Employees and Employers Covered
To be eligible for benefits under the Missouri workers’ compensation law, you must work for an employer that is covered by the law. The workers’ compensation law applies to all employers with five or more employees, as well as employers in the construction industry with one or more employees. Employers covered by the law are required to carry workers’ compensation insurance. Employers with less than five employees that are not engaged in hazardous operations may voluntarily elect to be covered by the workers’ compensation law.
Injuries and Occupational Diseases Covered
The Missouri workers’ compensation law provides benefits for employees who have sustained an “accident” “arising out of” and “in the course of” their employment that results in injury or death. The term “accident” is defined as an unexpected or unforeseen event happening suddenly and violently with or without human fault and producing at the time objective symptoms of an injury. The term “injury” means violence to the physical structure of the body and such disease or infection as naturally results. An injury alone does not constitute an accident. The terms “accident,” “arising out of” and “in the course of” are legal terms that are specifically defined in the workers’ compensation law and are subject to possible future interpretation by the courts. An injury is deemed to be compensable if it is incidental to and not independent of your employment, and your work is the prevailing factor in causing the resulting medical condition and disability.
The law also provides benefits for employees with occupational diseases. An occupational disease is any disease or medical condition caused by or directly related to the conditions of your employment. Injuries due to repetitive motion (carpal tunnel syndrome, tendinitis, etc.) are generally considered to be occupational diseases. Your work must be the prevailing factor in the development of the disease.
The Missouri workers’ compensation law provides several types of benefits to employees who suffer a work-related injury. First, you are entitled to receive medical treatment for your injury at your employer’s expense. Second, you are entitled to receive compensation for time that you are unable to work because of your injury, as long as the doctor who is treating your injury says that you are unable to work. Third, you are entitled to receive compensation for any temporary or permanent residual effects of your injury. Finally, when death occurs as the result of a work-related accident, your employer is required to provide additional benefits. Information about each of these types of benefits is provided below.
When you are injured on the job, your employer is required to provide certain medical benefits. These benefits include payment for all medical, surgical and hospital treatment (including nursing, ambulance services, and medications) reasonably necessary to cure and relieve the effects of your injury. Because your employer must pay for your medical treatment, your employer has the right to select the physician who will treat your injury.
Compensation for Lost Income
If you are temporarily unable to work because of a work-related injury, or if you are temporarily unable to perform the same type of work that you performed before you were injured, you may be eligible to receive Temporary Partial Disability or Temporary Total Disability benefits.
A Temporary Partial Disability (TPD) is a disability which permits you to return to some kind of work, either less physically demanding or otherwise different from your normal job, but nevertheless prevents you from earning as much wages as you did at the time of the accident. As the name implies, TPD benefits are temporary in nature, usually payable when you are under a physician’s orders to limit your activities.
A Temporary Total Disability (TTD) is a disability which prevents you from engaging in any occupation on a temporary basis. The workers’ compensation law does not require you to be completely inactive or inert to be eligible for TTD benefits. Generally, you are entitled to receive TTD benefits if you miss more than three consecutive days of work due to a compensable injury.
Compensation for Permanent Disability
If a work-related injury results in a permanent physical impairment, you may be eligible to receive Permanent Partial Disability or Permanent Total Disability benefits.
Permanent Partial Disability (PPD) benefits are designed to compensate you for the permanent and lasting effects of your work-related injury. The law assigns pre-determined values to each part of the human body, which are graphically represented on this chart. PPD is usually expressed as a percentage of the particular part of the body that is injured, converted into weeks of disability, multiplied by your weekly compensation rate, and then converted into dollars. PPD must be demonstrated and certified by a physician, giving greater weight to objective medical findings (demonstrable on physical exam or by test or diagnostic procedure) over subjective findings (complaints of pain, discomfort, etc.).
Permanent Total Disability (PTD) benefits are payments for a sustained inability to return to any employment as a result of your work-related injury. You are considered permanently and totally disabled if you are not able to compete for jobs in the open labor market. Aside from the permanent physical effects of your injury, other factors to consider in determining whether or not you have a PTD include your age, education, and prior work experience.
If a work-related accident results in death, your employer is required to pay burial expenses (not to exceed a maximum amount of $5,000) and make payments to your dependents in an amount calculated pursuant to a statutory schedule. If you are not married and have no dependents, your employer is only required to pay for your funeral expenses and the expenses related to your last illness.