We Help Injured Workers Secure Fair Compensation
There is always a possibility of getting hurt on the job, regardless of what sort of work you do for a living. Work-related injuries happen – it is a fact of life. Some occur due to the negligence of an employer or co-employee, or even their intentional act or their failure to act. Most of the time, these workers have the right to file a workers’ compensation claim.
Employees and injured workers are often surprised to learn that those who hire them are required by law to purchase workers’ compensation insurance.
In Missouri, nearly every employer with five (5) or more employees must do so; only domestic servants, farm workers, some real estate agents, direct sellers and commercial trucking owner-operators are excused from this obligation. Moreover, if that employer is in the construction industry, just one employee triggers the obligation to purchase that insurance.
In Illinois, with rare exception, if an employer has one employee (even a part-time employee), it must have workers’ compensation insurance.
Because insurers collect money (aka “premiums”) from the employer in exchange for the coverage of these claims, when injured workers file them, the claim is actually handled entirely by the insurance company. So, if Wile E. Coyote falls off a cliff at the Acme Co. construction site and injures his back, he has the right to file a workers’ compensation claim. Even though Wile will name Acme Co. as his employer, Acme’s insurer will handle everything – including the payment to him. Too often, those injured at work are reluctant to make a workers’ compensation claim for fear of pursuing a claim against the employer/person/business who pays them – when in reality, the entire claim is handled by an insurance company that is contractually obligated to the employer/person/business that pays the insurance premium.
The primary purpose of workers’ compensation is to pay the employee for experiencing an injury that makes him or her “less employable in the open labor market.” In other words, the largest reason there are workers’ compensation laws that require employers to purchase insurance and allow injured workers to file claims is to compensate the worker who has a permanent injury that reduces their capacity and/or longevity to perform work and earn a living. A secondary reason these laws exist is to help the employee during a time when he or she cannot work due to injury. Not every injured worker qualifies for pay after an injury. This benefit, commonly called temporary total disability, assists those workers who have experienced an injury that does not allow them to work for at least ten straight work days.
Every worker, injured or not, knows one thing about the insurance companies: they prefer to hold money than pay it out. This fact is just as certain as the fact that accidents and injuries will occur at work. So, it is not surprising to most workers that the insurance company defending their workers’ compensation claim will attempt to deny or minimize the payout to them. What is surprising to the injured worker, however, is the lengths the insurers will go to in order to minimize the payment, or worse, to deny and limit the health care the worker needs, deserves and has a legal right to receive. A smart employee needs a smart lawyer who knows the legal landscape, and how to avoid hidden landmines.
As a personal injury attorney with 30 years of experience, Noel Sevastianos leads a team of lawyers dedicated to helping injured workers receive the compensation they deserve. If you or a loved one has been injured on the job, the lawyers at Rogers Sevastianos & Bante LLP can help you pursue compensation for a full and fair recovery.
Workers’ Compensation Frequently Asked Questions (FAQ)
What do I do if I am injured at work?
In cases that require immediate and urgent care, the employee needs to seek that care right away – and then report the injury to a supervisor immediately. It is always preferable to report the injury to your supervisor in writing or via email/text – if possible. When the injury does not require urgent care, Missouri employees need to ask the employer to arrange for medical care (because the employer has the right to select who provides your healthcare), and in Illinois the employee can go to whomever he or she chooses. Finally, hire an experienced lawyer who can help you maximize your healthcare and the value of your workers’ compensation case.
How much does it cost to hire a workers’ compensation attorney?
When you choose the Rogers Sevastianos & Bante LLP to handle your case, you won’t pay anything unless we win your case. Our workers’ compensation attorneys work on a contingency basis.
How do I seek medical care for my work injury?
In Missouri, employers have the right to choose which medical providers will treat their employees for a work-related injury. In Illinois, the employee has the ability to select his/her own health care provider. In both states, however, health care must be authorized in order to avoid problems later – like billing issues. Those problems surface because treatment for work-related injuries should be paid by workers’ compensation insurance providers – not the insurer who provides health care coverage to the injured worker.
Let’s use an example to make this point clear: Wile E. Coyote works for the Acme Corporation. The Acme Corp provides Wile with health insurance so he, and members of his family, can receive medical treatment if and when they need it. Acme also pays for workers’ compensation insurance in case a worker is injured in the course of their employment. If Wile falls off a cliff or has an anvil drop on him as he chases roadrunner, his bills for treatment must be directed to the workers’ compensation carrier – not the health care insurer – at reduced rates.
