage loss caused by back injuries such as paralysis, disc herniations, disc protrusions, and fractured vertebrae, or shoulder injuries such as rotator cuff tears, labral tears, shoulder replacement surgeries and frozen shoulders; or fractured hips and pelvises that require plates, screws, or hip replacement surgery; or TBI's, traumatic brain injuries, also called concussions, PCS, or post concussion syndrome; ankle fusions; ankle joint replacements; knee joint replacements, PTSD from the injury, and depression and anxiety from chronic pain.

It does not take a large law firm to fight an insurance company. It takes a good lawyer. There's a reason why injured insurance adjusters and injured insurance doctors call me to represent them. They know I fight and will not back down.

Law Office of James M. Hoffmann
St. Louis, MO workers comp and auto accident attorney
314 361 4300
[email protected]

jelly W.

2 years ago

Great person. Even better lawyer. Thank you Mr. Hoffmann for being so good at workers compensation. Getting hurt at work is frightening. That went away as soon as we spoke. Bless you!

Response from the owner:It's scary because there are employers who go the attack when an employee gets hurt. There are insurance adjusters who deny claims and create hardships. There are insurance doctors who blame pre-existing arthritis even though you had no or little prior issues.

If the doctor says that you suffered a compensable injury by accident, then the legal standard for determining employer’s obligation to afford medical care under the Missouri workmans comp law requires the employer to provide treatment reasonably required to cure and relieve the effects of the injury. The prevailing factor standard no longer applies.
Further, it is immaterial that treatment may have been required because of the complication of a pre-existing condition or that treatment will benefit both the compensable injury and a pre-existing condition.
The fact that medical treatment may also benefit a non-compensable earlier injury or condition is irrelevant.
Whether or not claimant may have needed future treatment even if the injury did not occur is irrelevant to the analysis of whether future medical care flows from the injury actually occurred. With respect to permanent partial disability it is immaterial that the employee had a prior condition as an employee is entitled to compensation for disability rising out of the medical treatment reasonably required to treat the injury.
With respect to future medical benefits, the claimant need only show reasonable probability because of the work-related injury, future medical treatment will be required. A claimant need not show evidence of the specific nature of the treatment required.

In other words, prior conditions, such as arthritis, is irrelevant if the doctor says you suffered a work injury. The employer/insurer must treat both.

James Hoffmann
St. Louis, Missouri workers comp and car accident lawyer.
314 361 4300
[email protected]

Suzanne C.

2 years ago

Re: Law Office of James M. Hoffman

The Law Office of James M Hoffmann was referred to me from a previous client, that was extremely impressed, with his service and outcome.

I met with Jim Hoffmann to discuss a car accident. Three cars were involved, my car was totaled, and I was seriously injured. After meeting with Jim the very first time, I immediately felt comfortable, and knew that he would have my back, and would fight for me.

Throughout my journey, I dealt with a lot of pain and several issues that lasted for years. During this time I had to contact Jim and Jamie (Jim’s wonderful assistant) many times. Every time I sent an email with questions, I received feedback extremely quickly!

I feel Jim negotiated a great settlement for me!

The Law Office of James Hoffman will be the first place I contact if I ever need his help again!

Suzanne Charles

Response from the owner:Thanks Suzanne. Over the past 25 years, we are proud to help families through injuries from car accidents and work accidents in Missouri.

James Hoffmann
St. Louis, MO auto accident and workers compensation lawyer
314 361 4300

Cassie C.

2 years ago

This law firm handles the biggest workers compensation cases. Biggest cases require the best. This is it in St Louis. Everyone you call says the same thing that Jim Hoffmann is the best in Missouri and consistently beats the biggest defense lawyers and defense doctors and gets the highest awards.

Response from the owner:Thanks Cassie. Although the workers compensation statute in Missouri mandates that the process be simple, informal, and summary, it is anything but. Your attorney should use experts such as orthopedic surgeons for shoulder, hip, hand, and knee injuries, or neurosurgeons for herniated discs and other spine injuries, vocational rehabilitation experts to prove permanent and total disability, and pain management doctors to prove the need for future medical care for life. These experts are expensive, but I risk my money as we need them be successful whether at trial or to get a good settlement.

Glad to fight for the injured Missouri worker and those injured on car accidents.

James Hoffmann
Missouri personal injury attorney
314 361 4300
[email protected],

shane D.

