PERMANENT PARTIAL DISABILITY IN MISSOURI WORKERS’ COMPENSATION CASE
How do you calculate how much money your Missouri workers’ compensation case is worth?
Answer: In a Missouri workers’ compensation case, how much money that you get for your work injury is calculated by multiplying the percentage disability of your body part injured by your wage rate. For example:
An injured worker suffered a back injury that settles for 10% permanent partial disability (PPD) of the body as a whole (BAW); the wage rate is $200. Therefore, 10% x 400 weeks of the body as whole (BAW) = 40 weeks of wages x $200 (Rate) = $8,000.
The above is one example of how a workers’ compensation case turns into money. There are many examples of cases involving different body parts injured and higher or lower wage rates. The higher the wage rate, the more money a case is worth. Conversely, the lower the wage rate, the lower the value of the case.
Wage rate is calculated based on 2/3 (Two-thirds) of average weekly wage. In our example above, if an injured worker earned gross wages of $300 per week, then $300 x 2/3 = $200 Rate
By Steven Edelman, Attorney
If you’ve been injured at work, then please immediately contact our law firm, and one of our skilled attorneys will be happy to discuss your rights and benefits under workers’ compensation law. Call us for a free consultation: 314-631-6777
While a Missouri workers’ compensation is pending, the injured worker shall attend a reasonable medical examination at the request of the employer’s insurer. Missouri law states specifically:
“After an employee has received an injury he shall from time to time thereafter during disability submit to reasonable medical examination at the request of the employer, the employer’s insurer, the commission, the division, an administrative law judge, or the attorney general on behalf of the second injury fund if the employer has not obtained a medical examination report, the time and place of which shall be fixed with due regard to the convenience of the employee and his physical condition and ability to attend. The employee may have his own physician present, and if the employee refuses to submit to the examination, or in any way obstructs it, his right to compensation shall be forfeited during such period unless in the opinion of the commission the circumstances justify the refusal or obstruction.” See Missouri Law RSMo 287.210: https://revisor.mo.gov/main/OneSection.aspx?section=287.210&bid=15071&hl=287.210%u2044
The injured worker may have to submit to more than medical examination at the request of the employer’s insurer. This usually occurs when an authorized doctor recommends surgery or a specific medical procedure. The worker’s compensation insurer then requests a medical examination by another doctor to dispute the necessity of the recommended procedure. Most judges will allow the employer/insurer to obtain another medical examination in this situation.
An injured worker is not entitled to obtain a second opinion from another doctor. If you are unhappy with the doctor that is chosen by the workers’ compensation insurance company, and you want to obtain an opinion from your own doctor, then the employer/insurer does not have to pay for and provide you with another doctor. The employer/insurer may in good faith send you to another doctor for a second opinion, but this is rare. If an injured worker wants to obtain medical treatment from their own doctor while under the care of an authorized workers’ compensation doctor, then the injured worker will have to pay to see their own doctor.
By Steven Edelman, Attorney
If you’ve been injured at work, then please immediately contact our law firm, and one of our skilled attorneys will be happy to discuss your rights and benefits under workers’ compensation law. Call us for a free consultation: 314-631-6777
PENALTIES AND FEES MISSOURI LAW SECTION RSMo 287.560
In certain situations, in a Missouri workers’ compensation case, fees and penalties could be awarded against the employer/insurer for denying benefits without a reasonable defense. The law that allows for these fees and penalties is Missouri law section RSMo 287.560 which states:
“All costs under this section shall be approved by the division and paid out of the state treasury from the fund for the support of the Missouri division of workers’ compensation; provided, however, that if the division or the commission determines that any proceedings have been brought, prosecuted or defended without reasonable ground, it may assess the whole cost of the proceedings upon the party who so brought, prosecuted or defended them.”
If you’ve been injured at work, then please immediately contact our law firm, and one of our skilled attorneys will be happy to discuss your rights and benefits under workers’ compensation law. Call us for a free consultation: 314-631-6777
Can the employer fire an injured worker because they filed a workers’ compensation case?
Nothing under Missouri law prevents an employer from firing an injured work from their job. If an employee can not do the essential functions of the job, then an employer can and often times will fire the worker. However, if it can shown that the employer fired an injured worker because of their workers’ compensation case, then a civil action in circuit court for wrongful termination/discrimination may be appropriate.
