Abbott, Schappe & Francis, LLC

Workers’ Compensation

The Workers’ Compensation system can be viewed as a compromise between employers and workers. Proving negligence or fault within a work setting can be extremely difficult for a worker who has been injured on the job. While proving negligence or fault is difficult, employers worry that if it is proven, the amount of money that a jury could award would be too burdensome.

The Workers’ Compensation was developed to solve these two problems. Under this system, workers do not have to prove that negligence or fault caused an injury – they merely have to prove that the injury was work related (for example, straining a back while lifting boxes). On the other side, the problems of the employer are solved because the damages that are available under the system are very limited.

The Workers’ Compensation provides three general benefits to the worker.

            1.        Medical care: If a worker suffers a work-related injury, the employer is

obligated under the system to provide the worker with medical care. The employer must provide all care to alleviate the injury until the worker is at “maximal medical improvement.” This means the medial care provided by the employer has made the worker as good as he or she is going to be. It may mean simply a trip to the doctor or hospital, it may mean physical therapy, or it may means surgery.

Medical care is one of the most disputed parts of a workers’ compensation case. Most employers hire insurance companies to insure them against workers’ compensation claims. The insurance companies then direct the case on behalf of the employer. Insurance companies want to pay as little as possible on a workers’ compensation case. Therefore, it is not unheard of for an insurance company to deny needed coverage or medical services to an injured worker.

There is nothing that prevents a worker from seeking medical care on his or her own, however, unless the insurance company has denied coverage or denied a needed service, the employer will not be responsible for the medical bill. Abbott, Schappe & Francis, LLC always advises its workers’ compensation clients to make a written demand for further coverage to a human resources officer or supervisor before seeking medical care on his or her own. This protects the client against later claims from an employer that it did not know the client needed more medical care.

If an employer or its insurance company denies medical care, a worker can later be reimbursed for the medical bills as part of a workers’ compensation settlement or award from a worker’s compensation court.

            2.         Temporary Total Disability: Also known as TTD, temporary total disability is designed to help a worker continue to be able to pay bills while recuperating from an injury. The amount a worker can receive through TTD is generally two-thirds of the worker’s weekly wages, up to $742.72 per week . TTD is tax free.

TTD is available until a doctor releases a worker to go back to work. If a doctor has released a worker to return to work prematurely, and the worker can prove this, the worker can be reimbursed for TTD benefits that should have been paid as part of a workers’ compensation settlement or award.

Employers often ask a worker to take vacation time, sick leave, or short term disability while recuperating instead of taking TTD. This frequently happens when a worker does not know of his or her right to TTD and the employer does not reveal it. Under a recent law change, TTD is not available to a worker for attending doctor’s appointments, medical treatments or physical therapy – only for recuperation time away from work.

            3.         Permanent Disability: There are two types of permanent disability available under the Workers’ Compensation system; permanent partial disability and permanent total disability.

Permanent partial disability – or PPD – is available to workers who have permanently injured one part of the body. Under the system, each body part is assigned a certain number of weeks. A mathematical formula established by law determines the amount of the award based upon a “disability rating.”

While this sounds confusing, a skilled workers’ compensation attorney, such as those at Abbott, Schappe & Francis, LLC, will easily be able to perform this calculation. Frequently, an attorney for a worker and an attorney for an employer send the worker to different physicians and get different ratings. One of the areas of contention in the case is then which rating is the correct rating, the higher or lower rating.

Permanent total disability – or PTD – is available to a worker who has suffered an injury that has left him or her completely unable to work. PTD requires employers to make payments of two-thirds of a workers’ weekly wages to a worker every week until the time of his or her death. Sometimes, PTD cases are settled by determining a worker’s life expectancy through an actuarial table and then a lump sum payment being made to the worker instead of weekly payments for the remainder of a person’s life.

The statute of limitations in a workers’ compensation case can be short and a worker should contact an attorney right away if he or she is considering pursuing a claim.

A similar but distinct concept is notice to the employer. Even if a claim is filed within the deadline set by the statute of limitations, a worker could face a loss of benefits if he or she does not notify the employer of the injury within a set period of time. Abbott, Schappe & Francis, LLC advises its clients to notify employers as soon as possible following a workplace injury of the existence of the injury. This is especially true for repetitive motion injuries that develop over time and are not the result of a workplace accident.

The second injury fund is a fund administered by the state of Missouri that helps pay for the added disability that sometimes occurs when an older injury and a new injury combine to make a person more disabled then he or she otherwise would be. For instance, a ten year old knee injury and a current shoulder injury may render a worker more disabled than the simple mathematical sum of the two injuries. The second injury fund is designed to pick up the difference.

Abbott, Schappe & Francis, LLC advises its clients to adhere to all safety policies that are established by an employer. If an employer has safety policies that have been explained to workers and the worker fails to follow them, benefits under the Workers’ Compensation system can be reduced.

Finally, a worker should take into consideration attorney fees and litigation expenses when looking for a lawyer. Abbott, Schappe & Francis, LLC charges a 25% contingency fee in these cases. This means that the legal fee will be 25% of the amount of money received on the case.

There are several litigation expenses that occur in a workers’ compensation case. These can include a fee for an examination by a doctor to provide a rating, charges to obtain medical records, and court reporter fees. Abbott, Schappe & Francis, LLC fronts these expenses. We pay for these at the beginning and then get reimbursed after the case settles or an award is granted. This way, our clients never have to put forth their own money. The bottom line is that if a client gets nothing, we get nothing.

The decision to pursue a workers’ compensation case is an important one. Abbott, Schappe & Francis, LLC takes the approach that the injured worker is the most important person in the system. We work to quickly get clients the maximum recovery possible. If you have been injured at work, please call us to set up an appointment.