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Workers' Compensation Benefits
Determining the full workers' compensation benefits you are entitled to receive can be complicated. The determination can depend on calculations of your average weekly wage, which can be complicated depending on the industry in which you work. The insurance adjuster will often argue that you injury is not serious and will attempt to minimize your workers' compensation benefits. We have been representing injured Missourians for over 30 years. We know the benefits you are entitled to receive, and we know how to get them for you.
Below, we provide answers to some frequently asked questions regarding workers' compensation benefits. If you have any questions regarding workers' compensation benefits, call us today at today at 417-623-0900 or 800-371-8220 or send us an email. We will evaluate your case free of charge. We will never take a fee unless and until we obtain a settlement or award for you.
What benefits are included under WC?
Generally, there are three kinds of benefits. Your employer should pay for all of the medical care necessary to treat your injury. As explained below, your employer has the right to choose the doctors to furnish this service. Second, your employer should pay you two-thirds of your average weekly wage, up to a maximum cap, during the time that you are disabled from employment. See below for an explanation of how weekly benefits are calculated. Third, if you have a permanent impairment because of your injury, you are entitled to a lump sum payment for that permanent disability. See below for an explanation of how the lump sum payment is calculated.
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What are my rights to medical care?
If you require emergency care, your employer should make those arrangements immediately.
Your employer must furnish you with all medical care necessary to treat your work related injury. The employer has the right to select the doctor that will provide the medical care. The employer may also have a right to change doctors. Sometimes if a doctor is recommending medical care that the employer or insurance company believes is unnecessary, the employer will select a new doctor with a different opinion about medical care. This causes many difficulties and if this happens, you may need to contact an attorney experienced at Workers' Compensation law.
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Can I select my own doctor?
Your employer has the right to select a doctor to provide you with medical care and has the obligation to pay for that medical care. You have the right to select your own doctor for a second opinion or for additional medical care, but if you do so, you must pay the doctor that you select.
If you notify your employer that you have been injured and need medical care and your employer refuses to provide you with medical care, then you can select your own doctor, and your employer may be required to reimburse you for your medical expense.
If your employer refuses to provide you with medical care, you should contact an attorney experienced in Workers' Compensation law to advise you.
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What are the weekly disability payments?
Your weekly disability payment is called a temporary total disability (TTD) payment. Generally the TTD payment is two-thirds of the worker's average weekly wage for the last thirteen weeks. If this figure exceeds a maximum set by Missouri law, then the weekly payment is capped at the maximum. There are many alternate rules for calculating the average weekly wage if this simple formula does not apply.
Under Missouri law, you do not receive the weekly benefit for the first three days you are off work unless you are off work more than fourteen days. In that event, you receive the weekly payments from the beginning of your disability.
You have a right to continue to receive the weekly benefit as long as you are disabled from working at your old employment and still receiving medical care.
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What benefits can I expect for a permanent injury?
If you have an injury with a permanent impairment, you are entitled to benefits for the impairment even if you can continue working. For example, you may have a back injury that allows you to continue to work but causes restrictions such as lifting, bending, or twisting. The amount of the disability award is determined by a combination of an impairment rating (given to you by a doctor), your average weekly wage and the part of your body that is injured. For example, if you have a disability of 25% of the right arm, a lump sum payment can be calculated using that rating plus your average weekly wage.
The treating doctor, selected by your employer, may give you an impairment rating, when your medical care is completed. You are not bound by that rating and you have a right to a second opinion, but you must pay for the second opinion. Most doctors do not perform Workers' Compensation disability evaluations, and it is usually necessary to retain an attorney who will send you to a doctor that regularly does Workers' Compensation ratings. Also, the attorney will usually advance the cost of the examination and be reimbursed when your case settles.
The amount of the lump sum settlement payment can usually be settled by reaching a compromise. If a compromise cannot be reached, then a hearing will be held so the Judge can decide on the amount of your disability.
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IMPORTANT - This is not a substitute for legal advice. Please see Disclaimer.
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