The Workers' Compensation Law of the State of Missouri was enacted in 1926. Prior to that time, the only remedy available to an injured worker was a suit in court. This "remedy" that time, the only remedy available to an injured worker was a suit in court. This “remedy” was too frequently no remedy at all. The cost of court proceedings was often prohibitive. Technical defenses were often successfully used to prevent recovery of damages. It frequently took many years before a judgment could be obtained and collected, if at all.

The underlying aim of workers' compensation laws was to make the cost of industrial accidents and diseases, with resulting deaths and disabilities, regardless of their causes, a charge upon industry, which ultimately passes it on to the consumer as part of the cost of its product.

The Missouri Workers' Compensation Law (hereafter, “ACT”) has been of great benefit to workers; but it has fallen far short of providing adequate compensation to injured or disabled employees or their dependents in case of their death.

AS OF AUGUST 28, 2005, SUBSTANTIAL CHANGES TOOK AWAY ACCESS TO COVERAGE FOR TRADITIONALLY COVERED INJURIES AND DISEASES. EVEN IF COVERED UNDER THIS NEW LAW, BENEFITS WERE REDUCED. IT IS UNLIKELY THAT ANYONE SUFFERING A JOB RELATED INJURY WILL HAVE ACCESS TO FULL MEDICAL CARE AND TO PROTECTION FROM THE ECONOMIC RUIN CAUSED BY THE JOB RELATED DISABILITY.

It was the intention of the Workers' Compensation Law to make the remedy so simple that an injured employee would not be obliged to have any particular knowledge of its provisions or to retain an attorney in order to safeguard his rights. However, in practice, unless an employee is familiar with the provisions of the Act, the employee seldom receives the benefits which are legally due him. If a case is the least bit complicated or unusual, it is virtually indispensable for an employee to have a lawyer to represent him. Many of the intended benefits of the Act have vanished in a maze of legal opinions.

1 Hereafter, all references to “him” shall refer to both male and female gender.

The purpose of this pamphlet is to advise workers of their rights under the Workers' Compensation Law of Missouri, and what should be done to safeguard them. It must necessarily be general in its nature and serve as a guide in situations most commonly arising under the Act. Specific cases cannot be covered nor can it be said with assurance that the present interpretation of any provision will not be altered by future decisions.

When you have a specific problem about which you are doubtful, CONSULT YOUR COMMITTEE PERSON OR STEWARD. If your right to compensation has been denied by your employer, do not accept his decision as final. CONSULT YOUR UNION COMMITTEE PERSON, SHOP STEWARD, OR ATTORNEY.

COVERAGE
Employers with five (5) or more employees (except that in the construction industry, an employer comes under the law if he has one or more employees) are required to carry Workers' Compensation insurance under the Missouri Workers' Compensation Law. Employers not engaged in hazardous operations, who have less than five employees regularly employed, may come under the Act by filing an acceptance with the commission and posting notice thereof in accordance with the law.

1. MAY I ELECT NOT TO COME UNDER THE ACT?
NO, unless you are a member of a specific religious group which meets specific guidelines.

2. HOW CAN I FIND OUT IF MY EMPLOYER HAS WORKERS' COMPENSATION COVERAGE?
The Missouri Division of Workers' Compensation will advise you of the status of any employer if you write them at P.O. Box 58, Jefferson City, Missouri 65102. Or call toll-free at 1-800-775-2667.

3. IS THERE ANY WAY OF FORCING AN EMPLOYER TO BECOME SUBJECT TO THE ACT?
NO. However, by law, certain employers with five (5) or more employees (construction industry employer with one employee), who reject the Act are denied certain valuable defenses if they are sued for damages.

4. IF MY INJURY AT WORK IS CAUSED BY THE NEGLIGENCE OF A THIRD PARTY, CAN I SUE HIM/HER?
If there was any fault or negligence by anyone other than your employer which contributed to your injuries, you may have a third-party wrongful act, or tort claim against that individual or company. This third-party claim would be in addition to your rights under the Workers' Compensation Law. If you recover damages from a third person, you may be required to first pay back to your employer all or a portion of the sum which it has paid out, but you are entitled to any excess over and above that amount.

5. DO I HAVE TO SHOW THAT MY EMPLOYER WAS AT FAULT IN ORDER TO COLLECT FROM HIM UNDER THE COMPENSATION LAW?
NO. Recovery under the Workers' Compensation Law is irrespective of any negligence upon the part of the employer. Negligence is no longer a factor under the Act.

6. IF MY EMPLOYER IS COVERED BY THE ACT, CAN I SUE HIM FOR DAMAGES?
POSSIBLY. Traditionally, your sole remedy was under the Act. It is unclear if you may sue under the latest changes to the Act. However, the recent Missouri Supreme Court decision in MARA v. DOLIR has opened the possibility of allowing you to sue your employer when it denies the compensability, or work-relatedness of your injuries. Those injuries which are no longer covered by the Act, suggest that you can now sue your employer for those injuries, albeit in a civil court. Some occupational diseases and cumulative trauma injuries may be possible to pursue as a civil lawsuit. You will need to speak with an attorney if you have any questions.

7. HOW LONG DO I HAVE TO BE EMPLOYED TO BE COVERED BY WORKERS' COMPENSATION?
You are covered as soon as you begin your employment.

ACCIDENTAL INJURIES
In order to be covered by the Workers' Compensation Act in Missouri, there must have been an "accident" "arising out of" and "in the course of" your 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 from that. An injury alone does not constitute an accident. The terms "accident", "arising out of" and "in the course of" are legal in nature and have been the subject of literally hundreds of cases, although recent changes have eliminated the holdings of many of those cases. An injury is deemed to be covered, if it is incidental to and not independent of the Employment, and work is the prevailing factor in causing both the resulting medical condition and disability.

8. FOR WHAT INJURIES CAN I RECOVER COMPENSATION?
You may be eligible for all injuries caused by accident arising out of and in the course of your employment.

9. MUST MY DISABILITY BE THE RESULT OF THE ACCIDENT ALONE, INDEPENDENT OF ALL OTHER CAUSES?
NO. Your employer may also be held liable where your accident aggravates a pre-existing disease or condition, but it must be a prevailing factor in causing the injury. Your age may work to reduce your benefits under the newest changes.

10. ARE ALL INJURIES WHICH ARE SUSTAINED AT WORK COMPENSABLE UNDER THE ACT?
NO. It is possible for an injury to arise in the course of employment, but not arise out of it. However, the exceptions are rare. If you have such a case for which I you do not receive benefits, it would be well to consult your committee person, shop steward or attorney.

11. WILL DRINKING PREVENT ME FROM GETTING COMPENSATION?
If the employee fails to obey any rule or policy of the employer regarding alcohol or non-prescribed drugs, any compensation may be reduced by 50%. If the use of alcohol or non-prescribed drugs in violation of the employer's rule is the prevailing cause of the injury, then Workers' Compensation benefits shall be forfeited.

12. WHAT ACT OF MINE WILL PREVENT ME FROM GETTING COMPENSATION?
You cannot get compensation for an injury that is intentionally self-inflicted, but the burden of proof is upon the employer.

WHAT TO DO WHEN INJURED
When you are hurt on the job you should report your injury and the accident which caused it immediately to your foreman, first aid person, or such other person who is the proper party designated by your employer. Not only should this notice be given immediately in order that you might receive the necessary medical attention, but your injury will then be on record. The Act requires that you give notice in writing within thirty days of the date of the accident. However, if your employer has actual notice of the injury, written notice may be unnecessary although you may have to prove this.

13. WHAT ELSE SHOULD I DO TO PROTECT MY RIGHTS?
You should also obtain the names of any witnesses to your accident and their addresses and keep this information.

14. IF A REPRESENTATIVE OF MY EMPLOYER WRITES DOWN THE DETAILS OF MY ACCIDENT AND INJURY AND ASKS ME TO SIGN SUCH A STATEMENT, SHOULD I DO SO?
NO. It is only necessary that you notify your employer. You are not required to sign anything. In a number of cases in the past certain employers and their insurance companies have used the device of taking statements for the purpose of building up a defense to the worker's just claim for compensation. Too often the statement becomes a description of what the employer would like to have had happened instead of what actually did occur. Sometimes this is done by failing to question the worker as to the important details of the accident, sometimes by not writing in all facts given by the injured workers and sometimes by actually changing the answers. However, if you wish to make a statement do the following for your own protection:

(a) Be sure that the statement contains your entire story in your exact words and is not just a summary of your story made by the person who takes the information.

(b) Before signing it, take the statement with you and show it to your committee person or steward, so that you may be certain it contains all the true facts of the case. Be sure to read it over carefully before signing it.

(c) Get and keep a copy of the statement.

DO NOT DO THE FOLLOWING:
Do not swear to it.
Do not answer questions about matters not directly concerned with your accident, such as citizenship, draft status, etc.
Remember the Employer does not have the authority under the Act to require you to sign any statement!

15. IF I DISCOVER LATER THAT I RECEIVED INJURIES OF WHICH I WAS UNAWARE AT THE TIME OF THE ACCIDENT, WHAT SHOULD I DO?
You should report these newly discovered injuries as soon as possible. It is a good idea to have this reporting either witnessed, or to have such be written. Recent Courts of Appeal decisions indicate that for purposes of an occupational disease (e.g., carpal tunnel syndrome, repetitive traumas, etc.) that you MUST notify your employer within 30 days of a licensed physician advising you that your condition is work-related. Merely suspecting that your condition is work-related is not sufficient. Once you are notified by your physician that a condition is work-related, the 30 day window to provide notice will begin. If you fail to provide such timely notice, it is likely that your injuries will not be covered under the Act and will be denied by your employer.

16. SHALL I REPORT AN ACCIDENTAL INJURY EVEN IF IT IS A SMALL ONE?
YES, be sure to do so. Many very serious conditions develop from minor injuries. It is most important that you report all injuries and all accidents no matter how small they may seem to you at the time.

17. IS MY EMPLOYER REQUIRED TO MAKE ANY REPORTS CONCERNING INDUSTRIAL ACCIDENTS?
YES. The law requires that your employer make a report to the Division of Workers' Compensation of all accidental injuries within 10 days of the date they occurred. The employer is also required to make such further reports from time to time as the Division may require. If you find your employer is not reporting these accidents as required by law, you should pass this information on to your committee person or steward. If your own claim is involved, notify the Division immediately. The enforcement of the law requiring such reports is solely for the law enforcing agencies of the State of Missouri. Your right to compensation is not affected.

BENEFITS
Under the Workers' Compensation Law, you may be entitled to one or more of the following basic benefits:

(1) medical treatment
(2) rehabilitation
(3) temporary disability payments
(4) permanent disability payments, and
(5) death benefits.

18. FOR WHAT ACCIDENTAL INJURIES DO I GET COMPENSATION?
You are entitled to receive compensation if your accident results in:
(a) Disability to earn full wages for more than three days; or
(b) Specific loss of a part of your body as outlined in the schedule of losses.

19. SUPPOSE THE ACCIDENT DISFIGURES ME BUT DOES NOT DISABLE ME. AM I ENTITLED TO ANYTHING?
YES. If the disfigurement is to the head, neck, hands or arms, you may collect up to 40 weeks of compensation depending upon the extent of the disfigurement. Generally, our attorneys do not request an attorneys’ fee for disfigurement only cases.

