Table Of Contents
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The Moment You’re Injured, the Conspiracy Begins
As personal injury attorney Mark Cantor explains, the moment you’re injured on the job in Missouri, the workers’ compensation conspiracy kicks into high gear. Your employer will immediately demand that you take a drug test, with the goal of finding any reason to deny or reduce your benefits. Even if you test positive for something as innocuous as marijuana, your employer can use that as an excuse to dock your benefits by 50%.
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But the drug test is just the start. Your employer will also pressure you to fill out a report of injury and give a recorded statement, all while sending a nurse case manager to your doctor’s appointments. This nurse case manager isn’t there to help you – their job is to whisper in the doctor’s ear and convince them to release you back to “light duty” work as soon as possible, even if you’re still in pain and unable to perform your normal job duties.
TL;DR: Missouri Workers’ Compensation Conspiracy
Missouri workers’ compensation claims can involve disputes over medical treatment, whether an injury is work-related, disability ratings, return-to-work decisions, and the benefits an injured employee should receive. Employers and insurers may investigate claims, obtain medical opinions, review an employee’s activities, or dispute whether a medical condition resulted from the workplace accident. Understanding these issues can help injured workers recognize when a claim has become contested and what evidence may matter.
The Doctors Are in on the Conspiracy Too
The doctors that workers’ compensation insurance companies send you to are also part of the conspiracy. As Cantor explains, these doctors know where their bread is buttered – they get thousands of cases from the insurance companies, and they’re not going to risk losing that lucrative stream of business by siding with the injured worker.
Cantor cites several examples of doctors who have been caught lying or distorting the facts in order to help the insurance companies deny or minimize claims. In one case, a doctor falsely claimed that Cantor’s client had diabetes, which he said was the reason the client’s back surgery didn’t heal properly. The only problem? Cantor’s client didn’t have diabetes at all.
In another case, a doctor completely missed a rotator cuff tear on an MRI, only for another doctor to easily spot it later. The courts have even gone so far as to call some of these doctors “laden with falsehoods” and “utterly unworthy of belief.”
The Tricks the Insurance Companies Use
- Surveillance: Cantor warns that insurance companies will often send private investigators to secretly film injured workers, in the hopes of catching them doing something that contradicts their claimed injuries.
- Denying Causation: Even if the insurance company pays for your surgery, they may later claim that the need for surgery wasn’t actually related to your work injury, but rather a pre-existing condition. This allows them to avoid paying any additional benefits.
- Lowballing Disability Ratings: The insurance company’s doctors will often give you a very low disability rating, such as 1% or 3%, when in reality your injury may be worth 15% or more. Without a workers’ comp attorney to fight for a proper rating, you’ll be stuck with the lowball offer.
- Termination for Pursuing a Claim: In Missouri, it’s technically illegal for an employer to fire you solely for filing a workers’ compensation claim. But the law has been weakened over time, making it harder to prove that’s the real reason you were terminated.
- Penalties for Safety Violations: If you were injured due to your employer’s failure to provide proper safety equipment, you should be entitled to a 10% increase in your benefits. But the law allows employers to instead impose a 50% penalty if you weren’t wearing the safety gear, even if it was never provided to you.
Understanding the “Meat Chart”
One of the key tools in the insurance companies’ arsenal is what Cantor calls the “meat chart” – a schedule that assigns a specific number of weeks of benefits for the loss or impairment of different body parts.
For example, the complete loss of a thumb is worth 45 weeks of benefits, while the loss of a finger is worth 26-30 weeks. The loss of an eye is 140 weeks, and the loss of a leg at the knee is 160 weeks.
But as Cantor points out, these numbers bear little resemblance to the true impact these injuries have on a person’s life. Who would voluntarily lose an eye for just 140 weeks of pay? And how can the insurance company claim that losing a leg at the knee is only worth 3 years of benefits, when it affects a person’s entire mobility, back, and mental well-being?
This is where having an experienced workers’ compensation attorney like Cantor makes all the difference. He knows how to fight for a much higher disability rating that accurately reflects the true extent of the injury, rather than just accepting the lowball offer from the insurance company.
The Importance of Temporary Total Disability and Permanent Total Disability
In addition to the lump-sum payment for permanent partial disability, workers’ compensation also provides two other key benefits:
- Temporary Total Disability (TTD): This is the weekly benefit you receive while you’re off work recovering from your injury. In Missouri, the maximum TTD rate is currently $947.64 per week, but many workers will receive significantly less than that based on their pre-injury wages.
- Permanent Total Disability (PTD): If your work injury is so severe that you can never return to any type of gainful employment, you may be entitled to PTD benefits, which provide ongoing weekly payments for the rest of your life.
Cantor emphasizes the importance of making sure you have an attorney who understands how to properly calculate and fight for the maximum TTD and PTD benefits you deserve. The insurance companies will always try to lowball these figures, so it’s critical to have an advocate in your corner.
The Subrogation Trap
One final aspect of the workers’ compensation conspiracy that Cantor highlights is the issue of subrogation. If you have a work-related injury that also leads to a third-party liability claim (for example, if you were injured in a car accident while driving for work), the workers’ compensation insurance company has the right to be reimbursed for any benefits they paid out of your third-party settlement.
Key Takeaways
- Missouri employers generally control authorized medical treatment for workers’ compensation injuries.
- Workers’ compensation insurers may investigate claims, including through surveillance in some circumstances.
- Causation can become disputed when an insurer attributes an employee’s condition to a pre-existing condition rather than the workplace accident.
- Permanent disability ratings can significantly affect a permanent partial disability claim.
- Missouri uses a statutory schedule assigning different numbers of weeks to specified body parts for certain permanent partial disability calculations.
- Temporary total disability (TTD) and permanent total disability (PTD) are different types of workers’ compensation benefits.
- Third-party injury recoveries can create workers’ compensation subrogation issues.
- Missouri law contains provisions addressing retaliation and certain safety-related benefit adjustments, but these subjects should be described precisely rather than categorically.
This can create a tricky situation, as Cantor explains: “If you win that workers compensation money, let’s say you went a hundred grand and workers compensation and then you win a million dollars from the person that hit you because you had a neck surgery, you got to pay a portion of a hundred thousand dollars back.”
Cantor says good lawyers will try to get the subrogation waived or reduced as much as possible, in order to maximize the injured worker’s overall recovery. But it’s yet another example of how the system is stacked against the injured party.
Arm Yourself with the Right Legal Representation
In the end, Cantor’s message is clear: the workers’ compensation system in Missouri is rigged against injured workers, with insurance companies, employers, and even the doctors all conspiring to deny or minimize claims. The only way to level the playing field is to have an experienced, aggressive attorney like Cantor fighting on your side.
As Cantor says, “If you have a serious injury case, I’d like to meet with you. I’d like to help you. If it’s real and it’s true, I’ll fight it. I won’t tell you to settle it. I’ll take it to trial.” With Cantor Injury Law in your corner, you can rest assured that you’ll get the maximum compensation you deserve, without having to fall victim to the workers’ compensation conspiracy.
FAQs: Missouri Workers’ Compensation Conspiracy
Workers’ compensation insurers can investigate claims and evaluate evidence relevant to the injury and claimed limitations. The page specifically discusses surveillance as one investigative technique.
Surveillance may be used to gather evidence concerning an injured employee’s activities. Employees should accurately describe their limitations and follow medical restrictions rather than assume that everyday activities cannot become relevant to a disputed claim.
Causation can become contested when an employer or insurer argues that symptoms or treatment resulted from a pre-existing condition rather than the workplace injury. Medical evidence can be important in resolving that dispute.
