The general thrust of this blogpost is to show that it is the exception proves the rule.
Missouri Workers Compensation Law [Section 287.190.6(2)] clearly states that in order to prove the nature and extent of permanent disability (whether permanent partial disability or permanent total disability) an injured worker has suffered after the end of all their medical treatment, both the employee injured on the job or his employer and their insurance company are going to need to get a medical doctor to demonstrate and certify what injuries the injured worker has suffered and the percentage of permanent disability the employee’s work-related injuries have left him or her with.
The doctor who gives his official opinion on this is going to have to base that opinion upon a reasonable medical certainty that rest upon objective medical findings. It is not supposed to be based on mere guesswork or any kind of speculation or just on the injured employee’s say-so, but hard medical facts. It is the permanent medical disability rating that determines just how many weeks of permanent disability the injured worker is entitled to receive from their employer’s workers compensation insurance company.
The point I am making is that it would be crazy for any worker injured on the job who suffers a physical injury from their work activities to try to settle their claim for workmen’s compensation benefits with their employer or their employer’s workers compensation insurance company. The injured worker is going to have to hire a good workers compensation attorney to represent him. That attorney will know how to gather together all the worker’s medical records for treatment of the treatment the injury, get them to a good doctor who does workers compensation injury evaluations, and get from the physician a strong, convincing final and permanent disability rating on the employee’s work injuries.
Once the injured worker’s attorney gets such a rating report from their own expert doctor the attorney can then give it to the insurance company attorney. Then if no settlement can be reached with insurance company the attorney can submit our own doctor’s report and permanent disability rating to a workmen’s compensation administrative law judge at a hearing, fighting it out with the company-chosen doctor’s expected low-ball rating the insurance defense lawyer will be submitting to the same judge. How could any working guy or gal who suffers any kind of serious work-related injury possibly hope to fight their employer they got hurt working for and that employer’s insurance company by themselves? Always remember and keep in mind that it is the nature, extent and percentage of permanent disability of the employee’s different work injuries that determines what kind of money the employer/insurance company will be able to drag out of the insurance company for his permanent disability to the different parts of his body.
Any worker injured on the job who has any kind of serious and substantial workman’s compensation case will need to get their own rating or the company will be able to get away with giving them little or nothing and way less money than they deserve for the permanent disability. You as a worker injured on the job have no real choice but to fight fire with fire and get your own doctor’s rating. Remember that you as the injured worker hurt on the job have the built in legal burden to prove everything about your work injury, while the insurance company’s defense attorney, as told what to do by the claim adjuster pressuring them to save money at your expense 24/7, has to prove nothing at all.
Attorneys such as Tom Hyatt at St. Louis Workers Compensation Center/Workmen’s Compensation Legal Clinic know how to work for you against the insurance company. He will advise you on all legal aspects of our work injury and your benefits and then represent you aggressively against the insurance company before the legal system. Now to the very narrow exception that proves the rule about the injured worker’s need to get their own medical and vocational experts to provide disability ratings on all their work-related injuries they suffer either from work accidents or exposure to harmful poisons at work or from repetitive motion injuries sustained on the job and from the job.
In the case of Marciante v Charles Jarrell Contracting Company issued April 1, 2015 the Missouri Labor and Industrial Relations Commission decided that that “it is not necessary that physicians certify permanent disability in mathematical terms” and that a worker may establish disability with or without a rating provided there is other evidence to show the nature and extent of permanent symptoms, restrictions and/or limitations.” The injured worker in that case bent over to pop a line on a heating system when he suffered a herniated disc in his lower back that required surgery. Years earlier he had already suffered a previous work-related back injury and settled the claim and after filing a claim on his latest back injury his attorney got a doctor to evaluate him.
That doctor expert gave a medical opinion that the combination of the previous with the current job-related back injury, but did not specify exactly the percentage extent of permanent disability from the earlier back injury. The workers compensation judge hearing the case ruled that the doctor’s failure to specify the exact percentage of pre-existing disability to the worker’s back prevented her from making a legal finding that a combination of the previous with the current work injuries rendered the worker totally disabled for purposes of the Missouri Second Injury Fund. The Missouri Labor and Industrial Relations Commission disagreed, ruling that under Missouri Workers’ Compensation Law the lack of a doctor’s opinion as to the exact percentage of preexisting disability to the worker’s lower back did not prevent the judge from finding that the latest work injury combined with prior disabilities to render the man permanently totally disabled.
This case just goes to show that if the worker injured on the job as part of his work does not get a doctor working for him to examine him, diagnose what his injuries are from his latest work injury, his prior injuries, and whether they combine to render him totally disabled, he stands no chance whatsoever to win his claim. Only an attorney who regularly represents injured workers in filing and then proving with medical evidence their workers compensation claims could ever hope to meet the burden of proving what needs to be proven to a Missouri workers compensation administrative law judge in order to get awarded his proper benefits. The moral of the story is: ALWAYS HIRE AN ATTORNEY TO FILE, FIGHT AND REPRESENT YOU ON YOUR CLAIM, OR YOU WILL ALMOST CERTAINLY NEVER GET AWARDED YOUR PROPER WORKERS’ COMPENSATION BENEFITS! Do not try to prove your workmen’s compensation claim on your own since proving it would require the ability to prepare and produce complicated legal and medical evidence and testimony for a judge before he could rule in your favor and grant you your benefits.