20. IF MY ACCIDENT CAUSES ME PAIN AND DISCOMFORT, BUT I AM STILL ABLE TO WORK, AM I ENTITLED TO COMPENSATION?
NO. Temporary pain and discomfort alone do not entitle you to compensation, unless of course, the pain and discomfort are permanent. However, if the pain and discomfort become so intense that you cannot work, then you are entitled to compensation.

21. WHEN DOES MY COMPENSATION START?
It begins the 4th day following the accident. However, if you are disabled for more than fourteen (14) days, then you are entitled to compensation for the first three days of disability.

22. WHEN MUST MY EMPLOYER MAKE THESE PAYMENTS TO ME?
Compensation is payable as the wages were paid, or at least every two weeks.

23. CAN MY WORKERS' COMPENSATION BE GARNISHED OR ATTACHED?
YES, but only if for child support, alimony, or money owed the Veterans Administration. Workers' Compensation is not subject to ordinary creditors' claims, nor is it considered income. It is not taxable.

24. DOES THE FACT THAT I AM PAID FOR MY INJURY FROM THE PROCEEDS OF AN INSURANCE POLICY PREVENT ME FROM OBTAINING WORKERS' COMPENSATION FOR IT?
NO. No savings, insurance, benefit fund, or protective association payments to you can relieve your employer from paying your Workers' Compensation.

TEMPORARY TOTAL DISABILITY
Total disability is a disability which prevents you from earning any money at some occupation. It does not mean that you must be unable to get around or do some things about the house.

25. IF I AM TOTALLY DISABLED AS A RESULT OF AN ACCIDENT, HOW MUCH COMPENSATION DO I RECEIVE?
On and after each July 1, the maximum weekly compensation is equal to 2/3 of your average weekly wage, not to exceed an adjusted benefit maximum. If you have two or more employments on the date of your accident your income from both can be added to secure benefits up to the maximum amount. Each year maximum benefits are adjusted upwards, dependent upon the State’s average weekly wage. Your benefits are determined as of the date of your accident, and your weekly wage is determined based upon an average of your earnings over the thirteen weeks prior to your accident.

26. HOW LONG DOES MY COMPENSATION RUN IN A CASE OF TEMPORARY TOTAL DISABILITY?
For a maximum of 400 weeks from the date of your accident, which is a little less than 8 years, but only for so long as your inability to work is temporary. Furthermore, the Act was amended to include language that penalizes you if you are terminated from your employment for “post-injury misconduct.” Although this phrase has not been fully defined by the Courts of Appeal or the Supreme Court, it would serve to terminate your TTD benefits even if you were engaged in misconduct having nothing to do with your employment. (§287.170 (4) R.S.Mo.)

PERMANENT TOTAL DISABILITY
Permanent total disability benefits are payments for sustained inability to return to any employment. Ability to compete in the open labor market is a test for determining permanent total disability.

27. IF I AM INJURED SO BADLY THAT I CAN NEVER AGAIN HOLD DOWN A REGULAR JOB, HOW MUCH COMPENSATION DO I RECEIVE?
You will be paid for your lifetime (or the duration of your disability) 66-2/3% of your average weekly earnings for the 13 weeks preceding your injury. The weekly compensation rate in effect at the time of your injury determines the most that you can recover. This maximum changes annually.

TEMPORARY PARTIAL DISABILITY
Partial disability is a disability which permits you to return to some kind of work, either lighter or different from what you were doing at the time of the accident, but nevertheless prevents you from earning as much wages as you did at the time of the accident. It must be of a temporary nature, and most often occurs while you are under a physician’s orders to limit your activities.

28. HOW MUCH COMPENSATION DO I GET FOR PARTIAL DISABILITY?
You will receive, for not more than 100 weeks, 66-2/3% of the difference between your earnings prior to the accident and the amount you are able to earn during the period of your disability, but you cannot receive more than the maximum. This maximum changes annually.

29. DOES IT MAKE ANY DIFFERENCE WHETHER I AM A SKILLED OR UNSKILLED WORKER?
NO. It makes no difference under the Missouri Act whether you are a skilled or unskilled worker. The same rules apply.

30. HOW LONG DO TEMPORARY PARTIAL BENEFITS RUN?
For up to 100 weeks.

PERMANENT PARTIAL DISABILITY

31. WHAT COMPENSATION DO I GET IF I LOSE A MEMBER OF MY BODY?
Your compensation is the number of weeks in the schedule multiplied by your average weekly compensation rate.
The following is the schedule provided by the law:

Nature of Injury

Weeks

Loss of arm at shoulder 232
Loss of arm between shoulder and elbow 222
Loss of arm at elbow joint 210
Loss of arm between elbow and wrist 200
Loss of hand at wrist joint 175
Loss of thumb of hand at proximal joint 60
Loss of thumb of hand at distal joint 45
Loss of index finger at proximal joint 45
Loss of index finger at second joint 35
Loss of index finger at distal joint 30
Loss of either the middle or ring finger at proximal joint 35
Loss of either the middle or ring finger at second joint 30
Loss of either the middle or ring finger at distal joint 26
Loss of little finger at proximal joint 22
Loss of little finger at second joint 20
Loss of little finger at distal joint 16
Loss of one leg at the hip joint or so near thereto as to preclude use of artificial limb 207
Loss of one leg at or above the knee, where the stump remains sufficient-to permit the use of artificial limb 160
Loss of one leg at or above ankle and below knee joint 155
Loss of one foot, in tarsus 150
Loss of one foot, in metatarsus 110
Loss of great toe of one foot at proximal joint 40
Loss of great toe of one foot at distal joint 22
Loss of any other toe at proximal joint 14
Loss of any other toe at second joint 10
Loss of any other toe at distal joint 8
Complete deafness of both ears 180
Complete deafness of one ear, the other being normal 49
Complete loss of the sight of one eye 140

The amendments to the Act have also added language which, upon its face, would appear to discriminate against older workers. Namely, §287.190.5(3) states that “any award for compensation shall be reduced by an amount proportional to the permanent partial disability determined to be a preexisting disease or condition or attributed to the natural process of aging sufficient to cause or prolong the disability or need of treatment.” In effect, older workers are penalized for the “wear-and-tear” on their bodies, irrespective of whether that deterioration was caused by their work.

Additionally, the Act was further amended to state that in cases where there are inconsistent or conflicting medical opinions, OBJECTIVE findings shall prevail over subjective findings. More simply stated, if a diagnostic test suggests you are not hurt and you continue to complain of symptoms which cannot be found through objective standards, that the objective findings must be given the greater weight. The net effect of this change is to reduce the weight that a judge may consider when an MRI, X-ray, etc., are interpreted to read that you are not truly hurt.

32. IF I CONTINUE WORKING AFTER LOSING ONE OF THE ABOVE-MENTIONED PARTS OF MY BODY, DO I STILL GET COMPENSATION FOR THIS LOSS?
YES. You don't have to have any loss of wages in order to get compensation for specific loss.

33. IF I DO NOT HAVE A LOSS BY AMPUTATION BUT DO SUFFER A LOSS OF USE OF A MEMBER, AM I ENTITLED TO COMPENSATION?
YES. Loss of use is considered the same as loss by separation or amputation.

34. SUPPOSE I LOSE PART OF THE USE OF A MEMBER OF MY BODY. AM I ENTITLED TO COMPENSATION?
YES. You would be entitled to a proportionate number of weeks of compensation, depending upon the percentage loss of use.

35. CAN PAYMENTS MADE TO ME FOR TEMPORARY DISABILITY BE DEDUCTED FROM THE AMOUNT OWED FOR A PERMANENT LOSS?
No.

36. IF MY DISABILITY BECOMES A PARTIAL LOSS OF MY ENTIRE BODY, HOW MUCH COMPENSATION CAN I OBTAIN?
You can collect a percentage of 400 weeks depending upon the extent of your disability. The maximum changes annually. This is commonly referred to as a body-as-a-whole (BAW) injury.

37. WHAT HAPPENS IF I SUFFER A PERMANENT INJURY FOLLOWING A PREVIOUS DISABILITY FROM ANOTHER ACCIDENT?
If your previous disability is to the same part of the body that you injured in a current accident, you are entitled to medical treatment and temporary disability compensation. You will receive permanent partial disability to the extent your current accident increases your disability beyond the level of previous disability to the same part of the body. If your previous disability is to a different part of the body, and the resulting combination of disability is substantially greater than what would have occurred from your current accident, you may be entitled to benefits from the Second Injury Fund. There are certain thresholds which must be met, and you should seek legal advice if you think this may apply to you. Note that the previous disability does not have to be work related in order to be eligible for benefits from the Second Injury Fund. If the combination effect of all previous disabilities and that caused by your current accident is to render you unable to work, then Permanent Total Disability benefits payable over your lifetime may be made from the Second Injury Fund. The maximum changes annually.

DEATH BENEFITS
Death benefits include payment of burial expenses not to exceed a maximum amount of $5,000. Death benefits also include payments to the employees dependents in an amount calculated pursuant to a statutory schedule similar to that described in permanent disability benefits. If you are single and have no dependents, your employer would pay only for your funeral expenses and the expenses of your last illness and nothing more.

38. WHAT OTHER DEATH BENEFITS DOES THE WORKERS' COMPENSATION LAW PROVIDE?
If the injury which caused death occurred on or after July 1,1999, the weekly compensation shall be an amount equal to 66-2/3% of the employee's average weekly wage provided that said sum shall not exceed an amount equal to the maximum rate, which changes annually.

39. WHO DOES THE LAW CONSIDER TO BE MY DEPENDENTS?
Your spouse and any of your children under 18 years of age who are living with you are conclusively presumed to be entirely dependent upon you. Also, if your children over 18 years of age are physically or mentally incapacitated from earning a livelihood, or if a child attends an accredited educational institution to age 22 years, or if the child is in the Armed Forces of the United States and then commences college after service, the child is entitled to 4 years of benefits up to age 27. Additionally, the Supreme Court rendered an opinion in 2007 (Schoemehl v. Treasurer of the State of Missouri) which extended death benefits to the dependents of the injured worker who subsequently died from causes wholly unrelated to his injuries. For a limited period of time, dependents of an employee who is totally disabled but who dies from unrelated causes may have access to continued benefits after such death. Timely consultation with an experienced attorney is essential if you have any questions about availability of this benefit.

40. CAN ANYONE BESIDES MY SPOUSE AND CHILDREN BE CONSIDERED A DEPENDENT?
YES. Members of your family, brothers, sisters, grandchildren, parents or grandparents who are actually dependent upon you. These relatives are considered dependent if they actually receive money from you at the time of your injury and need it for their support.

41. IF MY SPOUSE REMARRIES, WHAT HAPPENS TO THE DEATH BENEFITS?
If there are no other dependents, the death benefits stop. If there are other dependents, benefits go to them. The surviving spouse would receive a lump sum of 104 weeks of compensation.

42. WHAT IS MEANT BY TOTAL DEPENDENT?
A total dependent is one who is entirely dependent upon you for support or who is conclusively presumed by the law to be dependent upon you at the time of the injury.

43. WHAT IS MEANT BY A PARTIAL DEPENDENT?
A partial dependent is a person who receives some support from you but is not entirely dependent upon you at the time of your injury. Provided that there are no total dependents, a partial dependent receives a part of the death benefit previously described for total dependents, the amount depending upon the proportion of your contribution toward the partial dependent or the percentage of dependency. Your lawyer's advice will probably be valuable upon any questions of partial dependency.

