Are Employers Likely to Dispute a Workers Compensation Claim?


Interviewer: Do employers ever try to dispute the claim?

Employers May Be Reluctant to File a Claim in Order to Keep Their Insurance Rates Down

Kevin Roach: Yes, in fact, I see this on a regular basis where the employer or the insurance company or even both will try to misrepresent what happened. Many times, the employers are influenced by the insurance company because they want to keep their rates down and they don't want to have a lot of claims. Everybody knows that if you have a lot of claims, your rates go up.

Frequently, the employers won't report injuries when they should. When you file a claim, a lot of times they will try to cover their tracks because they know they didn't file their Report of Injury like they were supposed to. They may become defensive and may not know what to do other than give a different version of the facts than my client.

The attorney who is working for the employer or the insurance company has no way of knowing who is telling the truth. Unfortunately, they are not provided a lie detector test. So, I will see situations where the employer will give the employee the run around after they are injured, won't report the injury, and won't accommodate them after they are injured. It's just a form of harassment. It's very common and I do see that on a regular basis.

Do Some Employees Delay in Reporting Injuries Because They Are Afraid of Retribution?

Interviewer: Are people sometimes hesitant to file for workers comp because they don't want to lose their job or they like their employer and they don't want to cause a rift?

Kevin Roach: I see this on a regular basis where people are injured and it may or may not be reported. They may have reported it and maybe they received some medical treatment but they don't want to hire a lawyer because they think that's it is going to be a black mark on their personnel file.

If You Are Injured at Work, You Are Legally Entitled to Receive the Full Complement of Benefits under Missouri Law

They think that their employer is going to get mad. What they don't realize is that under this scenario; if you're injured and the employer is providing you with medical treatment and Temporary Total Disability (TTD) pay as well – then there’s already a claim filed with the state. This in turn means that there is already a claim on your employer’s insurance.

The only other benefit that you're entitled to at that point is your Permanent Partial Disability Settlement. That's the benefit that a lot of times people miss out on because they want to be a nice guy and/or had no idea that they were entitled to anymore than they’ve already received through treatment and TTD. They say they don't want to tick their boss off or whatever. At that point there is already a claim started so all you're doing is exercising your right to receive your fully entitled benefits.

Permanent Partial Disability Settlement: It Is Advisable to Consult an Attorney to Know the Value of Your Case

In Missouri, you're entitled to three benefits, your Temporary Total Disability pay, your medical treatment, and a Permanent Partial Disability Settlement once you are released from treatment. Quite often I see employee’s miss out on the final PPD settlement.

Injured employees don't even get a settlement or they receive a fraction of what they should have received because they go to court and the defense attorney may say that, "Well, this is what we're offering you," and they take it having no idea of the true value. This is because most people have no idea what their claim is worth. They just accept what the attorney representing the insurance company offers them and they're done with it. That's a scenario that I see on a regular basis.


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