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The Difficult Aspects Of Handling A Workers’ Compensation Claim


Interviewer:  What are the more difficult aspects of workers compensation claim when you are working with someone?

Kevin Roach:  One of the most difficult things a lot of times with workers compensation claims is getting the initial treatment process started, getting them medical care. Under Missouri law, the employer is required to provide medical care from the effects of the injury. However, a lot of times, they may be providing care which might not be proper care and if they have a doctor, even though he's a work comp doctors, he may say, 'Well, he doesn't need surgery, he just needs physical therapy', it's kind of hard sometimes to prove otherwise because you don't have control of treatment.

Getting The Right Amount of Compensation for an Injured Client is one of the Most Difficult Aspects in a Workers’ Compensation Suit

So there are a number of things you can do to counteract that, but that's one of the more difficult aspects of these claims. Another one is getting a settlement, or getting the person the right amount of compensation for their injuries. There are hundreds if not thousands of different types of injuries, and body parts and strains and sprains and different types of amputations and eye injuries, ear injuries, finger injuries, all sorts of different types of injuries that someone can receive and it's difficult for someone that, all the times to get them a fair amount of compensation for their particular injury. That's where having an experienced St. Louis workers compensation attorney comes in, because most people, they have never dealt with this before in their life and they may have an operated shoulder, you know, how much is that worth?

Insurance companies take advantage of unrepresented workers

The state of Missouri puts out this disability chart which says the shoulder's worth 232 weeks, and your rate of compensation may be $245 a week and your disability level may be 20% of that shoulder, well, what's that worth? Most people have no clue, most attorneys have no clue unless they know how to do the math on that, and defense attorneys will use that to their advantage. They'll typically try to low ball these cases, they may offer a fraction of what the case is worth initially. But what we do is, we send all of our clients for an independent medical evaluation, we get them rated by our doctor, and our doctor, he renders an opinion on what the permanent part of disability is for that particular injury and then we use that report to get a mediation setting and once we get the mediation setting, we get in front of the administrative law judge and we hash out all the different disputes there may be with lost wages, unpaid medical expenses, permanent parts disability, we try to come up with, get a good recommendation from the administrative law judges to what benefits the claimant or injured worker is entitled to.

The Decision of an Administrative Judge Can Be Appealed

Interviewer:  If things go south, is there any way I can make an appeal?

Kevin Roach:  Absolutely, if you don't like the findings that the administrative judge came down with, then yes, you can absolutely, you can file an appeal.

The Success of an Appeal Depends Upon the Facts Connected to the Case

Interviewer:  What's the success rate for an appeal typically?

Kevin Roach:  The range is according to whether the judge followed the law or not. Most of the time judges follow the law, but if the judge was totally off base with the ruling, then your chances would be much greater, as far as what the percentage of cases that have won an appeal, I have no idea.