OCCUPATIONAL DISEASE
An occupational disease is any disease contracted out of and in the course of the employment that is particular to the employment, or incident to such work. Generally, the test is whether or not the employee is subjected to a greater hazard than the general public and whether or not the disease is caused by or directly resulted from working conditions or a particular employment. Work must be the prevailing factor in causing the disease and disability. Some examples of occupational diseases are: a. dust diseases of the chest b. diseases attributable to inhaling fumes c. metal poisoning d. silicosis e. lead poisoning f. industrial deafness g. radiation disability h. disease of the lung or respiratory tract i. hypotension j. hypertension k. disease of the heart or cardiovascular system l. Repetitive over use conditions, such as carpal tunnel syndrome.

44. ARE INFECTIOUS OR CONTAGIOUS DISEASES COMPENSABLE?
If your work is the prevailing factor in causing you to sustain the disease and disability, then it is compensable. If, however, the condition is caused by ordinary diseases of life, they are not. However, there are some who believe that the injured worker may be able to file a civil lawsuit. You should consult with an experienced attorney if you have any questions.

45. WHAT PAYMENTS ARE MADE FOR DISABILITY OR DEATH CAUSED BY OCCUPATIONAL DISEASE?
The compensation paid under the occupational disease section is the same as if the disability or death were by accident. If your physician tells you that you are suffering from an occupational disease caused by your work, consult your committee person, union steward or your attorney immediately so that your rights may be protected.

46. WHAT ARE THE PROVISIONS MADE FOR OCCUPATIONAL DEAFNESS?
The provisions of the Act relating to occupational deafness are extremely complicated and technical. The determination of partial or total occupational deafness under the provisions of the Act is so technical and hemmed in by restrictions that every employee who sustains any occupational deafness of either one or both ears should immediately consult the committee person, union steward or attorney, so that all of his or her rights may be fully protected.

HERNIA

47. WHAT MUST YOU PROVE IN A HERNIA CASE?
In all claims for compensation for hernia resulting from injuries arising out of and in the course of employment, the employee must meet very strict tests. (1 ) That there was an accident or unusual strain resulting in hernia; (2) That the hernia did not exist prior to the accident or unusual strain resulting in the injury for which compensation is claimed.

REHABILITATION
48. ARE ANY ADDITIONAL PAYMENTS PROVIDED IF MY EMPLOYER OR INSURER OFFERS ME PHYSICAL REHABILITATION?
YES if injured before August 28, 2005, but not for injuries thereafter. If after the medical care otherwise required by law has been rendered, the employer or insurer offers you physical rehabilitation and you accept it, and after notification and approval by the Division, a payment of $40 from a state fund will be paid to the employee while he is actually being rehabilitated.

49. WHAT IS REQUIRED FOR THE DIVISION TO APPROVE THE REHABILITATION PAYMENTS?
The injury must be a serious one where physical rehabilitation is deemed necessary by a qualified physician. The physical rehabilitation must be provided at a facility or institution which is specifically qualified to provide physical rehabilitation for seriously injured industrial workers and has received a certificate of qualification from the Division of Workers' Compensation.

50. HOW DOES THE PAYMENT FOR THE TIME I AM RECEIVING PHYSICAL REHABILITATION AFFECT MY OTHER COMPENSATION?
The payment of the additional benefits for physical rehabilitation is in addition to any other compensation to which you may be entitled.

51. HOW LONG DO THE PAYMENTS FOR PHYSICAL REHABILITATION LAST?
You receive the payments during all the time you are receiving physical rehabilitation, but the period of physical rehabilitation does not exceed beyond 20 weeks - except in unusual cases and then only by special order of the Division of Workers’ Compensation. Payments are not paid after an employee has returned to work.

52. WHAT ABOUT VOCATIONAL REHABILITATION?
Effective July 1, 1991, the employer may provide vocational rehabilitation to a severely injured employee. Temporary total and temporary partial disability benefits shall be paid throughout the rehabilitation process. The permanency of the disability cannot be determined until the rehabilitation process is completed. If such program is offered and the employee refuses to accept it, the employee's benefits shall be reduced by 50%. Few employers have chosen to voluntarily offer this benefit. It is “Employer” choice. You do not have the right to force your Employer to furnish Vocational Rehabilitation. However, you may contact the local Division office for Vocational Rehabilitation independently for possible assistance.

MEDICAL BENEFITS
Medical benefits are provided by the employer and include payment for medical, surgical and hospital treatment (including nursing, ambulance and medicines) that is reasonably required to cure and relieve you from the effects of the injury.

53. WHO HAS THE RIGHT TO CHOOSE THE DOCTOR TO TAKE CARE OF ME?
Generally, your employer has the right to choose the physician who is to treat you. However, in an emergency you may choose your own doctor.

54. IF MY EMPLOYER REFUSES TO GIVE ME MEDICAL CARE AND I GET MY OWN DOCTOR, WHO PAYS?
In such cases the employer must pay him, if there was a refusal.

55. DOES MY EMPLOYER HAVE TO FURNISH ME WITH ARTIFICIAL LIMBS, ARTIFICIAL EYES, OR FALSE TEETH?
The Division may require the employer to furnish an artificial leg, foot, arm, hand or brace or artificial eye when the Division shall find that the injured employee may be partially or wholly relieved of the effects of a permanent injury by the use of such artificial leg, etc. Loss of front teeth are rated as disfigurement in an amount sufficient to cover the reasonable cost of artificial teeth. You may also qualify for lifetime replacement. If this applies to you, seek legal assistance.

56. IS AN EMPLOYER REQUIRED TO REPLACE GLASSES, DENTURES OR OTHER DEVICES DESTROYED AS A RESULT OF AN INDUSTRIAL ACCIDENT?
Yes.

MEDICAL EXAMINATIONS
If your employer sends you a notice to report for an examination by his doctor, you must do so. The law requires that you submit to such an examination. This does not mean, however, that the doctor is entitled to cross-examine you on facts not related to your physical condition.

57. WHAT HAPPENS IF I REFUSE TO GO FOR SUCH AN EXAMINATION?
Your right to compensation may be suspended.

58. WHO PAYS FOR THIS EXAMINATION?
Your employer or its insurance company must pay for it.

59. MUST I ACCEPT THE COMPANY DOCTOR'S OPINION AS FINAL?
NO. If there is any doubt in your mind, consult your own doctor. Be aware you will have to pay your doctor, and any health insurance you have likely will not cover this cost. You should see a physician who is familiar with workers compensation, who has no allegiance with the Employer or its insurer. You may wish to consult you steward , committee person, or attorney.

LUMP SUM PAYMENTS AND COMPROMISE SETTLEMENTS
A lump-sum payment is the payment in one sum of the present value of your employer's established liability for compensation to you. A compromise settlement is a final settlement of a disputed claim by payment of a lump sum to you by your employer.

60. HOW ARE COMPENSATION BENEFITS PAID TO ME?
They are paid to you in the same manner as your wages were paid while working, but not less frequently than once every two weeks.

61. CAN I DRAW MY COMPENSATION BENEFITS IN ONE LUMP SUM?
YES, If permanent partial disability benefits are paid. If permanent total benefits are to be paid, ordinarily you cannot receive a lump payment, without approval from the Division.

62. MUST MY EMPLOYER CONSENT TO PAYMENT OF A LUMP SUM FOR ME TO OBTAIN IT?
No.

63. MUST MY EMPLOYER CONSENT TO A COMPROMISE SETTLEMENT?
YES. A compromise settlement is possible only after your employer and you agree on its terms and only if, after hearing the parties, it is approved by the Division. You cannot reopen your case after a compensation settlement. It is a final settlement, unless rare instances of fraud occur; or unless your settlement agreement provides for you to reopen it.

MISCELLANEOUS
64. WHEN I RECEIVE MY COMPENSATION CHECK MUST I SIGN A PAPER FOR IT?
NO. At least generally, partial receipts are not used. If you are asked to sign any written agreement, you should consult your committee person, union steward or attorney.

65. IF I RECOVER FROM MY INJURIES SUFFICIENTLY TO RETURN TO WORK, MUST MY EMPLOYER REHIRE ME?
NO. There is no obligation under the Worker's Compensation law on your employer to rehire you or to continue you in employment because of your accident. You must look to your union for protection.

66. SUPPOSE I HAVE A GROUP POLICY THAT ENTITLES ME TO WEEKLY BENEFITS. SHALL I ACCEPT THEM?
Most group insurance policies provide for weekly disability benefits for a limited period of time, payable only if your injury is NOT compensable. If your policy is of this type and your injury entitled you to Workers' Compensation, do not accept the insurance. If you are not absolutely sure what type of policy you have, consult your attorney. However, if you do accept group policy benefits, remember that any statements made by you in presenting your group claim may be used against you later in defense of your compensation claim.

67. SUPPOSE I HAVE A HOSPITALIZATION POLICY AND SUSTAIN AN ACCIDENTAL INJURY AT WORK, SHALL I HAVE MY DOCTOR BILLS PAID FROM THE HOSPITALIZATION POLICY?
NO. For the same reason as stated above. Your rights to Workers' Compensation and hospitalization benefits are usually inconsistent. If your hospitalization insurance is of this type, do not accept its benefits if you are entitled to Workers' Compensation. If you are in doubt, consult your attorney.

PROCEDURE FOR FILING A CLAIM
In about 90% of the cases, compensation is paid by the employer by an agreement. In about 10% of the cases, the employer may refuse to pay and in that event you must file a claim. File your claim with the Missouri Workers' Compensation Division on the printed form called "Claim for Compensation" which the Division furnishes. You can obtain this form by writing the Division of Workers’ Compensation, P.O. Box 58, Jefferson City, Missouri 65102, or by consulting with an attorney, which is recommended in such event.

68. IS THERE ANY DIFFERENCE BETWEEN MAKING A DEMAND FOR COMPENSATION FROM MY EMPLOYER AND FILING A CLAIM FOR COMPENSATION WITH THE DIVISION?
YES. The purpose of the demand for compensation is to notify your employer that you are entitled to compensation. The filing of a claim for compensation brings the matter of your right to compensation formally before the Division.

69. WHERE SHALL I FILE THESE FORMS?
File them with the Division of Workers' Compensation at the appropriate office listed above. Remember in filling out the forms to do the following:
(a) Make 4 copies of your claim, file 3 of them with the Division and keep a copy for yourself.
(b) See that the blanks are filed in as accurately as possible. If you do not know dates or amounts, or if there are other questions you cannot answer, leave the space blank.
(c) Consult your committee person, union steward or attorney.
(d) This form is a legal document which has the effect of binding you to certain admissions, so care must be used in completing the claim. Typically, have your attorney assist you.

70. HOW LONG AFTER THE ACCIDENT DO I HAVE TO FILE MY CLAIM?
You may file your claim any time within two years from the date of your accident or date of the last payment on account of the injury. However, do not wait that long. File your claim IMMEDIATELY because it may be hard to prove your case if you delay. If no report of injury was filed with the Division, the time is three years from date of accident or date of last payment.

71. HOW LONG DO I HAVE TO FILE MY CLAIM IF SOME COMPENSATION HAS BEEN PAID?
You have two years from the date of the last payment. Furnishing medical treatment has been held to be equivalent to the payment of compensation.

72. WHAT HAPPENS AFTER I HAVE FILED MY CLAIM WITH THE DIVISION?
Your employer must file an answer to your claim within 30 days, and after that your case is set for pre-hearing conference before an administrative law judge of the Division. The Division will mail you a notice of the time and place of the hearing. YOU MUST APPEAR FOR THE HEARING, unless you are represented by an attorney, in which case, he should advise you what to do.

