Missouri's system of workers' compensation is compulsory, meaning that employers are required to provide workers' compensation insurance to their employees. Workers' compensation insurance may be provided through private insurance carriers or self-insurance. Waivers may be permitted to exclude certain employees from coverage, including corporate officers and sole proprietors.
Exemptions from coverage may apply to certain employees, including farm labor, real estate agents, and caregivers working in private homes.
Medical Benefits are provided to employees entitled to workers' compensation benefits, with no limit on necessary medical care.
The employer chooses the employees' treating physician. The employee may change doctors with the permission of the employer or workers' compensation insurance agency, or upon successfully petitioning the workers' compensation agency to order a change.
Indemnity benefits are payable to injured workers to help make up for lost income. There is a waiting period of 3 days during which the employer is open for business before a worker is eligible for indemnity benefits, but if the worker's disability lasts more than 14 days indemnity benefits become retroactive to the date of the injury.
Benefits available to injured workers include the following:
Temporary Total Disability (TTD)
Temporary total disability (TTD) benefits are paid to workers who are unable to work due to injury, but who are expected to make full or partial recovery such that they may return to work. Benefits are based upon 2/3 of the injured worker's average pre-injury weekly wage, subject to a cap, and continue for up to 400 weeks.
Permanent Total Disability (PTD)
When a worker is not expected to recover from a total disability caused by a work-related injury, and as a result suffers a total loss of earning capacity, the worker becomes eligible for permanent total disability (PTD) benefits. In Missouri PTD benefits are calculated based upon 2/3 of the injured worker's pre-injury average weekly wage, subject to a cap, and may continue indefinitely. Benefit amounts may differ for certain occupational diseases resulting from toxic exposure.
Permanent Partial Disability (PPD)
Once an injured worker has recovered to the maximum possible extent, the worker may be able to return to employment but nonetheless remain partially disabled, and may potentially qualify for permanent partial disability (PPD) benefits. In Missouri PPD benefits take the form of a lump sum payment, based on a statutory schedule of losses assigned to the worker's body part, and 2/3 of worker's preinjury average weekly wage, subject to a cap. Benefits for unscheduled injuries are calculated based on the nature of the injury and wage loss, and are payable for a maximum of 400 weeks.
Temporary Partial Disability (TPD)
When a worker suffers an injury that limits his ability to return to work, resulting in a reduction of income as a result of reduced hours or wages, the injured worker may be eligible to receive a benefit based on the difference between the worker's pre-injury earnings and their reduced, post-injury earnings. In Missouri, TPD benefits are paid based upon 2/3 of the difference between the injured worker's pre-injury and post-injury wage, subject to a cap. Benefits may be payable for up to 400 weeks.
For some, more serious injuries, workers' compensation indemnity benefits may be paid according to a statutory schedule, instead of following the standard model of the weekly benefit based on the duration of the disability. Scheduled injuries include such injuries as the amputation of an arm, the loss of a dominant hand, the loss of a leg, the loss of a foot, the loss of an eye, or loss of hearing in an ear.
Coverage may be available for cumulative trauma, disfigurement, mental stress and occupational hearing loss.
When a worker dies as the result of a work-related injury, workers' compensation pays additional benefits, including a burial allowance, and benefits for a surviving spouse and dependents. Survivor benefits are calculated based on the worker's average weekly wage and number of dependents, subject to a cap in amount. Benefits may continue for minors until the age of 18, the age of 22 if the dependent is a student. Spousal benefits end upon remarriage, at which time the spouse may receive a lump sum benefit.
Attorney fees are subject to review by an administrative law judge or the Labor and Industrial Relations Commission.
This article provides a quick overview of the benefits available to injured workers, but the full formulas used for assessment of benefits, coordination of different types of benefits, and assessment of injuries and disability ratings can quickly complicate the determination of benefits. Also, states frequently revise their workers' compensation laws. Most workers who suffer a significant injury or wage loss as the result of a workplace injury will benefit from consulting a workers' compensation lawyer.
The state agency responsible for workers' compensation is:
Missouri Department of Labor and Industrial Relations
Division of Workers' Compensation
3315 West Truman Blvd., Room 131
P. O. Box 58
Jefferson City, MO 65102-0058
(573) 751-4231 or 1-800-775-2667