In Missouri, an employer shall not discharge or discriminate against an employee because of the employee’s workers’ compensation case. The Missouri Workers’ Compensation Law specifically states in Section RSMo 287.780 that:
“No employer or agent shall discharge or discriminate against any employee for exercising any of his or her rights under this chapter when the exercising of such rights is the motivating factor in the discharge or discrimination. Any employee who has been discharged or discriminated against in such manner shall have a civil action for damages against his or her employer. For purposes of this section, “motivating factor” shall mean that the employee’s exercise of his or her rights under this chapter actually played a role in the discharge or discrimination and had a determinative influence on the discharge or discrimination.” https://revisor.mo.gov/main/OneSection.aspx?section=287.780
The Missouri courts have interpreted the law in the following cases:
“Generally, an employer can discharge an at-will employee for any reason. Keveney v. Missouri Military Acad., 304 S.W.3d 98, 101 (Mo. banc 2010). There are exceptions and limits, however, to the at-will employment doctrine. For example, an employer cannot terminate an at-will employee for being a member of a protected classbased on “race, color, religion, national origin, sex, ancestry, age or disability.” Fleshner v. Pepose Vision Institute, P.C., 304 S.W.3d 81, 92 (Mo. banc 2010) (quoting section 213.055 of the MHRA). Additionally, this Court has adopted the following public policy exception to the at-will employment doctrine: An at-will employee may not be terminated (1) for refusing to violate the law or any well established and clear mandate of public policy as expressed in the constitution, statutes, regulations promulgated pursuant to statute, or rules created by a governmental body or (2) for reporting wrongdoing or violations of law to superiors or public authorities…. If an employer terminates an employee for either reason, then the employee has a cause of action in tort for wrongful discharge based on the public-policy exception. Id. at 92.7 Section 287.780’s Historic Construction June 24, 2025 23:04 4/18Downloaded from vLex by Steven Edelman Section 287.780’s Historic Construction Section 287.780 is a statutory exception to the at-will employment doctrine and provides: “No employer or agent shall discharge or in any way discriminate against any employee for exercising any of his [or her] rights under this chapter. Any employee who has been discharged or discriminated against shall have a civil action for damages against his [or her] employer.” This section was enacted in 1925 as a part of the original Missouri workers’ compensation law. Christy v. Petrus, 365 Mo. 1187, 295 S.W.2d 122, 124 (Mo. 1956). At the time of enactment, the workers’ compensation law was construed liberally in favor of the worker and the award of benefits. Maltz v. Jackoway-Katz CapCo., 336 Mo. 1000, 82 S.W.2d 909, 911 (Mo. 1934). Section 287.780 was amended in 1973 to provide employees with the private right of action that remains today.” See Templemire v. W&M Welding, Inc., No. SC93132 (Mo. Apr 15, 2014)
If you’ve been injured at work, then please immediately contact our law firm, and one of our skilled attorneys will be happy to discuss your rights and benefits under workers’ compensation law. Call us for a free consultation: 314-631-6777
Worker compensation is system under state law where injured workers have the right to recover limited statutory benefits from their employer, which are: 1. medical treatment, 2. wages while off work, and 3. typically a lump sum money settlement or award from a judge to compensate them for their work injury. Workers’ compensation is a no fault system, which means that regardless of whether the injury was caused by the injured workers’ own negligence or carelessness or whether the work injury was caused by the negligence of someone else, for example a co-worker or the employer, the injured worker can still recover benefits under workers compensation. Workers’ compensation is the exclusive remedy in most cases for injured workers to receive benefits. Therefore, an injured worker can not sue the employer in civil court for their work injuries. The injured workers’ exclusive remedy is through workers’ compensation.
Why was workers’ compensation created?
The workers’ compensation system was created to help facilitate work injuries quickly by creating a state law that spelled out the benefits and responsibilities of the employer and employee. It was also created as a compromise between employers and workers in that it eliminated the need for workers to prove fault in causing the work injury and in return it prevented workers from suing employers in civil court. Employers did not want to be sued in civil court where they could be exposed to a jury awarding large sums of money to injured workers. Employee’s could ensure recovery of benefits without having to prove fault and employer’s were not exposed to large civil court judgments.
The majority of injuries are caused by the employee and not by the negligence of another person. Therefore, workers compensation gives these workers the ability to recover damages for their injuries where otherwise under civil law they would recover nothing.
Who am I suing when I file a workers’ compensation case?
In a workers’ compensation case the injured worker is suing the employer. You are not suing your boss, foreman, co-workers, nor the owner of the company.
If you’ve been injured at work, then please immediately contact our law firm, and one of our skilled attorneys will be happy to discuss your rights and benefits under workers’ compensation law. Call us for a free consultation: 314-631-6777
The Second Injury Fund (SIF) was created to protect Employers from permanent and total disability (PTD) when an injured worker’s work injury combines with his pre-existing medical conditions and injuries to make him unable to return to any type of work for gainful employment. When the SIF is responsible for PTD then it is referred to PTD due to a “combination” of the work-related injury and the prior medical conditions and injuries. The employer is then responsible to pay for the permanent partial disability (PPD) only related to the work-related injury. The Employer is only responsible for PTD when the work-related injury alone renders the injured worker unable to return to work.