73. DO I HAVE TO BRING WITNESSES OF THE ACCIDENT WITH ME?
NO. If you have witnesses of the accident, you can take them with you to the hearing. If your witnesses refuse to go to the hearing, you can subpoena them. At your request, the Division will furnish you with the necessary form of subpoena. Do not subpoena witnesses to go to a pre-hearing. You are best served if you give the names of your witnesses to your attorney.

74. SUPPOSE THERE ARE NO WITNESSES TO THE ACCIDENT, HOW CAN I PROVE MY CASE?
Your own word may be enough, particularly if it is verified by surrounding circumstances, such as a prompt report of your accident to the employer, or a consistent history to a treating physician.

75. SUPPOSE MY EMPLOYER, WHILE ADMITTING THAT I HAD AN ACCIDENT, DENIES THAT I AM DISABLED BECAUSE OF IT; WHAT SHALL I DO?
Get your own doctor to examine you and to appear and testify in your behalf at the Division hearing. Many of the differences between the worker and his/her employer regarding the payment of compensation arise because of differences in medical opinions. Here, your steward or committee person can assist you, by referring you to experienced lawyers who can help you.

76. IS THE HEARING BEFORE THE ADMINISTRATIVE LAW JUDGE A TRIAL?
A hearing before an administrative law judge is very much like a trial of a case in court. You should be fully prepared to try your case. The rules of evidence apply, and if you are to have a trial, you should consult with an attorney.

77. DO I HAVE TO GET A LAWYER TO REPRESENT ME AT THE HEARING?
A lawyer is not necessary if you are certain that your employer or the insurance company has agreed to pay you everything to which you are entitled under the Act. However, remember that it would not be necessary to have a hearing at all unless your employer or the insurance company were disputing your right to compensation and unless they felt they had a chance of defeating your claim. They hire very able lawyers to present their side of the case. The rules of evidence in a compensation hearing are as technical as in a lawsuit. It is just as necessary to have a lawyer in a contested compensation case as it is in any other court proceeding.

78. WHAT HAPPENS AFTER THE HEARING?
The administrative law judge files his award and the Division mails you a copy of it.

APPEAL
You may file an "Application for Review" by the Labor & Industrial Relations Commission within 20 days of the date on which the award was rendered. The Division and the Commission furnishes printed forms of "Application for Review." These forms should accompany your notice of the administrative law judge's award. If not, get them from any of the Division's offices. File the Application for Review with the Division of Workers' Compensation, P.O. Box 58, Jefferson City, Missouri 65102, or with the Labor and Industrial Relations Commission, 3315 W. Truman Blvd., Jefferson City, Missouri 65109.

79. WHAT CAN I DO IF I HAVEN'T ENOUGH TIME (WITHIN 20 DAYS) TO OBTAIN THE FORMS REQUIRED AND TO FILE THEM WITH THE COMMISSION?
You must file your application for review or the award becomes final.

80. HAVE I LOST MY RIGHT TO APPEAL IF I WAIT LONGER THAN 20 DAYS?
YES.

81. IF I WIN MY CASE, CAN MY EMPLOYER APPEAL?
YES. He has the same right to appeal as you.

82. WHAT HAPPENS AFTER AN APPLICATION FOR REVIEW IS FILED?
In most instances the full Commission simply reviews the record of the case made before the administrative law judge. It may, however, in unusual cases, ask for oral argument. No further testimony is presented and the Commission thereafter makes its decision. You will be mailed your copy of the decision of the Commissioners.

83. CAN AN APPEAL BE TAKEN FROM A TEMPORARY AWARD?
Yes, under certain circumstances.

84. WHAT ARE THE GROUNDS FOR AN APPEAL?
The Court may change the Commission's award only upon the following grounds.
(a) That the Commission acted in excess of its powers;
(b) That the award was procured by fraud;
(c) That the facts found by the Commission do not support the award. That there was not sufficient competent evidence in the record to warrant making the award.

FINAL RECEIPTS

When you get well or return to work, your employer may submit a final receipt to you for your signature on a printed form supplied by the Division. A "final receipt" is a receipt to be filed with the Division showing the total amount of compensation paid. In signing a final receipt, please be careful of the following things:
(a) See that all names and dates and amounts are correct;
(b) Be sure your injury is properly described;
(c) All spaces should be filled out completely;
(d) Read the directions printed on the form and follow them.

85. SHALL I GET A COPY OF THE FINAL RECEIPT?
YES, be sure to do so.

86. DOES THE SIGNING OF A FINAL RECEIPT CLOSE MY CASE FOR GOOD?
NO. (See "Further Compensation or Reopening Case.")

87. WHAT HAPPENS IF I REFUSE TO SIGN FINAL RECEIPTS?
Your injury may be set for a conference. The conference is an informal hearing at which both you and your employer appear before a representative of the Division who hears both sides. If you and your employer fail to come to an agreement after your conference, then you must file a claim.

FURTHER COMPENSATION OR REOPENING YOUR CASE-SPECIAL SITUATIONS

88. IF MY EMPLOYER WILL NOT AGREE TO PAY ME FURTHER COMPENSATION, WHAT CAN I DO?
File a claim with the Division, if you have not already done so.

89. WHAT IF MY INJURY IS GRADUAL, AND I DID NOT HAVE A SPECIFIC ACCIDENT. AM I ENTITLED TO BENEFITS?
Conditions from repetitive overuse , such as carpal tunnel syndrome, tennis elbow, certain rotator cuff (shoulder) problems, reflex sympathetic dystrophy, thoracic outlet syndrome, CRPS, and fibromyalgia are examples of physical injuries which have been found to be caused or substantially related to employment. If you have worked for less than 90 days for the employer when you notice the symptoms of your injury, your past employers may need to be included in your claim. This often gets complicated, and you will need assistance from your steward, committee person, or lawyer.

90. ARE HEART ATTACKS EVER COMPENSABLE? POSSIBLY.
Given the recent changes to the Act, proving the compensability of these types of injuries has become very difficult . In most cases, Employers and their insurers will try to defeat your claim by indication your diet, lack of exercise, smoking, and heredity are the cause. If you or someone you know has a heart attack, it should be thoroughly investigated early to determine whether your work was a substantial factor in causing the heart attack. However, the Act provides a presumption for some workers who are members of a paid fire department or are paid police officers. This presumption suggests that certain diseases of the lungs, heart, cardiovascular system, etc., may be recognized as occupational diseases due to exposure to smoke, gases, carcinogens, lack of oxygen, but only if a direct causal relationship is established. (§287.067(6) R.S.Mo.)

91. DOES THE EMPLOYER OR INSURER HAVE THE RIGHT TO HAVE THEIR CASE MANAGER ATTEND MY DOCTOR’S APPOINTMENT?
NO. You have the right to privacy. Because you are injured, your Employer has the right to obtain information about your condition, but you don’t have to be subjected to a specialist, hired by the employer or insurer, who can seek to intimidate you or the physician. Other times, these nurses can be of limited use. The best advice is to be skeptical, ask the nurse whose interest it is they are representing and consult with your steward, committee person or attorney.

92. MUST I HIRE AN ATTORNEY WHENEVER I AM INJURED?
NO. However, you should realize your employer has his trained specialists watching out for his interests, from the personnel department, to the adjuster, case manager, administrator, and attorney. Consult with your steward or committee person first, and then an attorney. Most attorneys will give you a free initial consultation, before you decide whether or not to hire one.

93. ARE BENEFITS DIFFERENT FROM STATE-TO-STATE?
If you were hired, injured, or your employment is principally localized in Missouri, then you are entitled to Missouri benefits. If you were hired or injured in a different state, you may be entitled to greater benefits. Consult with your steward, committee person or attorney. Time limitations for reporting injuries and filing claims vary, so it is important that you act quickly following your accident.

94. IF I HAVE TWO OR MORE EMPLOYERS WHEN I GET INJURED, DOES THIS AFFECT MY CLAIM?
YES. Your wages earned from all jobs are combined, so that if you are temporarily and totally disabled, you will receive sixty-six and two-thirds percent up to the maximum rate in effect on the date of your accident

95. WHAT ABOUT FRAUD? IS IT REALLY A PROBLEM?
The statistics compiled to date suggest that fraud and abuse by Employers and insurers are in greater numbers then employees, lawyers or doctors. Many employers believe that employees seeking compensation nonetheless commit fraud when they apply for unwitnessed accidental injuries, or for injuries occurring after a weekend off work. It is a crime for anyone to knowingly claim compensation for an injury which did not occur at work. It is also a crime for the employer to knowingly discharge its obligations (which cannot be disputed) in such a way to deprive you of your benefits.

LABOR DOES NOT CONDONE ANY TYPE OF FRAUD COMMITTED BY EMPLOYERS, INSURERS OR EMPLOYEES. IF YOU SUSPECT AN ABUSE HAS OCCURRED, CONTACT YOUR STEWARD, COMMITTEE PERSON OR ATTORNEY.

96. HOW DO SOCIAL SECURITY OR MEDICARE BENEFITS AFFECT MY WORKERS’ COMPENSATION BENEFITS?
If you qualify for Social Security disability, you may have a reduction in that benefit for the same months that you receive Workers’ Compensation payments. Generally, you can expect to receive up to 80% of your monthly pre-injury earnings before Social Security benefits can be reduced. Your Workers’ Compensation benefits will not be reduced, however. If you have applied for Social Security Disability or Retirement benefits, or expect to do so within 30 months of your contemplated workers’ compensation settlement, Medicare’s interest will need to be addressed. This means that Medicare does will not pay for future treatment for a work related condition for which the workers’ compensation insurance company should have been responsible. You will need attorney help in this event, as the process is cumbersome and difficult.

97. WHAT ABOUT FUTURE MEDICAL CARE? CAN I GET IT, EVER?
Your employer has the obligation to provide you with such medical care and attention as may reasonably be required to care or to relieve, you from the effects of your injury. If your treating physician tells you that some day on down the road you will need surgery, ask him to write it down in his records, or better yet, to give you a copy of what it is he recommends. Frequently, employers don’t ask their doctors to express their thoughts as to what the future may hold for you. So, it is important to ask the company and even your doctor for an opinion before you consider any settlement. Once you have settled your claim, you are at risk because you have released your employer from this future responsibility. Also, if you have had surgery to replace a joint, your employer may owe lifetime replacement for these. Consult your steward, committee person or attorney if you have a specific question.

98. CAN I BE FIRED BECAUSE I FILE A CLAIM FOR WORKERS’ COMPENSATION?
NO. It is unlawful for your employer to terminate you or discriminate against you because you chose to pursue your rights to receive benefits. Contact your steward or committee person immediately if any actions are taken, or threatened, against you.

99. ARE STRESS INJURIES COMPENSABLE? POSSIBLY.
If you have an emotional disorder caused by the trauma resulting from a physical injury. If you do not have a physical injury, the standard of proof, and the causes for the emotional (stress) injury are limited. Consult your steward, committee person or attorney. A mental injury is not considered to arise out of and in the course and scope of your employment if it resulted from (a) disciplinary action; (b) work evaluation; (c) job transfer; (d) layoff; (e) demotion/termination; (f) or any similar action taken in good faith by your employer. (§287.120(9) R.S.Mo.)