2 years ago

The workers compensation doctor said to hire this attorney because he is the best to put towards the task of making sure I’m accurately represented and assured he would not give up in my time of need. This attorney is great and I would recommend them to any and everybody.

Response from the owner:Thanks Shane. I have fought for 1000's of injured Missouri workers and car accident victims. Workers compensation doctors and insurance adjusters have hired me to represent them, all saying "you fight for your clients." I hire experts. I take depositions. I try cases. The insurance adjusters know who settles cheap to meet big advertising bills and who fights for their clients. Glad to say I am a fighter.

Jim Hoffmann
Missouri workers compensation and car accident attorney
314 361 4300
St. Louis, MO

Austyn A.

2 years ago

Workers comp claim in the Missouri division of Workers
Compensation? Get this lawyer. Simply better than all the rest.

Response from the owner:Thanks Austyn. We represent workers all across the state of Missouri. We've won numerous permanent and total disability trials. We've won numerous hardship trials either for additional treatment and/or wage loss, known as TTD. We've helped construction workers, police officers, warehouse workers, production workers, firemen, workers compensation doctors and insurance adjusters have hired us when they get hurt, salesmen, nurses, and numerous others. Across Missouri from St. Louis , Kansas City, Springfield, Kirksville, Milan, Rolla, St. Joseph, Branson, Kennett, Cape Girardeau and other cities, we have helped people recover damages for auto accidents and Missouri workers compensation injuries.

James Hoffmann
314 361 4300
[email protected]

Alex B.

2 years ago

Higher this workers compensation lawyer. no question about it top notch.

Response from the owner:Thanks Alex. Recently won a hardship where the work comp adjuster and insurance doctor denied treatment for knee injury. My experts convinced the judge that the injury caused meniscus tears, cartilage damage, and traumatic arthritis, thus leading to the need for a knee replacement. My client's knee is now covered for life by workers compensation and all back pay, or TTD, was recovered too.

James Hoffmann
Missouri workers compensation and auto accident lawyer
314 361 4300
[email protected]

dylan F.

2 years ago

Every lawyer we spoke to said call this law firm for very serious worker’s compensation claims. They do the biggest workplace injury and death cases.

Response from the owner:Thanks Dylan. Here are a few things injured Missouri workers should immediately after the injury: report the injury in writing; if the employer says that he/she will fill it out and refuses to let you fill out the injury report, you can prepare a letter about what happened and give it to your boss (keep copies and date it!); ask for treatment: just telling your boss that your back is hurting isn't good enough; say "my back is hurting from breaking up concrete and I'd like to see a work comp doctor:; if your boss refuses, give your boss a letter confirming that you reported a back injury, asked for treatment, and it was refused; when you see the work comp doctor and the front desk gives you intake sheets that don't ask all of the necessary questions about what happened and only what x's and o's: just write anything anywhere you want to so that you explain how you go hurt and what body parts are hurting; on the body chart, circle your low back and write "back pain that shoots down my right leg"; if your employer gives you work that exceeds the light duty restrictions, refuse to do that work and give your boss a letter confirming what has transpired (date it and keep copies); when the work comp doc releases you in pain and blames a pre-existing condition even though you had no prior pain, no prior treatment and no prior limitations; give that doctor a letter :"Dr. No: to confirm, I am very upset that you are releasing me and sending back full duty despite ongoing pain from my work injury. My back pain is still a 4-7/10; it wakes me at night; and light duty was making it worse. You said I've healed from my injury and any ongoing issues are due to pre-existing arthritis. I told you I had no prior pain; no prior treatment; and no prior limitations. All of my pain, treatment, and limitations started with my work injury and have never resolved. If my back gets worse at work working full duty, I will hold you personally responsible."

Lexi S.

2 years ago

This lawyer is a workers compensation machine. Fights for injured workers hurt on the job and denied medical after a work accident.

Response from the owner:Lexi

Writing a proposed award for an upcoming work comp trial for an injured Missouri worker. L4-S1 lumbar fusion with plates and screws. Pursuing permanent and total disability plus denied medical. Here is the case law on denied medical in MO workers compensation:
The employer is held liable for medical treatment procured by the employee only when the employer has notice that the employee needs treatment, or a demand is made on the employer to furnish medical treatment, and the employer refuses or fails to provide the needed treatment. Hawkins v. Emerson Electric Co., 676 S.W.2d 872, 880 (Mo.App.1984).