Timeline of Developments in the Law regarding the Second Injury Fund:
“In 2013, the legislature amended section 287.220, which governs[Second Injury] Fund liability,” to limit the number of workers eligible for fund benefits because the Fund was insolvent.” Treasurer of Mo. v. Parker, 622 S.W.3d 178, 181 (Mo. banc 2021). Section 287.220.2 retained the pre-amendment framework for Fund liability for compensable work-related injuries that occurred before January 1, 2014. Id. Section 287.220.3, which governs compensable work-related injuries that occurred after January 1, 2014, eliminated Fund liability for permanent partial disability (“PPD”) claims and limited Fund liability for permanent total disability (“PTD”) claims by requiring that the claimant’s preexisting disabilities be medically documented, equal at least 50 weeks of PPD, and meet one of the criteria listed in section 287.220.3(2)(a)a(i)-(iv). Id. See RSMo 287.220 These Changes took effect on January 1, 2014 Weibrecht v. Treasurer of Mo., No. SC 99493 659 S.W.3d 588, 590-91 (Mo. banc 2023). This new section eliminated Fund liability for permanent partial disability (PPD) cases. Id.
Since January 1, 2014, there have been interpretations by the courts of section 287.220. The courts address this law in the following cases.
In 2019, the Missouri Supreme Court upheld the revisions in the law removing SIF liability for permanent partial disability (PPD) Cosby v. Treasurer of Missouri, 579 S.W.3d 202 (Mo. banc 2019)
Non-Qualifying Disabilities cannot be considered in determining SIF liability: 2022
Any pre-existing disabilities and injuries that do not qualify under RSMo 287.220.3(2)(a)a(ii) can not be considered in determining SIF liability. See Klecka v. Treasurer of Mo., 644 S.W.3d 562, 567 (Mo. banc 2022)
Medically documented qualifying pre-existing disability & Directly and Significantly Aggravated or Accelerated
Dubuc v. Treasurer of Missouri, 659 S.W.3d 596 (Mo. banc 2023)
Issue: What is a medically documented qualifying preexisting disability that directly and significantly aggravates or accelerates the primary work injury? AND What does “Directly and Significantly Aggravated or Accelerated” mean?
Holding: Claimant failed to establish any “medically documented” preexisting disabilities that “directly and significantly aggravated or accelerated” his primary injury pursuant to Section 287.220.3(2)(a)a(iii), and Claimant failed to prove that his pre-existing disability “directly and significantly aggravated or accelerated” his primary injury. Id. at 605.
The Court reasoned that Claimant’s self-reported pre-existing hernias was insufficient where there existed no pre-existing medical records for same. Though claimant self-reported his pre-existing by communicating them to the doctors, the claimant’s own statements did not conclusively support that any doctor medically documented claimant having hernias. Id. at 605. The court also reasoned that claimant’s doctor’s statement alone that claimant was permanently and totally disabled (PTD) due to the combination of his work injury and his pre-existing injuries was insufficient to support SIF PTD liability. Under the statute, claimant must show that the impact of his pre-existing injuries and medical conditions more than incidentally effects the work injury. The claimant must show that the prior injuries exacerbate the primary work injury in a meaningful way. Id. at 605.
Therefore, to help prove a PTD case against the SIF, an employee must have actual treatment records showing evidence of a pre-existing injury/medical condition. It is not enough to have reference of a pre-existing injury mentioned in the history of other doctors’ medical records. Additionally, It is necessary for a doctor to explain in detail the bio-mechanical, physiologically effects of a prior injury in how it combines with the work injury to make the employee PTD.
