Workers’ Compensation FAQS – Attorneys in Missouri Have Your Answers
If you sustain a workplace injury, you may have many questions about what you can and cannot do. Our Missouri workers’ compensation attorneys understand that it can be difficult knowing what to do to make sure your rights are protected. That’s why we provide the following frequently asked questions about workers’ compensation. If you have other questions are want to discuss a potential claim, don’t hesitate to contact us immediately. Call (800) 887-4030 today for a free consultation.
- Can I choose my own doctor?
- Do I have options if I am unhappy with my medical treatment?
- What if the doctor tries to bill me for services?
- What if my medical bills are not paid?
- Why is the insurance company refusing to provide medical treatment?
- Can I receive as many medical examinations and evaluations as I’d like?
- Do I have access to my medical records?
- Do I have to use leave time to visit the doctor during my work shift?
- What happens if my workers’ comp case goes to trial?
- What are the types of evidentiary hearings?
- What are the procedures at a hearing?
Can I choose my own doctor?
According to Missouri law, your employer has the right to select your health care providers if you are injured. Typically, the insurance company for the employer makes the decision. Your doctor will be chosen by the insurance company or employer, but will make decisions based on his or her own independent medical judgment. If the employer or insurance company disagrees with the doctor, it may authorize a change in physicians.
- 287.140 RSMo states, in part: “If the employee desires, he shall have the right to select his own physician, surgeon, or other such requirement at his own expense.” The key phrase here is at your own expense. Typically, most employees let the insurance company or employer choose because of this expense. Contact Tolbert Beadle to learn more.
Do I have options if I am unhappy with my medical treatment?
If you are unhappy with your medical treatment, you can request an evidentiary hearing. A judge at the hearing then can decide if your employer or the insurance company is required to provide you with additional medical treatment. This may include specific testing, a referral to a specialist or surgery. You will need to provide medical evidence. In some cases, the judge may allow you to choose your own doctor if the medical treatment you are receiving is endangering your health. Contact us to find out how we may be able to help you at an evidentiary hearing.
What if the doctor tries to bill me for services?
The health care provider selected by the insurance company or your employer is prohibited from billing you directly from you. But to protect yourself from being directly billed, you should notify the health care provider in writing that you have a workers’ compensation case. You will need to inform the provider of your employer’s name; the name of the insurance company used by your employer; your name; the general nature of the injury and where the claim has been filed and the claim number, if you know it. If you have questions, call us for a free consultation at (800) 887-4030.
What if my medical bills are not paid?
As soon as you become aware of any unpaid bills, notify the insurance company. Generally, unpaid medical bills are the result of miscommunication between the health care provider and the insurance company. If your employer or the insurance company does not pay the bill, you can ask the judge to order them to pay the bill. Our attorneys can help you prepare for this type of hearing. Contact us today.
Why is the insurance company refusing to provide medical treatment?
The following are a few reasons why an insurance company might refuse to provide treatment or discontinues your treatment:
- Your case may have been denied for any number of reasons. Your employer may believe the injury was not sustained at work or that it does not meet the definition of accident.
- Your employer or its insurance company may claim your work-related injury or condition has reached “maximum medical improvement.” In other words, you are no longer in need of medical care.
- Your employer or its insurance company may believe your condition is the result of a pre-existing condition.
- Your employer or its insurance company may believe you have missed appointments or otherwise have not complied with your medical treatment.
Contact Tolbert Beadle for help if any of the above reasons have been cited for denying you medical treatment. Call us at (800) 887-4030 for a free consultation. If you believe your employer or the insurance company has refused or discontinued your medical treatment without legal cause, we may be able to help you.
Can I receive as many medical examinations and evaluations as I’d like?
Each case is different, but a few state statutes address this situation. §287.210.1 RSMo states the following: “After an employee has received an injury he shall from time to time thereafter during disability submit to reasonable medical examination at the request of the employer (or) his insurer.” The only restriction on medical examinations is the word “reasonable.” Multiple examinations may be reasonable when the employee has multiple injuries or conditions, or treatment continues for several years. § 287.210.1 RSMo, also states that if the employee “refuses to submit to the examination or in any way obstructs it, his right to compensation shall be forfeited during such period unless in the opinion of the (judge) the circumstances justify the refusal or obstruction”.