The courts have consistently held that an award of past medical expenses is supported when the employee provides (1) the bills themselves; (2) the medical record reflecting the treatment giving rise to the bill; and (3) testimony identifying the bills. Martin v. Mid-America Farm Lines, Inc., 769 S.W.2d 105, 111-12 (Mo. 1989).

The pertinent case law requires employee to prove that the past medical expenses were “due” to support an award of interest. McCormack v. Stewart Enters., 956 S.W.2d 310, 314 (Mo. App. 1997). As explained in McCormack, this means employee must show that he actually paid the bills, or received demands that he pay interest on the bills, or suffered some other loss, such as a doctor refusing to provide additional treatment until employee paid his bill. Id.

Dj P.

2 years ago

Great attorney to work with. Work injuries and workers compensation is his specialty. Known as “the best” and that is 100% accurate.

Response from the owner:Thanks DJ. When the workers comp doctor treats you for an on the job injury, releases you still in pain, and then blames pre-existing arthritis as the cause of your ongoing knee, hip, shoulder, or back pain, make that doctor answer these questions: Please explain why you allege pre-existing arthritis when, before the injury, I had no knee/neck/shoulder pain; I had no limitations at work; I sought no treatment; I enjoyed xyz activities. All of my pain, my limitations, my need for treatment. started with the work injury and my pain has never stopped. Then say "let's look up the definition of arthritis": arthr means joint and itis means inflammation and pain... I had no inflammation or pain before the work injury. I may have had natural degenerative changes in my joints, but I had no pain, no limitation, no treatment. All of my pain and inflammation started with the work injury.

Lyndsey P.

2 years ago

Found this workers comp attorney on Google for a friend in St. Louis. Great reviews. This lawyer was by far much better than the others we interviewed. This was a bad injury and Mr. Hoffmann got him payments for life.

Response from the owner:Missouri work comp law mandates compensation for either partial disability (PPD) or permanent total disability ( PTD). Employees who can no longer work seek PTD which is either a lump sum by settlement or, if the parties cannot settle, then a trial a weekly check for life is sought, plus back pay and future medical care.

Angela D.

2 years ago

This lawyer does complex workplace injury cases resulting in total disability. If badly hurt at work, this is the attorney to hire for your workers compensation claim. You don’t get a second chance! Hire James!

Response from the owner:Thanks Angela. You are correct. You get one chance to win. Injured workers from across Missouri have hire me to represent them. Joplin, Springfield, Cape Girardeau, Kennett, Fenton, Kansas City, Poplar Bluff, St. Louis, Moberly, Kirksville, Columbia, Chillicothe, Sedalia, Moberly, St. Joseph, Nevada, Neosho, West Plan, Sikeston and other Missouri residents have hired me for their work comp or car accident case. Permanent total disability claims are life changing. Your attorney needs to hire experts and be thoroughly prepared for trial.

Law Office of James M. Hoffmann
314 361 4300

Hadleigh D.

2 years ago

A workers compensation judge told me to hire this lawyer for a relatives work comp claim. He was right, this lawyer is great.

Response from the owner:Thanks Hadleigh. I've handled 100 plus trials and 1000's of injury claims for injured workers over the past 25 years across the entire state of Missouri. Unlike these large law firms with their silly ads and their monthly settlement quotas, I hire experts and try cases. I've represented Missouri workers comp claim adjusters and insurance company doctors because they know I fight for injured workers.

Gold bless

James Hoffmann, attorney
314 361 4300

ReAnna N.

2 years ago

Work injury cases need a great lawyer who will fight to get treatment and pay. This lawyer does it. Most do not. He also gets you rated. Most lawyers do not. Best lawyer for Workers Comp in St. Louis.

Response from the owner:I appreciate your kind words ReAnna. I do not hesitate to hire experts for reports from pain management doctors, shoulder specialists, back specialists and life care plans for catastrophic injuries. If a biased work comp doctor releases my client too early and my client wants more treatment, we send the injured worker to our docs for opinions on additional treatment. Whether the injuries are work comp or a car accident, we spend a lot of money on expert witnesses.

Law Office of James M Hoffmann
St. louis, MO injury attorney
314 361 4300

How Missouri Workers’ Comp Law Treats Pre-Existing Conditions

Missouri workers’ compensation law recognizes that workers don’t arrive at work in perfect health. People have old injuries, degenerative conditions, prior surgeries, and chronic pain. The law does not require you to be in perfect physical condition before a workplace injury to qualify for benefits.

