What Is a Utilization Review and How Can It Affect My Workers’ Compensation Case?

Response from the owner:Thanks Glenn. Missouri residents need to contact their state representative about proposed changes to Missouri workers comp laws that only benefit the insurance company and limit the compensation to the injured worker. Jefferson City is full of state representatives and senators who do favors for the insurance companies because they like the donations and high paid lobbying jobs after they leave office. When work comp laws become so favorable to the insurance companies, lawyers stop representing the injured worker because the laws limit what the lawyer can do for the employee and how much he/she gets paid. Write the governor. Write your state rep and state senator. Tell them your story about how the employer, the insurer, or the work comp doctor mistreated you. Tell them you will not vote for any person who passess work comp laws that limit the recovery of the injured worker.

Response from the owner:Thank you Tonka. Remy and I are preparing for a permanent and total disability trial on Friday. Employee alleges that because of the work injury and two level lumbar fusion, she is unable to return to work. Another issue will be pursuing denied medical for the lumbar fusion surgery. Plus, we are pursuing future medical for life. The work comp adjuster sent my client a doctor who alleged my client suffered no back injury despite work comp sending my client to doctors immediately after the injury who diagnosed herniated discs and radiculopathy... and then did three lumbar steroid injections. Proud to fight for the injured. Law Office of James M Hoffmann 2001 S. Hanley suite 325 St. Louis, MO 63144 314 361 4300 [email protected]

Response from the owner:Thanks Phylicia. 30 years of representing 1000's of injured workers and car accident victims. Proud to be a Missouri personal injury and workers compensation attorney. We represent the injured across the entire state of Missouri. James Hoffmann St. Louis, Mo work comp and car accident lawyer 314 361 4300

Response from the owner:Very kind of you Kendall. Unlike the tv guys who are either from St. Louis but never step foot in court or are not from St. Louis and have never been in a MIssouri court, I've been taking depositions and trying cases in Missouri for over 30 years. I have deposed orthopedic and neurosurgeons regarding herniated discs, disc extrusions, neck fusions, back fusions, disc replacements, fracture vertebrae's, paralysis, and death. I've deposed doctors about hip fractures, hip replacements, knee replacements, shoulder joint replacements, shoulder fusions, carpal tunnel surgery, cubital tunnel surgery, ankle surgery, ankle fusions, lis franc fracture dislocations, traumatically induced arthritis, and future medical for life. I've depose psychiatrists about depression, anxiety, and PTSD caused by injury and/or chronic pain . I've deposed neurologists regarding TBIs, or traumatic brain injuries, skull fractures, brain bleeds, and post concussion syndrome. We spend money on expert witnesses as the work comp insurer will have experts who will deny your claim. I've taken 1000's of depositions and tried 100's of cases. Those guys on tv have not. Law Office of James M Hoffmann 2001 S. Hanley, suite 325 St. Louis, MO 63144 314 361 4300 [email protected] Your Missouri car accident and workers compensation attorney

Response from the owner:Thanks Jeffrey. My son, Remy Hoffmann, and I only represent those injured whether at work, car accidents, falls, product defects, dog bites or malpractice. Strains, sprains, herniated discs, fusion surgeries, amputations, joint replacements, compound fractures, rotator cuff surgeries, disc replacements, concussions, traumatic brain injuries, loss of vision, hearing loss.. we have successfully obtained compensation for pain and suffering, past medical bills, future medical care, loss of income, and permanent total disability. We are not the big firm advertisers who have monthly settlement quotas. We fight equally hard for every client across Missouri from St. Louis to Kansas City, Springfield, Rolla, Columbia, Jefferson City, Kennett, Cape Girardeau, Branson, Troy, St. Joseph... . Glad to help. All cases on a contingency fee which means we will never ask a client for a penny. Law Office of James M Hoffmann James Hoffmann Remy Hoffmann Missouri personal injury attorneys 314 361 4300 [email protected]

