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Injured on the Job and Need Help?

>>AMY SUSAN: Hi, I’m Amy Susan, Director of Communications for the Missouri Department of Labor.  On this week’s edition of Labor Talk, a podcast where experts discuss workplace issues that affect your life, I’m joined here with ALJ, Administrative Law Judge Robert Derket (ph.sp.), and we’re here to talk about the benefits available for those injured on the job and what to do if they’re not getting those benefits.  So let’s just start right off the bat.  What benefits are available for those who are injured on the job?

>>JUDGE ROBERT DIERKES: The worker’s compensation law basically provides for three benefits.  Probably the most important--they’re all important, but probably the most important is the medical benefits.  Then also if an employee is required to lose work because of an acute injury or because of treatment such as a surgery to address an acute injury, then time off benefits are also available.  And then the last benefit that we usually talk about is the benefit for permanent disability.  If, after the medical treatment is completed, the employee does have a permanent disability, then there is some monetary compensation for that, as well.

>>SUSAN: How far should an injured worker be expected to travel to seek that medical attention?

>>JUDGE DIERKES: Well, if you have someone who’s injured in let’s say Jefferson City, and the insurance company is located in Saint Louis, they might be asked to see doctors in Saint Louis where there might not--there might be just as good a medical specialist in, let’s say, Jefferson City or Columbia that they would see, but the insurance company, you know, just is more comfortable with the physician in Saint Louis.  There’s certainly nothing wrong with that if the employee wants to see the doctor in Saint Louis and is paid their expenses to see the doctor in Saint Louis.  But if it is a medical hardship or a financial hardship to travel such a distance, that is something that the employee should take up with the claims manager, claims adjuster, to see if treatment can be changed to a physician or a hospital or a physical therapy clinic closer to home.

>>SUSAN: Can they choose their own doctor?

>>JUDGE DIERKES: The law says that the employer must provide medical treatment, whether it’s the doctor, hospital, lab work, physical therapy, what have you, at the employer’s expense.  The employee has the right under the law to choose a doctor or physical therapist, etcetera, etcetera, on their own.  However, it is at their expense.  And so in the situation where the employer and the insurer is providing medical treatment and the employee makes a decision to see a massage therapist or a chiropractor or some healthcare specialist that the employer has not chosen for them, usually that’s at their own expense. 

>>SUSAN: If someone is injured on the job and they’re not getting those benefits, such as medical bills aren’t being paid, they’re not getting the lost wages benefits, what should that worker do?

>>JUDGE DIERKES: There are many cases that are settled without a claim for compensation being filed.  Probably 40 percent of our cases are, in fact, settled before a claim for compensation is filed.  Usually, those are either relatively minor injuries or relatively straightforward injuries, such as let’s say a rotator cuff tear or a meniscus tear in the knee or something like that that where the employee has a good recovery.  Those are often handled without a claim being filed.

>>SUSAN: Would an individual benefit from getting an attorney to help them through their case?

>>JUDGE DIERKES: Getting a lawyer involved in a case that doesn’t seem to be proceeding as the employee hopes it would proceed is always a good idea.

>>SUSAN: How does one get a voluntary settlement or have a hearing under an ALJ such as yourself?

>>JUDGE DIERKES: Basically, the claim for compensation in worker’s compensation is like filing a lawsuit.  You’re saying we want to have a trial on this.  It doesn’t mean you have to have a trial.  You may end up settling the case, but in order to get a trial in Circuit Court you have to file a petition in order to get a trial.  In the Division of Worker’s Compensation you have to file a claim for compensation.

>>SUSAN: Thanks a lot for joining us on the show, for yet again some information on the process to take when individuals are injured on the job.  If you guys have any other comments or concerns, please visit labor.mo.gov, click on News and Notices and then click on Labor Talk Podcast.