100. HOW DO I HIRE A QUALIFIED ATTORNEY?
Here are a few suggestions:
•If you have no experience with an attorney, ask your steward or committee person for a recommendation.
•You can ask other union officers, brothers or sisters for a referral based upon their experience.
•Your local union, area labor council, or the officers of the Missouri AFL-CIO can give you a recommendation.
•Ask the lawyer about his or her experience in litigating Workers’ Compensation Claims. Does the lawyer limit his practice (specialize)? How many times has he appealed cases to the Court of Appeals or the Supreme Court?
•Is the lawyer a member of the Union Privileges Legal Services network?
•Is the lawyer active in local, state and or national bar associations, such as The Missouri or Kansas Association of Trial Attorneys, American Association for Justice (formerly ATLA), and/or the Workers’ Injury Law & Advocacy Group (WILG)?
•Does the lawyer represent employers and insurers, or is his practice limited to representing injured workers and their families?

ENDNOTES

On February 24, 2009, the Missouri Supreme Court issued its long-awaited opinion in the matter of Missouri Alliance for Retired Americans v. Dept. of Labor & Industrial Relations, Division of Workers’ Compensation. In this opinion, the Supreme Court was asked to address whether the changes effected by Senate Bills 1 and 130 in 2005 were unconstitutional? The court did not address the issues of constitutionality, but instead, ruled that the various unions who were plaintiffs, did not have standing to bring the lawsuit as they could not demonstrate that any of their members had been subjected to a specific harm resulting from the 2005 amendments. However, the Court did issue a declaratory statement that by eliminating certain injuries and diseases from coverage under the Act, injured workers were permitted to seek suits for civil damages against their employers. This was important when considered in conjunction with another Supreme Court opinion issued on January 27, 2009 titled J.C.W. and T.D.W., minors, by their next friend, Kelly K. Webb v. Jason L. Wyciskalla.

In that opinion, the Supreme Court held that “the courts of this state should confine their discussions of circuit court jurisdiction to the constitutionally recognized doctrines of personal and subject matter jurisdiction; there is no third category of jurisdiction called “jurisdictional competence.” Another way of stating this is that the circuit courts no longer must defer to an administrative agency’s (such as the Division of Workers’ Compensation) decision that it has jurisdiction over an issue. Now, every circuit court judge in the state has the authority to decide if it maintains jurisdiction over the issue, allowing the injured party to proceed forward with a civil suit.

Any employee who is injured on the job or while engaged in activities related to that job may be entitled to workers' compensation coverage.

Typical benefits frequently used include access to medical care, payment of wage replacement income for temporary inability to work, and payment for permanent impairment or disability.

Whether you are entitled to workers' compensation benefits often involves complex legal and medical-legal analysis. Not every possible claim requires an attorney, but you should be aware you have specific legal rights and obligations. Experienced attorneys will discuss questions with you, typically without initial charge.

The definition of what falls within the category of an "injury" is very broad and includes almost any health impairment (i.e. back injuries, neck and shoulder injuries, broken bones, heart attacks, diseases, abnormal psychological conditions, etc.). If you have a specific question about an injury you have received, ask your Union's representative or your attorney. If your Union representatives cannot immediately answer your questions, they will put you in contact with attorneys who will speak with you.

Because each case is different and has many unique features, it is impossible to explain all aspects which may affect your directly.

Please understand this pamphlet is not intended to constitute specific legal advice on your case. You should rely upon the specific advice and direction that come from an attorney at Boyd & Kenter, P.C.

NOTICE
If you have suffered a work- related injury, it is important that you give written notice immediately to your employer. Unless the employer has actual notice of the occurrence of an injury with 10 days from the date of injury, you may be precluded from collecting workers' compensation. In some cases, that time may be extended to 75, days but only in unusual circumstances. If this is at all an issue in your claim, contact your attorney. Usually employers have an "employer's report of injury" filed after an injury. Use the Form 15 document to accomplish this task. Keep one copy for yourself and give the original to your Employer. Do not hesitate to report all injuries, no matter however small they may seem initially. Failure to timely provide notice could eliminate access to coverage, even if the slight injury becomes quite serious months later.

STATUTE OF LIMITATIONS
There are variable time limits in which a workers' compensation claim must be brought or you waive your right to any coverage or recovery. In some cases, this is 200 days from the date of accident or last payment of compensation, whichever is later. This is a typical matter to discuss with your attorney, who can assist you calculate the time limitations.

PERMANENT IMPAIRMENT OR DISABILITY BENEFITS
"If I return to work, is that the end of my case?" Not at all. If you have limitations of motion, decreases in strength, permanent restrictions, chronic pain, or decrease in future job opportunities as a result of any injury, you may be entitled to additional coverage and compensation. There are countless examples of permanent injuries that workers are not compensated for merely because they fail to make a claim after they return to work.

Furthermore, you are entitled to lifetime medical benefits related to your injury unless you release that right.

MEDICAL BENEFITS
The employer, through its insurance company, is required to furnish all reasonable medical services, including but not limited to medical, dental, physical rehabilitation, hospital services or the supply of prosthetic devices. In addition, the employer's insurance company is required to pay transportation expenses incurred by the employee going to and from his/her visits to the doctor. Unless the employee is required to go out of town, the benefits are normally limited to mileage.

The employer has the right to choose the physician to whom you will be sent for treatment. However, you may request a different doctor if the services provided by the appointed doctor are unsatisfactory. This requires intervention of the court. If you are dissatisfied with the medical treatment you are receiving or you think additional medical care would be beneficial, please feel free to talk with your attorney about it. Oftentimes, your lawyer is able to get the insurance company to cooperate with you in this regard.

WHILE YOU ARE UNABLE TO WORK DUE TO YOUR INJURY (TEMPORARY TOTAL DIS-ABILITY/TEMPORARY PARTIAL DISABILITY
If you were injured on the job to an extent that you missed work during the time you were recovering from your injury, you may be entitled to what is called temporary total disability payments. These payments commence after you have been off work 7 days and will continue so long as you are disabled. The first week of benefits is not due unless and until the employee is off three weeks.

In the event you are unable to return to work but you have reached your maximum level of recovery, then the insurance company will attempt to cut off your temporary total disability benefits since you, by definition, are no longer temporarily disabled. You need to anticipate loss of benefits when you are rated or released.

PERMANENT PARTIAL DISABILITY (PPD)
This is where your attorney can typically be of the most benefit in protecting your interests. If you return to work, there is usually little dispute regarding the amount of temporary total disability payments to which you are entitled and, therefore, the insurance company will usually pay these benefits. At the point you have either returned to work or the doctors believe there is no further improvement anticipated in condition, the insurance company may attempt to resolve your claim.

You must remember that the insurance companies are not in business to protect your interests.

If you are able to return to work of some kind, but you continue to have some permanent difficulties, then you may be entitled to permanent partial disability payments. There are two types of permanent partial disabilities under Kansas law. The first type of permanent partial disability involves an injury to a "scheduled member." If you suffered the loss of use of a finger, hand, arm, toe, foot, leg, eye, shoulder or loss of hearing, then your disability falls within this category. If you suffered a compensable loss or loss of use to more than one scheduled member, then you may be entitled to be evaluated on the "body as a whole."

For example, a carpenter who permanently injuries his wrist so that he can no longer engage in his occupation would receive the same amount as a banker with the same injury to his wrist who could not continue with his/her occupation. Although this is a very inequitable and arbitrary manner in which to handle workers' compensation for a scheduled member, it is what Kansas law currently provides.

WHOLE BODY DISABILITY
The second type of permanent partial disability involves an injury to the "body as a whole." This occurs when an injury produces a permanent disability that extends beyond a scheduled member injury into the trunk of the body, head or multiple scheduled injuries. The most typical injuries of this kind would be an injury to the back, hip or multiple scheduled injuries. If you suffer an injury to the "body as a whole," you will be entitled to benefits based upon your bodily disability. In some cases, you may be entitled to "work disability." Work disability takes into account the employee's age, education, training and medical restrictions as well as the claimant's inability to earn comparable wages. Because a severe scheduled member injury usually may include a psychological injury also, you may be entitled to compensation based upon work disability even though your original injury was to a scheduled member. Please feel free to discuss the physical and psychological ramifications of your injury with your attorney.

PERMANENT TOTAL DISABILITY
If you are unable to return to work for the rest of your life because of compensable injury, you may be entitled to permanent total disability as well as lifetime medical benefits.

DEATH BENEFITS
These benefits are payable to the dependents of an employee in the event the compensable injury results in the employee's death. These benefits are payable to the surviving spouse. In the event there are dependent children, the benefits will be apportioned, one-half to the surviving spouse and one-half to the dependent children. Dependent children are entitled to benefits until they reach the age of 18 or until the age of 23 if they are full time students in an accredited institution. Others may also qualify if there's an actual showing of dependency. Upon remarriage, if there are no dependent children, these payments cease, but the spouse is entitled to a 100-week lump sum settlement.

AMOUNT OF BENEFITS
The amount of weekly benefits is dependent upon the amount of your gross earnings at the time of your injury, but not to exceed 75% of the state's average weekly wage. We will check to make sure you are receiving compensation at the appropriate rate.

One of the most frequent questions asked by new clients is, "How much are we going to sue for?" Under the Director's rules, we do not ask for a specific amount in our claim. Before we can analyze your claim, it is necessary to review all of your medical records, wage records and perhaps conduct a vocational evaluation.

WHAT HAPPENS AFTER A WORKERS' COMPENSATION CLAIM IS BROUGHT?
Under the laws of the State of Kansas, there are few secrets in lawsuits. The employer/insurance carriers are entitled to obtain information about the accident, how the injuries have affected the person, and what is anticipated in the future. An attorney's policy should be to answer all legitimate questions from the carrier fully and truthfully.

Once a claim has been started, the claimant and defendant have the right to obtain information about the case by using depositions.

Discovery depositions involve the taking of verbal testimony from a person under oath. If a client's deposition is taken, the attorney is always present with them. A court reporter, who takes down the sworn testimony, is present. Before a deposition of a client, the attorney will take all the time necessary to go over the types of questions that will be asked so there are no surprises.

Medical examination: The employer/insurance company have a right to have you examined by a physician of their choice. This examination can occur once per month. The insurance company will pay the costs of this examination and a report will be given to the insurance company about the doctor's findings and opinions. This report must be produced to your attorney.

THE TRIAL
After the claim has been filed, the claimant will be evaluated and the matter will be set for a pre-hearing settlement conference. The purpose for this pre-hearing settlement conference is to determine what issues the parties are going to litigate. The pre-hearing settlement conference is an informal hearing before the Court which requires the attendance of the attorneys and the claimant. Prior to the pre-hearing settlement conference, it is important that the attorney be given all unpaid medical bills, itemizations of medical mileage as well as prescriptions. You will be asked to attend the pre-hearing settlement conference and will ordinarily discuss possible settlement options.

If the matter is not resolved at the pre-hearing, the Court may order an independent medical evaluation (IME). This procedure involves the Court appointing a physician to examine you and render a report regarding his/her findings and conclusions. The Court will consider this report without testimony from the doctor. Normally, the Court gives significant weight to the opinion of the independent medical examiner.

If the parties cannot resolve the matter after the IME, the matter will be set for a "trial." A trial is merely a hearing at which the claimant offers testimony to the Court about his/her accident, treatment, unpaid bills, medical mileage, the need for future care and treatment and permanency.

After the regular hearing, the attorneys will obtain evidentiary depositions of the appropriate witnesses, including examining physicians or vocational experts. The Court normally gives the injured worker 30 days after the hearing date to complete his/her evidence and the employer is given an additional 30 days to produce its evidence.

