The workers’ compensation system provides benefits that injured workers rely on after suffering a work-related injury or illness. Workers want to ensure that they negotiate a fair workers’ comp settlement, which may be the only financial assistance they are receiving while off work. Read on to learn the top secrets to negotiating a fair settlement from the seasoned negotiators at Steelman Gaunt Crowley. If you are negotiating a workers’ compensation settlement yourself, consider calling (573) 341-8336 to schedule a consultation with one of our experienced workers’ compensation attorneys.
Workers’ Compensation in Missouri
Workers’ compensation is a no-fault insurance system mandated by the State of Missouri. Under this system, employers are required to pay benefits to employees who are injured on the job within the course and scope of their employment. In most cases, workers’ compensation is the sole remedy, meaning that workers generally cannot sue their employers for compensation but instead must use the workers’ compensation system to recover financial compensation.
The Division of Workers’ Compensation of the Department of Labor and Industrial Relations oversees the workers’ compensation system in Missouri. Most workers’ compensation claims are handled by filing a claim with your employer’s workers’ compensation insurance provider.
Who Must Carry Workers’ Compensation Insurance?
According to the Missouri Department of Insurance, employers with five or more employees must be covered by workers’ compensation insurance, with some specialized rules applying to contractors in the construction industry that maintain a regular staff. Some rules apply to construction subcontractors with hourly employees, as well. Employees that are covered by Missouri workers’ compensation can be any of the following:
- Full-time employees
- Part-time employees
- Seasonal workers
- Temporary workers
Most Missouri employers must maintain workers’ compensation insurance, but there are some exceptions. For example, direct salespeople and farm laborers may not need to be covered. Employers can fulfill their obligations to maintain workers’ compensation by purchasing private insurance or by self-insuring.
What To Do After a Work Injury
The potential workers’ comp settlement an injured employee receives can be influenced by the steps they take immediately after the incident. For this reason, it can be useful for workers to familiarize themselves with the following best practices:
Reporting Your Injury
As soon as possible, report your injury to your employer or manager. The Division of Workers’ Compensation warns that failing to report the injury to your employer within 30 days can jeopardize your claim. If you reported the accident verbally, follow up with a written report within this timeframe.
Seeking Medical Care
If the injury is an emergency, seek emergency treatment. If it is not, your employer has the right to determine the health care provider if they are paying for the services, according to the Division of Workers’ Compensation. You can choose the provider if you pay for your own care.
Filing a Claim
File a claim with your employer’s workers’ comp insurer. If anyone else witnessed the accident, you can ask for a supporting statement to include with your claim.
Filing an Appeal
If you disagree with the insurer’s decision, you have the right to appeal it. Once you have gone through the hearing process and an administrative law judge has rendered a decision, you can ask the Labor and Industrial Relations Commission to further review the decision. The request for review must be filed within 20 days of the decision from the administrative law judge.
How Do You Negotiate a Workers’ Compensation Settlement?
Favorable rulings from government agencies with oversight over labor claims are not the only path toward compensation. Often insurance companies will offer settlements, in various amounts, during the claim and appeals process. Here are some tips to help you negotiate a fair workers’ comp settlement:
Learn Which Benefits May Apply to Your Situation
In addition to payment for the medical services you need to treat your workplace injury or illness, you may also qualify for partial wage replacement benefits. These can include:
- Temporary partial disability benefits: These benefits are two-thirds of the difference between the worker’s average earnings before the accident and the amount the employee makes after the injury, defined as a period during which they are cleared to return to work, but with some medical restrictions, such as not lifting heavy items or not standing for long periods of time.
- Temporary total disability benefits: Temporary total disability benefits are paid to an employee who cannot work at all during a limited period of time. These benefits are two-thirds of the worker’s average weekly wage, up to a state maximum.
- Permanent partial disability benefits: Permanent partial disability benefits are paid to workers whose ability to work certain types of jobs or work-related tasks are permanently hindered, but who are still able to work in some capacity. These benefits are generally two-thirds of the worker’s average weekly earnings but are sometimes paid in a lump-sum benefit.
- Permanent total disability benefits: Permanent total disability benefits are paid when the workplace injury or illness leaves the worker permanently disabled. In this case, the worker can receive two-thirds of their average weekly earnings for life or negotiate a lump-sum payment.
Follow Your Doctor’s Orders
Following all of your doctor’s orders and restrict activities as recommended is critical. This step can help you prevent further injury and also protect your legal claim.
Reach Maximum Medical Improvement
Maximum medical improvement (MMI) is the point in which an injured worker has recovered as much as is expected. In most cases, you will need to reach MMI before you can attempt to reach a final settlement, because often it is only at this point that the full extent and nature of someone’s injuries can be accurately determined. Assessment by a medical professional at this point helps to establish any lingering disability as a result of the injuries as well as documenting any need for ongoing care to manage post-injury conditions. Only with this assessment in will you be able to negotiate a fair workers’ comp settlement.
Keep Your Employer Informed
While you are out of work, be sure you stay in touch with your employer. Notify them of the doctor’s findings and recommendations. If you are assigned to light or restricted duty, you may need to work these duties to remain eligible for your benefits. If you disagree with any of your doctor’s findings, consider discussing your situation with an experienced workers’ compensation attorney to review your legal options.
Work With an Experienced Lawyer
Workers’ compensation lawyers are familiar with the system and the process of filing claims. A lawyer can manage your claim while you focus on your recovery.
Can You Negotiate a Compromise and Release?
Injured workers can agree to accept a settlement offer and release their employer from further legal action. This is called a compromise and release. Arrangements of this type generally provide a lump-sum payment to the claimant.
However, a compromise and release may not be the best for injured workers in all situations. They may not provide for future medical care, and in some cases there may be financial consequences involved in taking a lump sum. An experienced workers’ compensation lawyer from Steelman Gaunt Crowley can provide valuable legal advice and guidance so that you are informed throughout the process and have someone advocating for your interests at all times.
How Long Does It Take To Negotiate a Settlement?
Every workers’ compensation claim is different. Some claims are resolved within a few weeks, while others may take more than a year to resolve.
There is no truly “typical” timeframe for reaching a resolution in a workers’ compensation matter. Factors that can affect the amount of time it takes to reach a workers’ comp settlement include:
- The nature and severity of the injury
- Whether the employer contests liability for the injury
- The length and duration of treatment
- The benefits for which the claimant may be eligible
- Whether there are appeals
Contact an Experienced Lawyer for Help Negotiating a Workers’ Comp Settlement
If you would like assistance pursuing a workers’ comp settlement after suffering a workplace injury, consider contacting an experienced workers’ compensation lawyer from Steelman Gaunt Crowley. We can review your situation during a free, no-obligation consultation you can arrange by calling (573) 341-8336.