What Missouri law looks at is whether your work activity was a substantial factor in causing or aggravating your condition. If a workplace incident — a fall, a lifting event, repetitive strain, or a sudden accident — made an existing condition significantly worse, that aggravation may qualify as a compensable work injury.

This is an important distinction. The insurer may argue your condition is entirely pre-existing and therefore not their responsibility. But if your job duties worsened that condition, the analysis is more nuanced than the denial letter suggests.

What “Aggravation” Means in a Missouri Workers’ Comp Case

Aggravation is a legal and medical concept that frequently arises in pre-existing condition disputes. It refers to a situation in which a workplace event accelerates, worsens, or permanently aggravates an existing condition.

There’s a difference between a temporary flare-up and a true aggravation. A temporary flare-up — where your condition worsens briefly but returns to its prior baseline — may not support a full workers’ comp claim in Missouri. A true aggravation — where the workplace event causes a permanent worsening beyond what you would have experienced otherwise — may be compensable.

The distinction matters because it affects what benefits you may be entitled to, how your case is valued at settlement, and what your treating physician needs to document. If your doctor’s notes describe your condition simply as “chronic” or “pre-existing” without addressing the work-related aggravation, the insurer will lean on that language heavily.

Why Insurance Companies Target Pre-Existing Conditions

Denying or minimizing claims based on pre-existing conditions is a deliberate strategy. Insurance adjusters are trained to look for prior treatment records, prior claims, and prior diagnoses that overlap with your current injury.

When they find that history, the argument they make is straightforward: your condition existed before you worked there, it was going to progress regardless, and your employer’s workers’ comp policy shouldn’t be responsible for it.

That argument can be effective when medical records are vague, when treating physicians don’t address causation directly, or when the injured worker doesn’t have legal guidance early in the process. It becomes much weaker when the medical record clearly documents the work event, the change in condition, and a physician’s professional opinion connecting the two.

The Medical Evidence That Makes the Difference

In a pre-existing condition case, the quality and specificity of your medical documentation are everything. Here’s what strengthens a claim:

A clear baseline. If your medical history shows your condition was stable or managed before the workplace incident, and your records reflect a measurable change after it, that contrast supports the aggravation argument. Treat your pre-incident records as an asset, not a liability.

A causation opinion from your treating physician. This is one of the most important pieces of evidence in a disputed pre-existing condition case. Your doctor should be willing to state, in writing, whether the workplace event caused or significantly aggravated your condition. A well-supported causation letter from a treating physician carries real weight in Missouri workers’ comp proceedings.

Consistency between your reported account and your medical records. The mechanism of injury — what happened, when it happened, and how it affected your body — should be consistent across your incident report, your medical records, and your own account. Inconsistencies are exploited in pre-existing condition disputes more than almost any other type of claim.

Documentation of functional decline. If your ability to work, move, or perform daily activities declined measurably after the workplace event — beyond your prior baseline — that functional change should be reflected in your treatment notes, your work restrictions, and, if applicable, your disability rating.

Independent Medical Examinations and Pre-Existing Conditions

If your claim involves a pre-existing condition, there’s a strong chance the insurance company will order an independent medical examination. IME physicians are selected and paid by the insurer, and their reports frequently minimize or dismiss the work-related aggravation argument.

A common IME conclusion in pre-existing condition cases is that the workplace event was not a substantial contributing cause of the current condition — that the natural progression of the pre-existing condition accounts for the worker’s current state. This finding, if left unchallenged, can significantly damage your claim.

Challenging an IME report requires strong documentation from your treating physician and, in some cases, an additional independent evaluation from a physician of your choosing. Going into an IME without understanding what it is, who ordered it, and how the findings will be used puts you at a serious disadvantage.

Talk to a St. Louis Workers’ Comp Attorney About Your Case

Pre-existing condition disputes are among the most aggressively contested in Missouri workers’ compensation law. The insurer has experience handling these cases. You deserve the same level of preparation.

Attorney James M. Hoffmann has spent more than 30 years representing injured Missouri workers in exactly these situations — disputed causation, IME conflicts, aggravation arguments, and denied claims involving prior conditions. When you contact the firm, you speak directly with him. No call center, no handoff. Call (314) 361-4300 or fill out our online contact form.

Frequently Asked Questions