Thereafter, the matter will be submitted to the Court for a decision.

The Court makes an attempt at writing the decision within 30 days but is not always successful.

APPEALS
Either party that is unhappy with the findings of the Administrative Law Judge may appeal the matter to the Workers' Compensation Appeals Board.

The appeal has to be requested within 10 days, so it is important that you immediately contact your attorney's office regarding your assessment of the Award and whether or not you desire to appeal. Appeals normally take several months and additional work. Decisions from the Workers' Compensation Appeals Board may be appealed to the Kansas Court of Appeals. Again, this procedure is time consuming but often necessary.

HOW CAN YOU HELP YOUR ATTORNEY?
You are entitled to the best medical care available for injuries caused by the accident. It is important that you continue to go to the doctors as long as your injuries continue to bother you. You should cooperate with the doctors in every way and should relate to the doctors truthfully and fully all symptoms effected by the accident. You should realize that medical treatment often takes time to obtain results, and often the possibility of a doctor's diagnosis being accurate is improved by opportunities for further examination. Do keep your attorney constantly informed on your recovery from the injury you received, your employment status, and your address and telephone number changes.

Do not discuss the details of your accident or injuries with persons not entitled to the information. It is possible that the individual who injured you, their insurance company, investigators, or even attorneys, may contact you and want to speak to you directly about the case. If this occurs, you should refer these individuals to your union or attorney. Do not make statements to any persons without your union's or attorney's specific approval.

If you have already made statements to an insurance company representative, or anyone else, tell your union and attorney immediately so he can get a copy of the statement.

When Personal Injuries Result in Death: Wrongful Death Cases
In general, a wrongful death claim is one in which it is alleged that a person died as a result of another's negligence. The deceased person's surviving relatives, dependents, or beneficiaries may bring suit against the responsible party or parties, seeking monetary damages for their losses. Each state has its own wrongful death law and not every state follows the same guidelines, principles, or rules. A personal injury attorney at our firm can advise you on whether you have a valid wrongful death claim and can help you pursue that claim against the responsible party or parties.

Wrongful Death Laws Vary from State to State
Some states have "true" wrongful death acts in which the deceased person's survivors or next of kin are entitled to bring a cause of action for their damages resulting from their family member's death. Other states have acts that are more properly called "survival actions." In general, survival actions are brought on behalf of the deceased person for the deceased person's pain, suffering, and other damages resulting from the injuries that caused his or her death.

The individuals who are entitled to bring a wrongful death claim also depends on the jurisdiction. Generally, the primary beneficiaries of the person who has died (often the spouse and children) are able to bring a claim, and in some states the parents of the deceased person may be also designated as beneficiaries. In most states, if the deceased person did not leave behind a husband or wife, children, or parents, there may be no one who may bring a wrongful death claim. Sometimes, the recovery, if any, is simply doled out to the deceased's "heirs at law" or as provided by law.

In many jurisdictions, it is not necessary that the defendant's conduct be the sole cause of death. Even when the defendant's negligence contributes only in part or in tandem with other circumstances to a person's death, liability may still attach.

When must a wrongful death claim be filed?
Every state has its own statute of limitations for wrongful death, which defines the time frame during which a lawsuit must be filed. In Missouri, the statute of limitations for a wrongful death claim is 3 years, but can be as short as 2 years for claims involving medical negligence. In Kansas, the statute of limitations for both wrongful death and medical negligence is 2 years. The statute of limitations usually runs from the time of the victim's death, although some states may allow a lawsuit to proceed if the act which caused the death was not discovered until later. In some cases, an estate must be opened in a time period specified by law. This time period may be as short as 1 year.

Wrongful Death Damages
When a defendant is found legally liable for the death of another, the types of damages that may be recovered can also vary greatly. For example, the plaintiffs in a wrongful death case may be able to recover the following:

• the deceased's medical expenses
• funeral and burial expenses
• lost earnings, and lost benefits (such as pension benefits or medical and health insurance coverage)
• in some states, the plaintiffs may be able to recover damages for pain and suffering or mental anguish that they experienced as a result of the death as well as punitive damages.

Non-economic damages are more difficult to calculate than economic losses. Recoverable non-economic losses may include damages for loss of household services, loss of companionship, comfort, instruction, guidance, counseling and consortium (i.e. the relationship between a husband and wife). Generally, there can be no recovery for grief and bereavement suffered because of the death. In order to recover for any damages, economic or non-economic, the plaintiff must prove that the losses did in fact occur or that future losses are more likely than not to occur.

The method and manner of calculating damages in a wrongful death action can be very complex. This potential complexity is especially true when trying to calculate the monetary loss to which the plaintiffs are entitled. Monetary loss, sometimes called pecuniary loss, generally includes the survivor's lost support, contributions, and services of the deceased person. The computations for these damages are typically based on the deceased person's life expectancy and work life expectancy as well as the life expectancies of the beneficiaries and, where necessary, the remaining period of minority of any beneficiaries.

In cases where there is more than one beneficiary, the damages will be distributed among those beneficiaries. Most states allocate the damages among the beneficiaries in accordance with their losses. However, in some states the recovery is divided as spelled out in its wrongful death or intestacy laws.

Defenses to Liability in Wrongful Death Cases
In general, a defendant is entitled to raise any defenses in a wrongful death action that could have been raised in an action brought directly by the decedent, had he or she not died. Therefore, if the decedent was contributorily negligent in causing his or her own death, the defendant may assert that defense in the wrongful death action. Also, in most states, if the decedent had already recovered damages, such as in a case where the death was not immediate and the decedent was able to bring his own successful personal injury claim, the survivors may not then successfully bring a wrongful death action and recover for the same injury. There are limitations to this prohibition, and in some situations the survivors may still be entitled to bring a wrongful death action in their names.

Conclusion
When a loved one dies, the complexities of a legal claim against the wrongdoer can be overwhelming. At this already stressful and emotion-laden time, the assistance of an experienced personal injury attorney at our firm who can guide surviving family members through the complex legal maze and help secure compensation for their devastating losses can be invaluable. The experienced attorneys at Boyd & Kenter, P.C. urge you to call us for a free consultation. In Kansas City, that number is 816-471-4511 and in Sedalia, 660-829-1118. We are committed to protecting the rights of injured people and their families. If your family member has died in a car accident, you might have a wrongful death case. We can help recover economic and non-economic damages for the injuries you sustain.

Practice details text will go here.

Injuries from accidents occur in many different settings. Sometimes the injuries arise from an automobile or motorcycle accident, other times they may occur as the result of a dangerous condition on another person's property or perhaps from the use of a product which malfunctions or is improperly designed. In the worst of circumstances, injuries can result in the wrongful death of a person leaving behind surviving family members to deal with the emotional and financial losses caused by the wrongful death.

Q. I have been in a car accident, now what?
A. Many personal injury cases arise from the operation and use of motor vehicles. It is always a good idea to call a local law enforcement officer to make sure that the proper accident report is made to document the facts ofthe accident.

Q. I don't like the idea of calling the police on a minor accident, should I?
A. Although it may not seem important in instances where the accident seems tobe relatively minor in nature, many times injuries from low speed impacts do result in significant permanent personal injury and if the local law enforcement agency has not had an opportunity to investigate and prepare a report regarding the accident, then there is no "official" report of the facts. Additionally, police officers frequently take the names of persons who may have observed the accident as witnesses and later, if the cause of the accidentis in dispute, this information can be critical in resolving any disputes as to how the accident occurred. Finally, the law requires you report all accidents involving $500.00 or more in property damage.

Q. Right after the accident I didn't think I was injured, but now I am very sore, what should I do?
A. Get in to see your doctor immediately and advise that at first you thought youweren't hurt, that you were wrong and need be checked out. In any type of accident whether it is a car accident, a slip and fall, or injuries resulting from a defective product, a person rarely has the ability to assess their own injuries. Many times injuries received in an accident do not become apparentfor several days or weeks.

Q. If someone asks me if I am hurt and I am not sure, what should I say?
A. If you are asked how you were doing at the scene of an accident by anyone,simply indicate that you don't know. In time, you will be able to tell if you have injuries from the accident and can seek appropriate medical treatmentat that time.

Q. Should I contact my insurance company?
A. Yes, in most instances you should immediately contact your insurance company. Kansas, like many states, requires automobile liability insurance policies to provide Personal Injury Protection benefits in any auto liability policy issued in the state of Kansas. We will look at PIP benefits later in thisbooklet.

Q. Should I give a statement to people that call on the phone or come by the house to asking about how I got hurt?
A. It is also better practice to consult with an attorney before giving any statements about how the accident occurred.

Q. What happens if I'm hurt on somebody's property?
A. Just like with automobiles,property owners carry liability insurance to protect them in the event someone is injured while on their property. These types of accidents are commonly referred to as "slip and fall" cases. Injuries can happen from such things as slippery areas caused by bad whether, open trenching or holes on the property, or inadequate lighting resulting in an area being unsafe because dangerous conditions are hidden in darkness. The owner of the property is required by law to exercise reasonable care for the protection of persons invited upon the property.

Q. Does that mean anytime I am hurt on someone's property they are responsible for my medical bills?
A. If it can be shown the owner of property failed to use reasonable care in maintaining the property in a reasonably safe condition you can usuallyrecover your medical expenses and other damages.

Q. What damages can you recover if you are hurt on someone's property?
A. An injured person may recover damages for their injuries including medical expenses, loss of earnings from work, pain and suffering and for any permanent disfigurement of disability. An experienced personal injury attorney can assist you in analyzing the facts of your case, the law that applies to the facts and help you reach an educated decision about whether or not you have a valid claim against the owner of the property. As with car accident claims, it is wise not to give any statements to any insurance adjusters until you have had an opportunity to consult with an attorney of your choice.

Q. What is a "wrongful death" claim?
A. A wrongful death claim is a claim arising out of the death of a family membercaused by the negligence of a third party.

Q. What are the damages in a wrongful death claim?
A. With the death of a husband, wife, parent or other family member, there are often other losses beyond the loss of the person. The loss of earnings from a spouse, the loss of the financial support from a parent or other family member can have devastating financial effects on the surviving members of the family.

Q. Is there a limit to damages for the economic harm that can be recovered?
A. There is no limit on the amount of money that can be recovered for economic loss caused to the family as long as the available evidence at trialsupports the jury's decision.

Q. What other damages may a jury award?
A. Juries are also permitted to award damages for the emotional losses suffered by the family following the death of a loved one.

Q. I have heard of a "survival action," what is that?
A. Occasionally, the injured person initially survives the trauma of the accident,living for days, weeks or even months after the accident before dying. The remaining family members also have a right to bring a claim on behalf of the estate of the person to recover the damages the deceased's family member suffered before death.

Q. What damages would this include?
A. This type of claim is referred to as a "survival" action and provides paymentto the estate of the deceased for the lost earnings, medical expenses pain, suffering and emotional distress that was experienced from the date of the accident to the date of death.

Q. How do I know if I need an attorney?
A. The more severe the injury the more certain it is that the advice of an experienced personal injury trial attorney is necessary. Successful personal injury trial lawyers routinely analyze complex fact patterns, assess the financial losses suffered by the injured party following an accident and understand the process of preparing the file to successfully negotiate asettlement or successfully try a case to a jury.

Q. What does it cost to get initial advice from an attorney?
A. Most experienced personal injury attorneys will gladly meet with you and discuss your case at no cost initially.