- 287.143 RSMo, states: “An employee shall submit to appropriate vocational testing and a vocational assessment scheduled by an employer or its insurer.” Vocational testing and assessment are generally performed by “vocational rehabilitation counselors”; these persons are usually not physicians, but do have specialized training or experience in the area of vocational rehabilitation, job training, and placement. Vocational testing and assessment are usually done only in cases in which the employee is alleging that he is permanently and totally disabled (that is, no longer able to work at any job). The law can be difficult to interpret, which is why we recommend contact us at (800) 887-4030 to discuss your options.
Do I have access to my medical records?
Yes. The law states that every hospital or other person that provided the medical care and treatment to the injured employee shall allow its records to be copied and to furnish full information to the Division or Commission, the employer, the employee or his dependents and to any other party to the workers’ compensation proceeding. You may need to pay copying costs. Pursuant to § 191.227.2 RSMo, a health care provider may charge a fee for copying, in an amount not more than seventeen dollars and five cents plus forty cents per page for the cost of supplies and labor; postage, to include packaging and delivery cost; and notary fee, not to exceed two dollars, if requested. The Missouri Department of Health and Senior Services is required to report the annual adjustment and the adjusted fees that are authorized in § 191.227 RSMo on its website.
Do I have to use leave time to visit the doctor during my work shift?
The law states that your employer may allow or require you to use accumulated paid leave, personal leave, medical leave or sick leave for your medical appointments.
What happens if my workers’ comp case goes to trial?
While most cases settle, some workers’ comp cases that are not settled must be resolved at trial, which is called an “evidentiary hearing.” These are formal matters that are conducted in the same manner as a non-jury civil trial in a Missouri circuit court. You, as the employee, have the burden to prove your case on most contested issues in the case. Proper pre-trial preparation is essential. Because these hearings can be complicated, we recommend you contact a Missouri workers’ comp attorney for a free consultation. At Tolbert Beadle, our attorneys have a comprehensive understanding of workers’ compensation law and are well-versed in courtroom procedures. We know how to present your case in the best light possible. Call (800) 887-4030 today. While you have the right to represent yourself at trial, it is never a good idea.
What are the types of evidentiary hearings?
1) “Hardship hearing:” Requested by an employee or his or her attorney when there is a dispute over medical treatment, payment of temporary total disability benefits or both.
2) “Final hearing:” Requested by either party and generally results in the judge issuing a “final award” and is the end of the case (unless there is an appeal).
What are the procedures at a hearing?
Whether you are attending an evidentiary hearing or hardship hearing, the same procedures are in place. You and your lawyer will appear before a judge and a court reporter. The other parties will also attend. You will tell the judge which issues you agree on (called stipulations) and which issues you do not agree on. The judge will address the contested issues in the award. The next step will be evidence, or testimony by the employee. In some cases, other witnesses may be called to testify. Anyone who testifies will be sworn by the judge to tell the truth. If you are testifying, you will be subject to cross-examination by the other parties’ lawyers.
As the employee, you will present medical evidence, which may include medical records and statements from doctors. While doctors sometimes appear to testify, they usually provide their testimony in depositions. After you are done presenting evidence, the employer or insurance company will present evidence.
The court reporter records verbatim everything said during the evidentiary hearing, including testimony and anything else said at the hearing. The court reporter also marks all exhibits for identification.
When the evidence has been presented, the judge may allow the parties a window of time (usually 21 days or less) to file “briefs” in the case. Briefs are written statements arguing each party’s position as to how the case should be decided.
After reviewing the evidence and considering any briefs, the administrative law judge will issue the award, which should contain detailed findings of fact and rulings of law. By law, the judge must issue the award within 90 days of the last day of the hearing. The award is mailed to the employee, to the insurance company, and to all the lawyers in the case. All final awards are subject to appeal by any party. Some temporary or partial awards are subject to appeal.
Understand Your Rights and Obligations: Consult With a Lawyer
Missouri workers’ compensation cases can become complicated quickly. That’s why it’s important to speak with an experienced attorney if feel you need assistance. If you have any questions about the issues discussed above, you may call us toll free at 800-887-4030 or complete our online contact form.