Most Missouri workers are eligible for workers’ compensation benefits to cover the costs of medical expenses and missed wages caused by work-related injuries. In some cases, these benefits may also apply to the effects of recognized occupational illnesses, subject to certain limitations. If you have questions about the types of workers’ compensation benefits for which you may be eligible, consider calling the Rolla workers’ compensation lawyers at Steelman Gaunt Crowley and scheduling a free consultation to review your case. You can reach us at (573) 341.8336.
What Is Workers’ Compensation and How Does It Work?
Individuals who are injured “on the job” often have concerns about how they will cover the costs of medical care to treat their injuries, as well as how they will make up for the wages they may miss if they need time off from work to recover. Fortunately, most employees throughout the United States are able to receive coverage for medical care needed to treat injuries or illnesses sustained as a result of their job-related activities, and in many cases, they may also be eligible for partial replacement of their wages to mitigate the loss of income if they are unable to work for an extended period.
The practice of covering job-related medical expenses and, to a lesser extent, the costs of wages lost due to injuries or illnesses resulting from an employee’s performance of his or her job duties is called workers’ compensation, and workers’ compensation programs – also sometimes informally referred to as “workers’ comp” or, in a holdover from the days when the “default” employee was presumptively male, “workmans’ comp” – provide workers’ compensation benefits, managed through workers’ compensation insurance. Most employers in the United States are required to maintain some form of workers’ compensation insurance coverage, but the specific requirements for how such policies are determined and which workers must be covered under a company’s plan can vary from one state to the next, so you may wish to consider speaking with an attorney in your jurisdiction to be sure you understand the workers’ compensation legal requirements in your area.
Types of Workers’ Compensation Benefits
There are two primary types of workers’ compensation benefits: coverage for medical treatments and wage-replacement benefits. The Missouri Department of Labor & Industrial Relations further subdivides wage-replacement benefits into four categories:
- Temporary total disability
- Temporary partial disability
- Permanent total disability
- Permanent partial disability
In Missouri, if an eligible employee sustains an injury or illness in the course of performing their assigned duties at work, the employer or the employer’s insurer is required by law to cover the costs of medical treatments needed to help the worker recover from their injury. The employer, or the company with whom the employer maintains a workers’ compensation insurance policy, is allowed to choose the health care provider or providers the employee sees for assessment and treatment following a work-related injury, and the employee’s benefits may be reduced or eliminated if their injury can be shown to have been caused or exacerbated by a failure to maintain the employer’s workplace safety standards, among other exceptions outlined under MO Rev. Stat. §287.120, but the medical coverage itself is a legal requirement for workers’ compensation insurance policies.
How Much Are Workers’ Comp Benefits in Missouri?
Technically, the payments made on an injured worker’s behalf to cover the costs of his or her medical care related to a work injury, just as much as the wage-replacement payments for which some injured employees may be eligible, are “benefits” provided through the employer’s workers’ compensation insurance provider. There is no “cap” to the total costs of care covered, as long as the insurance provider agrees that the workers’ compensation claim is “compensable” (generally speaking, “compensable” means that the injury for which the employee is seeking treatment stemmed from a valid work-related activity and the treatment the employee is receiving is recommended and administered by a provider approved by the insurance company).
In most cases, however, when injured workers have questions about the amount or scheduling of workers’ compensation benefits, most often they have in mind Missouri’s requirements for wage replacement eligibility. For these types of workers’ compensation benefits, there can be a few factors that may affect both the individual workers’ eligibility and the total amount paid.
Total Temporary Disability
Injured employees who have to miss three or more days of work due to their job-related injuries are entitled to partial wage-replacement benefits known as “total temporary disability” benefits. The terminology can be confusing because these “partial” wage replacements are made to cover “total” disability, but the important thing to remember is that all workers’ compensation wage replacement benefits in Missouri are “partial” – the payments do not cover the full amount of lost wages, but rather a percentage.
Total temporary disability wage replacement benefits begin with the fourth consecutive day of work missed on a doctor’s orders pursuant to a “compensable” injury claim and are calculated as two-thirds of the employee’s average wages, up to 55% of the state average wage. High-income employees will therefore see the sharpest drop in wages due to time off due to work-related injuries, but the schedule for benefits payments will be the same regardless of the amounts, and eligible employees who miss more than two full working weeks will receive “back pay” for the initial three-day waiting period.
Partial Temporary Disability
Sometimes the doctor approved by the employer’s insurance company may recommend a period of “light duty” during their recovery. These recommendations are common after a number of accident-related injuries, as well as for several days or weeks after certain types of surgeries. If an employee is able to return to work with restricted activities, and the employer is willing to offer work that falls within the medical guidelines at a reduced wage, then the employee may be eligible for partial wage replacements to cover the partial loss of income occasioned by their partial disability.
Permanent Partial Disability
In some cases, the effects of the worker’s injury or injuries may be lifelong, and the employee may never be able to return to their former job role. In these instances, if the individual is able to re-enter the workforce but with restricted earning potential, they may be eligible for long-term payments to make up for a portion of the difference between the income they are able to earn after reaching “maximum medical improvement” and the wages they were earning prior to the work-related injury. Ensuring the accuracy of the calculations involved can be difficult, and you may wish to consider speaking with an attorney if permanent partial disability becomes an issue in your case.
Permanent Total Disability
In the most unfortunate cases, a worker’s injuries may be so severe that a doctor may determine that the individual is unlikely to be able to return to work in any capacity. In these situations, the employer’s workers’ compensation insurance provider may be called upon to cover a permanent payment schedule for partial wage replacement due to total disability.
Speak With an Experienced Workers’ Compensation Attorney in Your Area
Missouri employees may find themselves asking a number of questions about the types of workers’ compensation benefits for which they may be eligible, as well as how to navigate the process of filing and pursuing a Missouri workers’ compensation claim. Fortunately, the workers’ compensation team at Steelman Gaunt Crowley has decades of experience helping Missouri residents find answers and pursue fair resolutions to their justified claims – and our team offers free evaluations for Missouri workers’ compensation cases. Call (573) 341.8336 to learn more today.