Compensable Prior Injury:
A Commission determined what is means for a pre-existing injury to be defined as “compensable” under Missouri law to qualify for SIF liability. An injury is defined as “compensable” under RSMo 287.020.3(1) which states that an injury is compensable if the accident was the prevailing factor in causing both the resulting medical condition and disability. In this matter, the claimant testified that he had an out-of-state work injury for which he received benefits. However, claimant failed to produce evidence that his prior work injury in another state was “compensable” as defined under Missouri law. No evidence was presented from a doctor stating the the prior out-of-state work injury was the prevailing factor in causing the injury and resultant disability See Commission Decision, Thomas v. Collins & Hermann, Inc., 052924 MOWC 15-092163
Occupational Diseases do not qualify as Pre-existing injuries: 2025
The Missouri Supreme Court held that occupational diseases, such as carpal tunnel syndrome do not qualify as pre-existing disabilities under Missouri law RSMo 287.220.3(2)(a)a(iii), See Treasurer of the Missouri v. Penney, SC 100693 (Mo. banc 2025)
If you’ve been injured at work, then please immediately contact our law firm, and one of our skilled attorneys will be happy to discuss your rights and benefits under workers’ compensation law. Call us for a free consultation: 314-631-6777
Often in a Missouri workers’ compensation case, the employer/insurer will unjustifiably stop payment of weekly temporary total disability (TTD) benefits to an injured worker. This termination of TTD benefits is sometimes in contradiction to a doctor’s off work order. When a hardship hearing is requested, the court shall set the case for trial on this issue within 30 days of such request. In practice, some judges will have a pre-trial hardship mediation/conference to discuss possible resolution of the matter prior to having a hardship trial.
Under Missouri law RSMo 287.203 states as follows:
287.203. Termination of compensation by employer, employee right to hearing — assessment of costs. — “Whenever the employer has provided compensation under section 287.170, 287.180 or 287.200, and terminates such compensation, the employer shall notify the employee of such termination and shall advise the employee of the reason for such termination. If the employee disputes the termination of such benefits, the employee may request a hearing before the division and the division shall set the matter for hearing within thirty days of such request and the division shall hear the matter on the date of hearing and no continuances or delays may be granted except upon a showing of good cause or by consent of the parties. The division shall render a decision within thirty days of the date of hearing. If the division or the commission determines that any proceedings have been brought, prosecuted, or defended without reasonable grounds, the division may assess the whole cost of the proceedings upon the party who brought, prosecuted, or defended them. Seehttps://revisor.mo.gov/main/OneSection.aspx?section=287.203
If you’ve been injured at work, then please immediately contact our law firm, and one of our skilled attorneys will be happy to discuss your rights and benefits under workers’ compensation law. Call us for a free consultation: 314-631-6777
When an employer/insurer fails to pay an injured worker temporary total disability (TTD) then your attorney can file a request for 19(b) hearing and also requests fees and penalties against the employer/insurer for failure to to pay TTD. Fees and penalties are allowed under section 19(k), 19(l) and 16 of the Illinois workers’ compensation law found under 820 ILCS 305.
820 ILCS 305/19(k)
19(k) penalties: Under this section employer/insurers are penalized for non-payment of benefits owed to an injured worker. The penalty under this section is 50% of the unpaid amount.
See Illinois law per 820 ILCS 305/19(k)
“In case where there has been any unreasonable or vexatious delay of payment or intentional underpayment of compensation, or proceedings have been instituted or carried on by the one liable to pay the compensation, which do not present a real controversy, but are merely frivolous or for delay, then the Commission may award compensation additional to that otherwise payable under this Act equal to 50% of the amount payable at the time of such award. Failure to pay compensation in accordance with the provisions of Section 8, paragraph (b) of this Act, shall be considered unreasonable delay.” https://www.ilga.gov/legislation/ilcs/fulltext.asp?DocName=082003050K19
820 ILCS 305/19(l)
19(l) penalties: This section of Illinois law allows a penalty against the employer/insurer of $30 per day for failure to pay weekly TTD compensation benefits up to a maximum penalty of $10,000. The law states under 820 ILCS 305(l):
“If the employee has made written demand for payment of benefits under Section 8(a) or Section 8(b), the employer shall have 14 days after receipt of the demand to set forth in writing the reason for the delay. In the case of demand for payment of medical benefits under Section 8(a), the time for the employer to respond shall not commence until the expiration of the allotted 30 days specified under Section 8.2(d). In case the employer or his or her insurance carrier shall without good and just cause fail, neglect, refuse, or unreasonably delay the payment of benefits under Section 8(a) or Section 8(b), the Arbitrator or the Commission shall allow to the employee additional compensation in the sum of $30 per day for each day that the benefits under Section 8(a) or Section 8(b) have been so withheld or refused, not to exceed $10,000. A delay in payment of 14 days or more shall create a rebuttable presumption of unreasonable delay.”
820 ILCS 305/16
16 penalties: This section provides for attorneys’ fees when 19(k) and 19(l) penalties are sought. The law states under 805 ILCS 305/16:
“Whenever the Commission shall find that the employer, his or her agent, service company or insurance carrier has been guilty of delay or unfairness towards an employee in the adjustment, settlement or payment of benefits due such employee within the purview of the provisions of paragraph (c) of Section 4 of this Act; or has been guilty of unreasonable or vexatious delay, intentional under-payment of compensation benefits, or has engaged in frivolous defenses which do not present a real controversy, within the purview of the provisions of paragraph (k) of Section 19 of this Act, the Commission may assess all or any part of the attorney’s fees and costs against such employer and his or her insurance carrier.”