Response from the owner:Thanks Ryan. We recently went to trial on a denied Missouri workers compensation low back injury that caused two herniated discs, radiculopathy, and eventually required a two level lumbar fusion. Once a case is tried, the attorneys have 30 days to submit proposed awards. The work comp judge has 90 days to issue a final award. We had orthopedic and neurosurgeon experts testify as to causation, permanency, wage loss, the denied medical bills. We also requested sanctions as the employer/insurer denied the injury even before a doctor reviewed the case on behalf of the employer. I cited a prior trial award I obtained for a client where we received an award that included sanctions: The LIRC in Nouraie v. MO. Baptist Medical Center et al, Injury No.: 10-111746, March 13, 2013, sanctioned the employer for refusing medical care in connection with a repetitive use claim. The Employer obtained an expert long after the wrongful denial of benefits. This did not justify the prior wrongful denial. The LIRC explained: “In any event, whether an employer has sent a worker for a medical examination prior to denying a claim is a factor for our consideration in determining whether an employer had reasonable grounds for denying a claim.” The LIRC in Nouraie also explained: “The courts have instructed us we are only to award such costs “where the issue is clear and the offense egregious.” Landman v. Ice Cream Specialties, Inc., 107 S.W.3d 240, 250-251 (Mo. 2003). We think it is clear that employers have an obligation to investigate the circumstances giving rise to alleged work injuries before denying benefits. And where the worker is available to discuss the injury, we think any reasonable employer conducting an investigation designed to determine whether an injury is work-related would discuss the alleged injury with the worker. In the instant case, Ms. Bequette, as employer's agent, denied evaluation, treatment and benefits to employee without even discussing employee's alleged back condition with employee. We think employer's act of denying workers' compensation benefits to employee before even discussing the alleged injury with employee constituted an egregious offense. Based upon the forgoing, we find employer defended this claim at the outset without reasonable ground.”

Response from the owner:Thank you Michelle. If you are injured while working in Missouri, or if you are hired while in Missouri and injured whether in or out of Missouri, we can pursue a Missouri workers comp claim for you. Workers injured due to another's fault, such as a car accident or machine failure, can also pursue a civil claim for personal injury in addition to a work comp claim. Merry Christmas. James Hoffmann, Missouri work comp and auto accident attorney 314 361 4300 [email protected]

Response from the owner:Thank you Dave. We recently finished an all day work comp hearing. Below is a summary: Claimant, a full-time carpenter for Employer, developed low back pain in September of 2017 making cabinets and displays for the Employer. Claimant’s job is physically demanding. Cabinets and displays can range from 60 to 500 lbs. Claimant job duties include lifting displays weighing up to 500 hundred pounds during the assembly process. Carts, each with 100 lbs of materials, are brought to Claimant who must lift the materials from each cart and assemble same. In October 2017, Claimant’s job duties caused his low back soreness to become severe pain with numbness down his right leg. At the final hearing, the Employer/Insurer produced no evidence of non-work activities that could have caused, or did cause, Claimant’s low back pain. When Claimant’s low back pain became severe in Oct. 2017, he sought treatment with a chiropractor, Dr. Lynch, on 10/17/20217. Claimant then, on 10/23/2017, reported to Employer a repetitive use work injury to his low back. He went sent to Concentra by the Employer but left due to delays in providing immediate treatment as he had severe pain and radiculopathy. He went immediately to an urgent care and returned to work with a light duty slip for 6 weeks for which the Employer complied. Despite asking the Employer for additional treatment during the next few months, none was offered. He kept the Employer informed of the treatment he was receiving on his own. IN December 2017, Claimant contacted attorney James Hoffmann who instructed Claimant to hand deliver a letter to the Employer making a written demand for treatment. Claimant delivered the letter in December 2017. At the hearing, Employer presented no evidence that it disputed the contents of the letter. Immediately after receiving the letter, the Employer contacted the Insurer which then sent medical authorizations to Claimant who signed and immediately returned same to the Insurer. The Insurer then obtained a statement from Claimant in Dec. 2017 where Claimant informed the adjuster of a repetitive use low back injury at work and need for treatment. After 6 weeks of light duty, Employer requested another light duty slip which Claimant provided. Claimant continued to work light duty until Feb. 15, 2018, when Employer informed Claimant there was no more light duty and sent Claimant home. In the meantime, neither the Employer nor the Insurer offered treatment. The Employer’s attorney was aware of Claimant’s treatment as he was sending copies of Claimant’s medical records to Claimant’s attorney received via the authorizations signed by Claimant. In Feb. 2018, Claimant’s attorney obtained a medical report from Dr. Armond Levy who related lumbar disc herniations and the necessity of surgery to Claimant’s work for Employer. Several demands were sent IN Feb. 2018 to the Employer for the surgery recommended by Dr. Levy and for TTD. At the hearing, Employer presented no evidence of any response to the demands for treatment and TTD made by Claimant’s attorney in February 2018. Claimant then underwent 2 surgeries on his own for his low back, the first being in March 2018 and the second in August 2018. During that time, no TTD or treatment was offered. When Claimant returned to work in November 2018, after recovering from the second surgery, he was informed by the Employer that he was fired. The Employer eventually sent Claimant to a physician, Dr. Bernardi, in November 2018, who is of the opinion that a person cannot suffer a repetitive use herniated disc. It is his opinion that herniated discs can only acute, and that any degenerative changes in the low back are genetic and cannot be caused by repetitive use occupations. In other words, Employer sent Claimant to a doctor who disagrees with Missouri law which specifically recognizes and accepts repetitive use injuries. Claimant had zero chance of a favorable opinion from Dr. Bernardi