Q. If I hire an attorney what does that cost?
A. Personal injury cases are usually taken on a contingent fee, meaning if thereis no recovery for you, no fee is owed.

Q. What are expenses?
A. Expenses are things like charges for medical, official, and other records; photocopying costs; postage; long distance telephone charges; legal, medical, and other research charges; travel expenses; charges for physicians' reports; consultation and expert witness fees; messenger and special delivery charges; court costs; service of process fees; witness fees; subpoena expenses; deposition charges; exhibit preparation expenses; and mediator fees

Q. Who pays expenses while the case is progressing toward settlement or trial?
A. Generally, your attorney will cover these expenses as part of his contract of employment with you on the claim. At the conclusion of the matter you reimburse the attorney.

Q. I have heard the term comparative fault, what does it mean?
A. The concept of comparative fault is that anytime there is an accident, the causes of the accident can be determined and expressed as a percentage of fault. In Kansas, the concept of comparative fault means that when you look at how an accident happened, you determine how much fault the parties to the accident contributed to its occurrence. The combined total fault of the parties should add up to 100%.

Q. Can you give me an example?
A. Sure, for example, if two cars run into each other head on straddling the center line on the highway both drivers might claim the other driver is at fault. A jury looking at those facts may determine that the drivers are equally at fault and assign the fault at 50% to each driver, the combined fault of both drivers equaling 100%.

Q. Why is this important?
A. In Kansas, the assignment of comparative fault becomes important because you can only collect that percentage of fault assessed to someone other than yourself in the occurrence of an accident.

Q. Can you give me an example of how that works?
A. Certainly, let's say a jury determines you were 20% at fault in an automobile accident and the other driver was 80% at fault. You cannot recover damages from yourself. Since you were 20% at fault, you are only allowed to recover up to 80% of your provable damages.

Q. Are there other comparative issues I should be aware of?
A. Yes, in Kansas your fault must be less than 50% you recover nothing. Kansas uses a "modified comparative fault" rule which says that if you are 50% or greater at fault your claim is barred by law. Basically stated if the accident is mostly your fault, you lose

Q. Who decides the fault of the parties?
A. A jury or judge is required to consider the facts and determine what percentage of fault the injured party should be assigned measured against the fault of the person(s) causing the accident.

Q. How is all this important in personal injury cases?
A. Because of the judge or jury decides fault, proper development of the case is important to place as much of the fault in the accident on the other parties. An experienced personal injury attorney can be very valuable in proper case development thereby maximizing the fault placed on other parties and increasing the recovery for the injured person and his or her family.

Q. Does comparative fault apply to all personal injury cases?
A. Yes, comparative fault principles apply to all accident cases whether they are an auto accident, a slip and fall case, a defective product case or -a wrongful death case.

AS ALWAYS, IF YOU HAVE QUESTIONS, PLEASE CONTACT THE ATTORNEYS AT BOYD & KENTER, P.C.

Nothing is simple about an automobile accident. Failure to act quickly is often the downfall of people who have been involved in vehicular collisions. The attorneys of Boyd & Kenter, P.C. want to help you make the right choices about your injury and your claim. Chances are good that the insurance company for the defendant will call you within days of an accident. Failure to have the right information available for the insurance company, saying the wrong thing or providing the wrong information may hurt your chances of receiving a fair settlement later.

If you have been injured in a car accident, contact the attorneys of Boyd & Kenter, P.C. immediately. We'll meet with you to discuss our reputation and success in cases like yours.

Some of the types of motor vehicle accident cases we handle:

automobile/car accidents
motorcycle accidents
wrongful death accidents
driver negligence
uninsured or underinsured motorist accidents
drunk driver

At Boyd & Kenter, P.C. , our job is to make things right for our clients. In automobile accident cases, building successful cases includes a meticulous attention to detail. Here are some things to keep in mind:

1. Was the accident reported as quickly as possible to the police?
2. Have you been able to obtain a copy of the police or accident report?
3. Did you obtain prompt and complete medical treatment and testing?
4. Was an adequate investigation done at the scene of the collision to find clues that will help later in proving your case?
5. Were good photographs taken of the scene, the vehicles involved and the injuries you suffered?
6. Has a thorough estimate been made of the damage to your vehicle?
7. Have you identified and taken statements from the witnesses?
8. Are there other types of claims that may exist due to the fact there was a vehicular collision?
9. Should a claim be made against the other driver's employer?
10. What rights may you have against your own insurance company if the other driver is uninsured or has too little insurance (underinsured) to fully compensate you for your injuries and losses?
11. What do I do when the insurance company wants me to sign something?

Call the law offices of Boyd & Kenter, P.C. to speak with an attorney and have your questions answered. Our lawyers have experience handling the issues behind many of your questions. Let us put your mind at ease by helping answers these complex questions for you.

QUESTIONS AND ANSWERS ON NO-FAULT INSURANCE

Q. What are Personal Injury Protection benefits?
A. Personal Injury Protection benefits, commonly known as PIP benefits, are insurance benefits which must be included in any policy of automobile insurance issued in the State of Kansas. By law, you are required to carry insurance on any car which is registered in the State of Kansas. PIP coverage provides immediate money to pay medical, lost wages, and other benefits without regard to who caused the accident.

Q. Who is covered by PIP benefits?
A. Typically, the benefits cover you and your immediate family. This would cover relatives residing in the same household by any degree of blood, marriage, or adoption.

Q. Do I have to be driving my car to receive PIP benefits?
A. No. You may be able to receive PIP benefits even if you are driving another vehicle. You are also entitled to receive PIP benefits if you are a passenger in your car or someone else's car.

Q. Does this mean that I can have one car insured with PIP benefits and drive another uninsured vehicle which I own and still be covered?
A. No. You must have insurance on all cars that are registered to you in the State of Kansas. If you are driving a car that is not insured, you will not have any PIP benefits available under any policy that may be issued on another vehicle.

Q. What happens if I am driving a friend's car that is uninsured?
A. The insurance on your personal automobile will provide your Personal Injury Protection benefits.

Q. No-fault insurance sounds good. How do I go about claiming my PIP benefits if I am in an accident?
A. Contact your insurance agent or the claims office of your insurance company and ask them to mail you an application for PIP benefits. Once you receive it, fill out your application and return it to the insurance company so they can process your claim.

Q. I have a car and insurance in a state that does not have no-fault laws. I have checked and I do not have PIP benefits. I was involved in an accident in Kansas and received an injury. What do I do?
A. If you are an out-of-state resident and you received an injury by accident in the State of Kansas, you are still entitled to minimum PIP benefits as provided by Kansas law. You need to contact your insurance agency and tell them that you want to make application for PIP benefits.

Q. I just bought a new car, and with my luck, I had an accident two days after I purchased it. Unfortunately, it was before I could contact my insurance agent to get insurance on the car. Now what?
A. If you already have insurance in place on your old car, bylaw, you have up to 30 days to add your new car to your policy. You should check with your agent upon purchasing a new car; some policies do limit the time period to add a new vehicle. Once your insurance on the new car is effective, you will also have PIP benefits in effect.

Q. Is "PIP" mandatory on motorcycles?
A. No. The statutes define an automobile very specifically. PIP coverage is mandatory on passenger cars and trucks. Policies on motorcycles and other specialty type vehicles are not required to provide PIP coverage. Many companies will write PIP benefits for motorcycles or other specialty vehicles; however, there is always an additional charge. To insure that you have benefits, you must contact your agent at the time your purchase a motorcycle or other specialty vehicle and make sure that your company adds "PIP" coverage to the insurance policy which you take out on the motorcycle or specialty vehicle.

Q. I had a friend tell me about increased or deluxe benefits. What are those?
A. The minimum PIP benefits are defined by statute. Most insurers provide only this minimum level of coverage unless you specifically ask for increased benefits. To obtain these, you need to specifically request the company quote you a premium for deluxe or increased benefits.

Q. What kind of benefits are available under PIP if I am injured in an accident?
A. The benefits are set by contract between you and your insurance company. However, the laws in the State of Kansas provide minimum benefits which areas follows:

1. Disability benefits;
2. Funeral benefits;
3. Medical benefits;.
4. Rehabilitation benefits;
5. Substitution benefits; and
6. Survivor benefits.

Q. What are disability benefits?
A. Disability benefits represent part of your monthly earnings. Disability benefits may be available even if you were unemployed at the time of the accident. You must be unable to work due to the injuries received. If you were unemployed at the time of the accident, your benefits can be calculated on past income and present ability. If you were employed at the time of the accident, the law allows you to collect up to 85% of your monthly income up to a maximum amount of $900.00 per month in disability benefits. These benefits normally do not run for more than one year. Of course, you may purchase increased or deluxe benefits as noted above, which can dramatically increase your monthly disability benefits figure.

Q. What are funeral benefits?
A. This is an allowance for the funeral, burial, or cremation, not to exceed $2,000.00.

Q. What are medical benefits?
A. By law, your insurance company must provide at least $4,500.00 in medical coverage. This covers reasonable medical expenses rendered by practitioners licensed by the Board of Healing Arts. These include surgical benefits, x-rays, dental, as well as prosthetic devices, ambulance charges, hospital charges and specialized nursing care. These benefits are to name a few and are not representative of the types of benefits covered, but are certainly not the only ones covered.

Q. Are doctors of chiropractic care covered under the medical benefits?
A. Yes. Since they are licensed by the Board of Healing Arts, reasonable chiropractic care would be covered under the medical benefits portion of your policy.

Q. What are rehabilitation benefits?
A. Rehabilitation benefits are allowances up to $4,500.00 for psychiatric services, occupational therapy, or occupational training necessary to enable you to obtain suitable employment. This would include any retraining that you might have to have to return to employment or gain new employment.

Q. Are you saying that my insurance company might pay for me to learn a new trade?
A. Yes. In some cases, your insurance company under the policy is obligated to retrain you to gain employment if your injuries prevent you from returning to your old job.

Q. What are substitution benefits?
A. Substitution benefits are the reasonable expenses incurred in obtaining ordinary and necessary services that you would have been performing, but for the injuries. There is a maximum of $25.00 per day for no longer than 365 days if such expenses incur. This would include any maid or cooking services, as well as other types of services that you might perform around the house that you are unable to do because of the injuries.

Q. What if my spouse performs those services for me now, but he/she didn't use to? Do I still get benefits?
A. The answer is not clear on spouses performing services. However, in many cases, spouses can be reimbursed for the services they have to perform because of your injuries.

Q. What are survivor benefits?
A. Survivor benefits are a total allowance to all survivors for the death of a covered person. Survivor benefits shall be up to a maximum of not less than $900.00 per month. Survivor benefits enter into a fairly complex area of the law that is best reviewed by an attorney. Survivor benefits can be set off by other things, such as Social Security, reduced expenses because of death, and other benefits that a person may receive at the time of death. If you think you have a survivor benefit claim, it is very important to obtain the advice of an attorney to make sure you are not giving up other benefits, which you might also be able to claim in addition to survivor benefits.

Q. If I am driving a friend's car and I have higher PIP benefits, which company pays?
A. The insurer of the motor vehicle which you are driving provides the "primary" coverage and your coverage would be "secondary" coverage on the accident. In any event, you get the amount of the highest benefits.

Q. In the above example, if I had higher benefits, does that mean I would be limited to my friend's benefits?
A. No. While you cannot add the benefits, you are entitled to the maximum benefits available under either policy. In the above example, your friend's policy would provide the basic level of benefits and the deluxe benefits available under your policy would pay you the difference between the basic benefit level and the deluxe level.

