Workers’ compensation systems are intended to be efficient and keep injury cases out of the courts. 
States develop and implement their own systems, so the way that each state approaches and handles workers’ compensation injuries can vary significantly from state to state. Workers are generally supposed to be guaranteed benefits for injuries and medical treatment regardless of whose fault the injury was and in return employers are protected from workers taking legal action against them. When the system is working well, an injured worker should be able to report an injury and receive medical care right away. But for many workers, getting the care and benefits they need can be a real struggle.
States are constantly amending their systems, trying to make them more efficient and cost effective, but the reality is that workers’ comp systems are not perfect. And in many cases workers are either denied the care that they need or are required to wait for a long time before they can receive necessary care.
Examples of fraud, retaliation, biased expert witnesses, inattentive attorneys, and delayed medical care are easily spotted, and illustrate the dysfunction of a broken system. Lawyers say that supposedly independent medical examiners will bend to the will of insurers in order to keep their business.
Long delays and denial of benefits is a serious problem. Some injured workers end up waiting a year or more for surgeries or after a long wait are denied benefits altogether. These issues can be very disheartening for injured workers and their families who are affected by the injuries and lack of income. It is not unusual for injured workers to have their injuries disputed by the insurance company, be accused of faking an injury, or told that another cause other than the workplace accident was the real source of their injuries. Because the insurers are the ones paying the independent medical examiners, getting them to support these claims can be too easy. These delays can impact employees’ health, cause injuries to heal improperly, or cause a condition to significantly worsen.
Many workers are afraid to even file a workers’ compensation claim because they fear punishment or retaliation from their employers, while others are strongly discouraged by their employers from even filing a claim at all. While retaliatory action against an injured worker is illegal, some employers may seem to get away with it.
Problems like these are a reality for many states. Reform is a necessity, but it is slow going. Fraud perpetrated by workers is oftentimes cited as a reason for reform, but it is more common for employers to commit fraud by falsely reporting the number of workers they employ in order to avoid paying premiums or by doctors who pad their bills in order to receive bigger payments.
St. Louis Workers’ Compensation Attorney
If you have been injured on the job in Missouri and are having trouble getting compensation, contact an experienced Missouri workers’ compensation attorney at the Law Office of James M. Hoffmann. Delays or denial can be incredibly discouraging for injured workers who do not know how to navigate the system. Having the help of an experienced workers’ comp attorney who understands the state laws and have successfully handled workers’ comp cases can make a world of difference.