Sometimes, an employer does not have a system in place to report the injury and provide medical care. Other times, employers elect to ignore their legal responsibilities, making it very difficult for the employee to get needed care.
When emergency care is needed, the injured worker can always seek it via an ambulance, visit a hospital’s emergency room or go to an urgent care facility. These visits will create a bill that a Missouri or Illinois employer can challenge as unauthorized or unnecessary treatment, but a skilled attorney can link these expenses to your claim and force the employer to pay them. While the medical bill may go unpaid for a while, it is better to get the medical treatment you require and deserve first then link up the expense later.
The more common problem arises when the employee learns that he/she needs particular treatment (like surgery, an MRI or an injection) from an ER doctor or a treating physician, but the insurance adjuster monitoring the scope and cost of the injured worker’s care simply delays or denies authorization of that treatment. In those instances, the employee must ask for a “denial letter” and/or file a “hardship motion.”
The denial letter is a statement where the employer affirmatively states that it will not provide the particular care requested or any care. That letter allows the employee to represent to a doctor of his/her choice, with confidence, that even though he/she believes the treatment to be for a work-related injury, the employer had refused to pay for it. Health care providers want that statement for their record, as it justifies their billing of private health insurance (as opposed to workers’ compensation insurance), and thereby avoid billing and collection issues that can bog down a medical practice.
However, employers do not like to write denial letters – especially in Missouri – because that allows the employee to select care from their own doctor who the insurer/comp carrier does not control. More often, therefore, the employee will have to file a “hardship” motion, wherein they represent that a doctor has recommended specific care of their work-related injury and that the employer has not provided that care. These motions must be mediated in Missouri within 30 days of the motion’s filing date, and they are almost always resolved prior to hearing by judge’s order or by agreement of counsel.
The steps to receive the health care you need and deserve is not always as clean-cut a process as it ought to be, and an employee is wise to gain the assistance of competent and trustworthy counsel early on in a case, like Noel A. Sevastianos and his team at Rogers Sevastianos & Bante LLP.
Will my workers’ compensation claim include a request for the tremendous pain and suffering I’ve endured since my work injury?
In both Missouri and Illinois, a workers’ compensation claim is an “administrative claim.” Basically, the process for making the claim and pursuing it is very streamlined. For instance, the worker does not need to prove to a jury that his/her employer owed them a duty (like a duty for a safe work environment), breached that duty, and that they suffered damages due to the breach. Instead, the injured worker’s burden to prove a workers’ compensation claim is greatly reduced. The trade-off of a lower burden of proof and a streamlined process for proving the case is that damages recoverable in a jury trial are not available to the injured worker, like pain and suffering, loss of enjoyment of life, inconvenience, etc.
A skilled lawyer, however, always keeps his or her eyes open for the possibility of another claim – one that can be made outside of the administrative process of workers’ compensation laws. Such a claim can be made in civil courts, before a jury, freeing the attorney to make claims for pain and suffering, loss of enjoyment of life and the like. The workers’ compensation lawyers at Rogers Sevastianos & Bante LLP frequently resolve workers’ compensation claims, and then file private lawsuits in civil court against third parties whose negligence injured their client.
What is the statute of limitations for a workers’ compensation claim?
An injured worker in Missouri or Illinois has the right to file a workers’ compensation claim within two (2) years of the injury; however, that two-year period is very often extended by a variety of factors. You should NOT give up on your right to pursue a workers’ compensation claim just because two years have passed since the injury occurred. Instead, seek the help of an experienced and trusted attorney to help you determine if a claim can still be made.
We Help Those Who Are Injured On The Job
At Rogers Sevastianos & Bante LLP, our priority and focus in handling your claim for workers’ compensation includes:
- Maximization of all benefits available to you;
- Obtaining the best medical treatment that you deserve; and
- Educating you about the workers’ compensation system so you understand the process, our goals and how we intend to achieve them.
Our track record is proven, and our competitors and opponents rate us as a firm possessing the highest legal ability and ethics possible. More importantly, our clients agree – consistently scoring us at 14 of 14 in blind ratings.