If this is your situation, you’re not alone. This is a common scenario that many injured workers find themselves in.
When a worker is injured, it’s the job of the adjuster and insurance doctor to get you back to work as soon as possible. That means they’re not on your side. In fact, both parties are often unprofessional, making it difficult for you to get the benefits you need and deserve.
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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]
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]
God bless, love and hugs
Jim
Fighting for the injured.
James Hoffmann
Your Missouri car accident and workers comp lawyer
314 361 4300
[email protected]
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]
James Hoffmann
St. Louis, Mo work comp and car accident lawyer
314 361 4300
Law Office of James M Hoffmann
314 361 4300
[email protected]
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
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]
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.”
Merry Christmas.
James Hoffmann, Missouri work comp and auto accident attorney
314 361 4300
[email protected]
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
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.
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.
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
James Hoffmann
314 361 4300
[email protected]
Law Office of James Hoffmann
314 361 4300
[email protected]
James Hoffmann
attorney
St. Louis workers comp and car accident lawyer
314 361 4300
[email protected]
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]
Law Office of James Hoffmann
St. Louis personal injury and work comp lawyer.
314 361 4300
[email protected]
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)
Law Office of James M. Hoffmann
2001 S. Hanley
St. Louis, MO 63144
314 361 4300
[email protected]
James M Hoffmann, attorney
2001 S. Hanley, suite 325
St. Louis, MO 63144
314 361 4300
[email protected]
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]
Law Office of James M. Hoffmann
St. Louis, MO car accident and workers compensation lawyer
314 361 4300
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]
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.
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]
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]
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
James Hoffmann
St. Louis, MO auto accident and workers compensation lawyer
314 361 4300
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],
Jim Hoffmann
Missouri workers compensation and car accident attorney
314 361 4300
St. Louis, MO
Compensation? Get this lawyer. Simply better than all the rest.
James Hoffmann
314 361 4300
[email protected]
James Hoffmann
Missouri workers compensation and auto accident lawyer
314 361 4300
[email protected]
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.
Law Office of James M. Hoffmann
314 361 4300
James Hoffmann, attorney
314 361 4300
[email protected]
Gold bless
James Hoffmann, attorney
314 361 4300
Law Office of James M Hoffmann
St. louis, MO injury attorney
314 361 4300
If you have been injured at work and the insurance adjuster has figured out a way to cut off your weekly check, or your doctor won’t listen to you because they don’t have your best interests at heart, call the Law Office of James M. Hoffmann. We can stop the carrier and employer from harassing you into returning to work before your doctor says that you are ready to return to work. In addition, you need to make certain you have a good doctor working for your interests, not trying to make the insurance company happy so that they can maintain a good relationship with the carrier.
Your Doctor vs the Insurance Doctor
Adjusters always base paying TTD on the opinion of the authorized treating doctor because that doctor is usually very biased toward insurance companies. They will: give you the least amount of time off work, give you the least amount of protective restrictions, or send the injured worker back to work despite complaints.
But, remember that employees are free to treat with their own doctors and decline treatment from the insurance doctor. Yes, the employee has to pay for his/her own doctor. But it is perfectly legal to have the work comp doctor do your lumbar fusion or rotator cuff tear surgery, then decline further treatment with the work comp doctor and do the rest of your treatment with your own doctor. It is also perfectly legal to use your health insurance to pay for a work injury. But, the problem there is that “front desk” personnel at many medical offices do not understand this and will refuse to submit to your bills to your health insurance saying “we need to be approved by the work comp insurer” but this is wrong!
Workers compensation adjusters will “counter” your private doctor’s off work recommendations by getting an independent medical exam (IME) with a doctor they chose. When the insurance company doctor says full duty, and your doctor says to stay off work, and of course they follow the work comp doctor recommendations, then a hardship hearing is needed to resolve the issue.
If Your Employer Gives You a Humiliating or Unsafe Job
Many workers comp doctors play games. For example, after a surgery they will authorize 3 days off work and then light duty. No TTD is paid for those 3 days, and then the employer provides a worthless made up job that is humiliating to the employee.
The work comp statute, CH. 287, mandates no retaliation by an employer, so in a situation where the employer gives the employee a humiliating job, or says “go work at this other place down the street until you are full duty; we will pay you.” However, this other job is unsanitary and unsafe.
If something similar has happened to you, give the employer a letter, and keep copies. In the letter ask why employees who are injured outside of work are not forced to do this; ask where in the employee manual are you required to do this; explain that before the injury you got along great with all the bosses but since the injury none of the bosses will talk to you; explain why the workplace down the street is unsafe and not sanitary.
How to Deal With an Unprofessional Doctor
Another game is where the authorized doctor says “full duty trial” while you are still treating. Even though you know you can’t do your job due to ongoing pain and limitations, you contact your employer who says “sorry, we don’t need you anymore.” So, the workers comp adjuster cuts off your TTD saying “the doctor said full duty.” You are unable to work because of your injury and your employer offers you no work. The work comp doctor didn’t listen to you when you said there is no way I can work.
In this situation, the best plan is within a few days of your doctor visit, drop off a letter at the front desk of the doctor’s office. Date it! Write “please put this letter in my medical records” across the top. Print your name, email, and cell at the bottom. Using short and simple sentences, confirm what you told the doctor, confirm how he refused to answer your questions, and confirm that when you said “I am a laborer for a concrete company. You did a 2 level lumbar fusion. I am 6 weeks out from surgery and still in severe pain”, that the doctor just looked at you and refused to address your concerns. CC your employer and given them a copy of the letter along with a letter demanding a new doctor and explaining you cannot work full duty as you fear further damage to your lower back. Keep copies!
Then, file a complaint against the doctor: https://pr.mo.gov/healingarts-complaint-forms.asp. Your relationship with a work comp doc is supposed to be the same as with your primary care doctor – professional! Being unprofessional, disrespectful, and ignoring your concerns are all grounds for a licensing complaint. These complaints will be the only way we can stop biased and unprofessional doctors.
Insurance Adjusters Want to Cut Off Your TTD Benefits
Insurance adjusters want TTD cut off as soon as possible. Demanding the authorized treating doctor to cut off TTD would get them sanctioned. So instead they start emailing, calling, and writing the doctor (yes, they will harass their own doctors) about “when do you expect MMI.” This is the “hint” that the adjuster wants the employee released to full duty so that TTD can be stopped. You may notice a change in the doctor’s attitude. Maybe you had a nice doctor and then, out of nowhere, he becomes abrupt and says got back to work: my bet is that we’ll find recent letters, emails, or calls to that doctor from either the adjuster or the nurse case manager, asking about MMI or returning you to full duty.
The Letters You Write are Critical
Your letters to the doctors and to your employer are critical in proving what actually was said at a doctor visit. You will be shocked when you finally get your medical records and see that your doctor failed to document your complaints: “patient still sore but getting better”. Your letters are worth their weight in gold at trial: short sentences; keep them simple; keep them short; date them; keep copies; do not mail them:either fax or drop off at front desk even if they refuse.