The first thing you should do when you have suffered an injury on the job is to report the injury to your supervisor immediately. Your supervisor should make a report of the injury to indicate how, when, and where the injury happened. This report can and may be used as evidence in a court of law.

Next, seek medical attention ASAP. If an employer refuses to provide medical treatment, you should seek needed care on your own and obtain documentation of that. It is also best to document the denial of medical treatment by your employer in that event. Write down who you spoke with, what was said to you, and when. Speak to a lawyer as soon as you can and save this information for them.

Keep all of your medical appointments, make sure you keep your employer informed of your medical condition, and when you can return to work. Your doctor will generally provide you with a form to give to your employer. Be sure to keep copies of these forms for yourself as well.

Almost any injury sustained in the course and scope of one’s employment is covered under workers’ compensation. However, laws are in flux and there is an increasing trend for states and employers to deny coverage. Obtain an in person or telephone consultation with a lawyer as soon as you can following an injury sustained on the job.

• Medical Care: including physician bills, prescriptions, hospital bills, surgeries, laboratory tests, other tests including X-rays, physical therapy, and assistive devices such as crutches, should all be paid for by the employer.
• Lost Wages: the employer pays lost wages following strict guidelines. A waiting period applies before any lost wage benefits are paid. To receive any payment for lost wages, you must be disabled for three consecutive days. If you are disabled for more than fourteen consecutive days, the original three-day waiting period will be paid.
• Mileage: mileage is paid to the employee in some cases.
• Funeral Expenses and Death Benefits: when a workers’ compensation injuries result in death, funeral expenses and death benefits are paid when an on-the-job injury results in the worker’s death. The amount of the benefit payable to a dependent depends on several factors.
• Temporary Total Disability: temporary total disability results from an injury that keeps an employee from working temporarily. These benefits, subject to a few rules, are paid until the doctor releases the employee to return to work.
• Temporary Partial Disability: temporary partial disability refers to an employee who can work on light duty less than full pay and full duty.
• Permanent Partial Disability: permanent partial disability refers to a permanent disability that does not prevent a person from returning to some employment. If a person is determined to have a permanent partial disability, they may receive a lump sum settlement based on the percentage of disability.
• Permanent Total Disability: permanent total disability refers to a person who will never work a regular full-time job again. An attorney can often settle the case for a lump sum of money in exchange for lifetime payments. Moreover, an attorney will advise you if a lump sum offer fairly compensates the worker for the life benefits he or she would have received.

Filing for workers’ compensation after a work-related injury can seem like a straightforward process, but many claims in Missouri are denied for various reasons. If your workers’ compensation claim is denied, it’s important to understand why and what you can do to challenge the decision. Below are some of the most common reasons for workers’ compensation claim denials in Missouri and how an experienced attorney like Dr. Brad Bradshaw can help you navigate these challenges.

1. Insufficient Evidence of Injury

One of the most common reasons for claim denial is the lack of sufficient medical evidence proving that the injury occurred at work. Missouri workers’ compensation laws require claimants to show that their injury was directly related to their job duties. If there’s no clear documentation or if the medical records don’t support the claim, the insurance company may deny it.

• How to Avoid This: Make sure to seek immediate medical attention after your injury and clearly explain to the doctor how the injury is related to your job. Keeping detailed medical records and obtaining testimony from healthcare professionals can strengthen your claim.

2. Missed Deadlines

Missouri law imposes strict deadlines for reporting work injuries and filing workers’ compensation claims. If you fail to notify your employer or file your claim within the required time frame, your claim may be denied.

• Missouri’s Reporting Deadline: You must report the injury to your employer within 30 days of the incident. The sooner you report the injury, the better, as waiting too long can lead to questions about the validity of your claim.
• Claim Filing Deadline: In Missouri, you generally have two years from the date of injury to file your workers’ compensation claim, though in some cases, this may be extended to three years.

3. Disputed Injury

In some cases, the employer or their insurance company may argue that your injury is not work-related or did not occur while you were performing job duties. For example, if you were injured during your lunch break or while engaging in horseplay, the insurance company may dispute the claim.

• How to Challenge This: Gather witness statements, security footage, or other evidence that proves your injury occurred in the course of your employment. Dr. Brad Bradshaw can help you gather and present this evidence effectively.

4. Pre-Existing Conditions

Missouri workers’ compensation law does not cover injuries caused solely by pre-existing conditions. If your injury aggravates a pre-existing condition, your claim may be denied, especially if the insurance company argues that the injury was not substantially worsened by work-related activities.

• How to Avoid Denial: If you have a pre-existing condition, be sure to document how your job duties directly worsened the condition or caused additional injury. A medical professional’s testimony can be critical in these cases.

5. The Injury Was Not Reported Properly

Failure to provide adequate or accurate details about the injury to your employer or on the workers’ compensation claim form may result in a denial. If there is any inconsistency in your statements about how the injury occurred, it can raise red flags for the insurance company.

• How to Avoid This: When reporting your injury to your employer, be detailed and consistent in explaining how it happened. Keep a personal record of the events surrounding the injury to ensure accuracy when filing the claim.

6. No Medical Treatment or Delayed Treatment

If you did not seek medical treatment or waited too long to see a doctor, the insurance company might argue that the injury wasn’t serious or didn’t happen at work. Prompt medical treatment is crucial to establishing a connection between the injury and your job.

• How to Challenge This: Always seek immediate medical care after a workplace injury, and follow your doctor’s recommendations. A detailed medical report can serve as key evidence in proving the validity of your claim.