Q. I was on foot when I was struck by another vehicle. Am I still entitled to benefits?
A. Yes. You are still covered by PIP benefits, so long as you had insurance on your car at the time of the accident and your injuries were caused by an automobile.

Q. My son goes to college nine months a year, but he lives at home in the summer. Is he still covered by my benefit?
A. Yes. Since your son is a blood relative residing in the home, even though temporarily absent, he is still covered by your benefits.

Q. I was driving in the course of work when I had an automobile accident. My employer says I have workers' compensation benefits. Does that make a difference?
A. Yes, workers' compensation benefits are always primary.

Q. If I was working when I got injured, should I not even worry about PIP benefits?
A. You should still notify your insurance agent or claims adjuster that you are injured. It doesn't cost you anything to make a claim under your PIP policy. In some cases you may qualify for both benefits. This area of the law is new and complex. You should contact an attorney familiar in these matters to see if you qualify for both benefits.

Q. Is it hard to get these PIP benefits?
A. No. PIP benefits are simple to obtain in most instances. You obtain the application for PIP benefits from your insurer, complete it, and mail it back in. Technically, on proper notice, your company is supposed to immediately begin payments of PIP benefits. In some cases, it maybe necessary to hire an attorney to collect PIP benefits.

Q. How long will it take to get these PIP benefits?
A. Personal injury benefits are payable by law and shall be overdue if not paid within thirty (30) days after an insurance company is furnished with written notice of the loss. Disability benefits shall be paid at least every two (2) weeks after the notice. Overdue payments bear simple interest at the rate of 18% per year.

Q. What if my insurance company doesn't pay on time?
A. The law allows the insurance company to make reasonable denials of benefits. If they are correct, the benefits are not overdue since they didn't have to be paid. If they are incorrect, it is altogether possible that you might be able to collect the interest as well as the benefits.

Q. Can I hire a lawyer or will I be penalized?
A. Many people hire lawyers to help them with PIP benefits since they can be complex to understand. There are no penalties for hiring a lawyer.

Q. Is it worth a lawyer's time if we are only a few dollars apart?
A. If your company is voluntarily paying you the maximum stated benefits under your policy, it is probably not worth your effort to retain an attorney. On the other hand, if you are uncertain whether or not your company is making proper payment to you under the policy, most reputable lawyers will not charge you anything to advise you whether or not there appear to be any additional benefits to which you are entitled. Secondly, if your insurance company refuses to pay you these additional benefits to which you maybe entitled, your attorney may be entitled to attorney's fees against the company if it is necessary to file suit against the company to secure payment.

Q. These PIP benefits sound great, but what happens if they are not enough to cover my losses? Does that mean I can't sue?
A. No. You still retain your rights to sue for the injuries you received out of the accident. However, because no-fault insurance is a compromise, there are certain restrictions on suing. The laws of the State of Kansas provide the following prerequisites before you can recover damages for pain and suffering, mental anguish, inconvenience, or other non-pecuniary losses because of the injuries. These threshold limits are:

A. Medical services having reasonable value of $2,000.00 or more; or
B. An injury consisting, in whole or in part, of permanent disfigurement; or
C. A fracture to a weight-bearing bone; or
D. A compound, comminuted or displaced, or compression fracture; or
E. Loss of a body member;
F. Permanent injury within a reasonable medical probability,permanent loss of bodily function, or death.

Q. I receive free medical benefits. Does that mean I can never sue?
A. No. The medical threshold is based on the value of the medical treatments, not on the amount that you actually paid. This could even include the value of benefits provided by a family member that would normally be performed by a nurse or other professional.

Q. How long do I have to make a claim for my PIP benefits?
A. In Kansas, the statute of limitations on a written contract is five (5) years. However, if you also have a negligence claim arising out of a two-vehicle accident, you must bring any negligence action against the other driver who you feel is at fault within two (2) years of the date of the accident

Q. If I want to sue the person who caused the injuries, how long do I have to file that lawsuit?
A. By statute, if you have not filed suit within 18 months, your insurance company has the right to file suit to protect its interests and on your behalf.

Q. What does it mean if the insurance company brings it on my behalf?
A. Your PIP insurance company has a right to be repaid. If you don't file suit within 18 months to protect your rights and the rights of the insurance company, they may file suit to recover what they have paid. If the insurance company files suit against the negligent third party who caused the accident, they are also obligated to contact you and make sure that your rights are protected as well.

Q. Are benefits anything like uninsured motorist coverage or underinsured motorist coverage?
A. No. Uninsured motorist coverage is coverage that you have in addition to PIP. It covers you for injuries you receive from another vehicle that does not have insurance. Uninsured motorist coverage is a complex area of the law, and you should consult with an attorney if you have been involved in an accident and the other party does not have insurance, or you believe that they do not have insurance. Underinsured motorist coverage is an offshoot of uninsured motorist coverage. Underinsured motorist coverage means that the person's coverage for insurance is less than your coverage. Again, this is also a very complex area of the law, and you should seek the advice of an attorney qualified in these types of cases.

Q. Is this all I need to know about PIP benefits?
A. Probably not. This booklet was designed to provide you with a general understanding of PIP benefits. In some cases, the information will be enough that you know what your rights are. Unfortunately, there are still many cases in which a person will need to hire a lawyer to aid them in recovering their PIP benefits.

Q. What happens if I am not sure that I need a lawyer? Where do I get advice?
A. Our firm members have dedicated themselves to providing a first consultation free for people with questions. This consultation can be either by phone or by person. If you have questions regarding your PIP benefits, please call us at BOYD & KENTER, P.C. Insurance coverage can be complex and confusing; sometimes you just need to know what you have to do to obtain your benefits.

Q. If my insurance company and I don't sue anyone for this accident, do I have to pay my insurance company the money back?
A. No. The insurance company only has a right to be paid back if you are paid by the person causing the accident. If neither you nor your insurance company sue anyone on this accident, then you will not have to pay any of the money you received in PIP benefits back.

Q. Should I tell my doctor that I have PIP benefits?
A. Yes. It is very helpful for the doctor to have a copy of your policy so he knows to whom to send the bills. If a doctor does not want a copy of your policy, sometimes it would be helpful if you just let him know who the insurance company is and the type of benefits you have available. Remember, PIP benefits are required by law in the State of Kansas.

DO's AND DON'T's - THE FINAL CHECKLIST

Do notify your insurance agent in writing of your accident.

Do claim PIP benefits even if the auto accident occurred while at work.

If the auto accident occurred when you were at work, notify your employer immediately and notify your insurance agent that it was a work-related injury.

Do tell your doctor that you have PIP benefits available for treatments.

Do turn in all your bills to your insurance agent or adjuster for payment.

Do keep a copy of all your bills should your insurance company deny payment.

Do cooperate with your insurance claims adjuster regarding any reasonable request that they may make.

Do remember that claims involving automobile accidents must be filed within two (2) years of the date of the accident.

Do seek advice of a lawyer qualified in this area of the law, if your insurance company is seeking to change your physician, refusing to pay your bills, or not being responsive to your needs.

Claims against an insurance company on any written policy of insurance must be brought within five (5) years. However, do not mistakenly think that you have five (5) years to file suit on an automobile claim. These claims are governed by a two (2) year statute of limitations as set forth above.

Make sure that any car you sell is properly transferred to the new owner. If not, you may still be the registered owner of the car. Kansas requires that you carry the title to insurance on all vehicles "registered" to you.


IF YOU HAVE QUESTIONS, PLEASE CONTACT ONE OF THE ATTORNEYS FROM BOYD & KENTER, P.C.

Content for this section coming soon.

To: Social Security Disability and SSI Applicants
Re: Common questions about:

1. Applying for disability benefits from the Social Security Administration
2. Appeals
3. Attorney Representation

This memorandum answers common questions about applying for social security disability or supplemental security income (SSI) benefits. Please read it carefully.

How can I tell if I am disabled enough to apply for social security disability benefits?
Although it gets easier to be found disabled as you get older, you don't have to be bedridden, even if you're a young person. If you cannot work at a regular job, including your past jobs, because of your medical problems, that ought to be enough.

Nevertheless, being unable to work and being found "disabled" by the Social Security Administration (SSA) are two different things. It is often not easy to convince the SSA that you are disabled, even if you genuinely cannot work. At the same time, however, it is not impossible.

If you really cannot work, apply for social security disability benefits. And keep appealing any denials at least until you go through the hearing before an administrative law judge.

How do I apply for social security disability or SSI benefits?
Go to your local social security office and apply. Or telephone the SSA at 1-800-772-1213 and say you want to apply. When you call, you will be given the option of
1) going to your local social security office to apply for benefits, or
2) having your application taken over the telephone.
If you choose to go to the social security office, the person at the 800-number will schedule an appointment for you and give you directions to your social security office. If you want to apply by phone, you will be given a date and an approximate time to expect a phone call from someone at the social security office, who will then take your application over the phone. Or you can apply over the Internet at www.socialsecurity.gov.

What happens if I am denied benefits and I do not appeal within 60 days?
You'll have to start over with a new application, and you may then lose some benefits. So appeal all denials within 60 days. If you appeal quickly, you should get through the bureaucratic denial system faster.

How do I appeal?
You can appeal in one of three ways:
1) telephone your social security office for your appeal to be handled by phone, or
2) go to the social security office to appeal in person, or
3) call me and ask me to appeal for you.

What is the biggest mistake people make when trying to get disability benefits?
Failing to appeal. More than half of the people who are denied initially fail to appeal.
Another mistake is when people fail to obtain appropriate medical care. Some people with long-term chronic medical problems feel that they have not been helped much by doctors. So they may stop going for treatment. This is a mistake. First, no one needs good medical care more than those with chronic medical problems. Second, medical treatment records provide the most important evidence of disability in a social security disability case.

Since medical evidence is so important, should I have my doctor write a letter to the Social Security Administration, and should I gather medical records and send them to the SSA?
You can if you want to. A few people (a very few) actually win their cases because of such efforts. But because the deck is stacked against most people until they get to the hearing stage, such efforts at the initial application stage are usually a waste of time. The SSA will gather the evidence it feels it needs.

Do I need an attorney to apply for disability benefits?
No, there is no requirement that you have one. But at each stage of appeal the forms get a little more involved and complicated.

When should I contact you about representing me?
As soon as you want me to start representing you. But at the very latest, as soon as you get your first denial.

How much do you charge?
My usual fee is 25% (one-fourth) of your past-due benefits up to the maximum allowed by Social Security ($5300 at this time). That is, the fee is one-fourth of those benefits that build up by the time you are found disabled and benefits are paid. Nothing comes out of current monthly benefits. In addition, you will pay for medical records, medical opinion letters, etc. I will pay for such expenses, and then ask you to reimburse me at the end of your case. In a few cases, I use a different method of calculating the fee.

Do you have any words of wisdom about getting through the first steps?
Yes. First, give the SSA all the information it asks for in a straightforward, candid way. Be truthful. Do not exaggerate or minimize your disability. Second, do not be discouraged if you are denied. Third, appeal all denials immediately.

If I have other questions, will you answer them by telephone?
Yes. If this memo doesn't answer your questions, please call me. <sup>1

1</sup> This information has been prepared and reviewed by Susan Fershee. Ms. Fershee is "Of Counsel" to the Law Firm of Boyd & Kenter, P.C., and works out of the Kansas City office. She can be reached at 816-471-4511 or 1-800-279-5978.

Content for this section coming soon.