If you’ve been injured at work, then please immediately contact our law firm, and one of our skilled attorneys will be happy to discuss your rights and benefits under workers’ compensation law. Call us for a free consultation: 314-631-6777
In a Missouri Workers’ Compensation case either the employer or the employee can serve a complete report of their doctor’s rating report on each other at least 60 days prior to a trial/hearing. Service of the complete report removes the necessity for the serving party to incur the costs to take the deposition of their rating doctor. The party receiving the served report then has 10 days to file objection with the court to the other party’s service of complete report.
The requirements to serve a complete report are stated under Missouri law in RSMo section 287.210.7 which states as follows:
“The testimony of a treating or examining physician may be submitted in evidence on the issues in controversy by a complete medical report and shall be admissible without other foundational evidence subject to compliance with the following procedures. The party intending to submit a complete medical report in evidence shall give notice at least sixty days prior to the hearing to all parties and shall provide reasonable opportunity to all parties to obtain cross-examination testimony of the physician by deposition. The notice shall include a copy of the report and all the clinical and treatment records of the physician including copies of all records and reports received by the physician from other health care providers. The party offering the report must make the physician available for cross-examination testimony by deposition not later than seven days before the matter is set for hearing, and each cross-examiner shall compensate the physician for the portion of testimony obtained in an amount not to exceed a rate of reasonable compensation taking into consideration the specialty practiced by the physician. Cross-examination testimony shall not bind the cross-examining party. Any testimony obtained by the offering party shall be at that party’s expense on a proportional basis, including the deposition fee of the physician. Upon request of any party, the party offering a complete medical report in evidence must also make available copies of X rays or other diagnostic studies obtained by or relied upon by the physician. Within ten days after receipt of such notice a party shall dispute whether a report meets the requirements of a complete medical report by providing written objections to the offering party stating the grounds for the dispute, and at the request of any party, the administrative law judge shall rule upon such objections upon pretrial hearing whether the report meets the requirements of a complete medical report and upon the admissibility of the report or portions thereof. If no objections are filed the report is admissible, and any objections thereto are deemed waived. Nothing herein shall prevent the parties from agreeing to admit medical reports or records by consent.”
If you’ve been injured at work, then please immediately contact our law firm, and one of our skilled attorneys will be happy to discuss your rights and benefits under workers’ compensation law. Call us for a free consultation: 314-631-6777
What are the reporting requirements for an injured worker and the employer in a Missouri Workers’ Compensation Case:
Employee Required to make written report of injury:
The injured worker must make a written report of injury to the employer within 30 days of the work injury. This report of injury in writing should be made to a person in a position of manager, human resources, an owner of the employer, boss or supervisor.
See Missouri law RSMo 287.420 “No proceedings for compensation for any accident under this chapter shall be maintained unless written notice of the time, place and nature of the injury, and the name and address of the person injured, has been given to the employer no later than thirty days after the accident, unless the employer was not prejudiced by failure to receive the notice. No proceedings for compensation for any occupational disease or repetitive trauma under this chapter shall be maintained unless written notice of the time, place, and nature of the injury, and the name and address of the person injured, has been given to the employer no later than thirty days after the diagnosis of the condition unless the employee can prove the employer was not prejudiced by failure to receive the notice. https://revisor.mo.gov/main/OneSection.aspx?section=287.420
Employer Required to Report work injury to the Court:
The employer then has 30 days file a report of the work injury with the court, which is called the Missouri Division of Workers’ Compensation. The employer’s report of injury to the court is called a Form 1 or WC-1 See RSMo 287.380, which states: “Every employer or his insurer in this state, whether he has accepted or rejected the provisions of this chapter, shall within thirty days after knowledge of the injury, file with the division under such rules and regulations and in such form and detail as the division may require, a full and complete report of every injury or death to any employee for which the employer would be liable to furnish medical aid . . .” https://revisor.mo.gov/main/OneSection.aspx?section=287.380
Extension of Statute of Limitations if Employer fails to make report of injury within 30 days to the Court:
If the employer fails to make a report of injury to the court within 30 days of their knowledge of the work injury, then the statue of limitations to file the injured worker’s workers’ compensation case is extended to 3 years, instead of 2 years.
If you’ve been injured at work, then please immediately contact our law firm, and one of our skilled attorneys will be happy to discuss your rights and benefits under workers’ compensation law. Call us for a free consultation: 314-631-6777