7. The Employer Disputes the Claim

In some cases, your employer may outright dispute that the injury occurred or argue that you were not injured while on the job. Employers may dispute claims to avoid higher insurance premiums or if they believe the injury wasn’t serious enough to warrant workers’ compensation.

• How to Respond: If your employer disputes your claim, an attorney can help you file an appeal and present evidence, such as witness testimonies or expert reports, that prove the validity of your claim.

8. Misclassification of Employees

If you are classified as an independent contractor rather than an employee, you may not be eligible for workers’ compensation benefits under Missouri law. Employers sometimes misclassify workers to avoid paying insurance premiums.

• How to Challenge Misclassification: An attorney can help you prove that you were misclassified and should be considered an employee eligible for workers’ compensation benefits. Factors such as your work schedule, control over duties, and the nature of the job can help establish your employment status.

Conclusion

Workers’ compensation claim denials are common, but they are not the end of the road. If your claim is denied for any reason, it’s important to seek legal advice. Dr. Brad Bradshaw has extensive experience handling workers’ compensation cases and can help you appeal a denial, gather necessary evidence, and fight for the compensation you deserve. Contact us today for a free consultation and let us help you navigate the complexities of Missouri workers’ compensation law.

If you’ve been injured on the job in Springfield, Missouri, you may be entitled to workers’ compensation benefits to cover your medical expenses and lost wages. However, the workers’ compensation process can be complex, and insurance companies may try to limit or deny your benefits. This is where a workers’ compensation lawyer can help. Here’s a breakdown of what workers’ compensation lawyers do in Springfield, MO, and why hiring one can be crucial to the success of your claim.

1. Evaluate Your Workers’ Compensation Claim

A workers’ compensation lawyer will begin by reviewing the details of your injury and employment situation to determine whether you have a valid claim. In Missouri, workers’ compensation covers a wide range of injuries, but proving that your injury was job-related is crucial. A skilled lawyer will assess whether your case meets the legal requirements for a workers’ compensation claim.

2. File and Submit Your Claim

Filing a workers’ compensation claim involves significant paperwork and adherence to strict deadlines. Your lawyer will ensure that all required forms and documents are properly filled out and submitted on time, reducing the risk of your claim being delayed or denied due to administrative errors.

3. Gather and Present Evidence

To build a strong workers’ compensation case, your attorney will collect crucial evidence, such as:

• Medical records proving the extent of your injuries and treatment.
• Witness statements from coworkers who saw the accident or were aware of your job duties.
• Accident reports or safety violation reports that may have contributed to your injury.

Having comprehensive evidence will strengthen your claim and help counter any challenges from the insurance company or employer.

4. Negotiate with Insurance Companies

Insurance companies often look for ways to minimize payouts, and they may offer low settlements or deny claims entirely. A workers’ compensation lawyer will handle all communications with the insurance company on your behalf, ensuring that your rights are protected. Your attorney will negotiate aggressively to secure the maximum compensation for your medical bills, lost wages, and any permanent disability.

5. Represent You in Appeals

If your workers’ compensation claim is denied, your lawyer can file an appeal and represent you throughout the appeal process. This may involve presenting your case to the Missouri Division of Workers’ Compensation or, in some cases, taking the matter to court. Your lawyer will guide you through this process and ensure that all legal arguments are presented effectively.

6. Help You Receive Proper Medical Care

In Missouri, employers typically have the right to choose the medical provider for your workers’ compensation-related care. However, your lawyer can help ensure that you receive appropriate medical treatment and may be able to advocate for a second opinion or a change in provider if the care you are receiving is insufficient.

7. Secure Permanent Disability Benefits (If Applicable)

If your injury results in long-term or permanent disability, your lawyer can help you pursue permanent disability benefits. This may include:

• Temporary Total Disability (TTD): Benefits if you are unable to work temporarily.
• Permanent Partial Disability (PPD): Compensation for lasting injuries that partially impair your ability to work.
• Permanent Total Disability (PTD): Benefits if you are permanently unable to return to work.

Your lawyer will work with medical professionals to assess the extent of your disability and ensure that you receive the full benefits you’re entitled to under Missouri law.

8. Protect You from Employer Retaliation

Sometimes, injured workers fear that filing a workers’ compensation claim will result in retaliation from their employer, such as being demoted, fired, or harassed. Under Missouri law, employer retaliation is illegal. A workers’ compensation lawyer can protect your rights by holding your employer accountable if they take adverse actions against you for filing a claim.

9. Advise on Other Legal Remedies

In some cases, your workers’ compensation claim may not be your only legal option. If a third party (such as a subcontractor or equipment manufacturer) contributed to your injury, your lawyer may advise you on the possibility of filing a personal injury lawsuit in addition to your workers’ compensation claim. This can help you recover additional damages that workers’ compensation may not cover, such as pain and suffering.

10. Provide Peace of Mind

Navigating the workers’ compensation system can be overwhelming, especially when you’re recovering from an injury. By hiring an experienced workers’ compensation attorney, you can focus on your recovery while knowing that your legal matters are in capable hands. Your lawyer will handle every aspect of your case, from filing paperwork to negotiating with the insurance company, giving you peace of mind throughout the process.

Conclusion

If you’ve been injured on the job in Springfield, MO, working with a skilled workers’ compensation lawyer like Dr. Brad Bradshaw can significantly increase your chances of receiving the benefits you deserve. With a deep understanding of Missouri workers’ compensation law and extensive experience in handling complex injury cases, Dr. Bradshaw and his team are here to help you navigate the claims process, appeal denials, and fight for your rights. Contact us today for a free consultation to learn more about how we can assist you with your workers’ compensation case.