Response from the owner:Thanks Blair. We are preparing for another trial! Client worked as a carpenter and injured his L4-5 and L5-S1 discs from repetitive heavy lifting. We made several demands for treatment. We obtained an opinion from a neurosurgeon and an orthopedic surgeon that back surgery was necessary. The employer refused treatment so our client had surgery, a lumbar fusion, on his own. We are pursuing the employer/insurer for 6 months of wage loss, denied medical of $245,000, permanency, and future medical for life. Law Office of James M. Hoffmann 2001 S. Hanley, suite 325 St. Louis, MO 63144 314 361 4300 [email protected] Your Missouri workers comp and car accident attorney.

Response from the owner:Thanks Justin. Happy to report another win a trial. Client injured his knee at work. He underwent a meniscus surgery. The doctor also "cleaned up" other degenerative changes in the knee. This is called a chondroplasty. After the surgery, client's knee go worse. The doctor blamed prior arthritis even though my client had no prior knee issues and no prior pain. Yes, at his age he had prior natural degenerative changes. We retained experts who testified that chondroplasty caused those areas top become inflamed and painful, thus causing the "arthritis." We argued that prior to the injury, there was no "itis", which means inflammation and pain. We argued that all of the "itis", and thus arthritis, was due to the surgery. The judge agreed and also awarded future medical for life which includes knee replacements. So, why did the doctor shave areas in the knee that were not symptomatic? Look at the bill: a meniscus surgery is onl $3000; but for every other area he "cleaned up", he gets $3000 for each area. Law Office of James Hoffmann 314 361 4300 [email protected] Your Missouri workers comp and car accident lawyer

Response from the owner:Thanks Katie. We also help families through car accidents and slip/falls. We recently recovered $500,000 for a client who fell at service station! James Hoffmann 314 361 4300 [email protected]

Response from the owner:Thank you Zach. I represent injured Missouri workers from St. Louis to Kansas City and all throughout Missouri: Springfield, Cage Girardeau, Hannibal, Rolla, Columbia. Ozarks. Kennett, Poplar Bluff, etc. We fight hard for every client and do not have monthly settlement quotas like the big advertisers do to pay for all of their advertising! Law Office of James Hoffmann 314 361 4300 [email protected]

Response from the owner:Falls at work are not compensable under Missouri work comp unless it is shown that something specific at work caused the fall. Just walking and stumbling for no reason is not work comp. Walking, and carrying a box, which causes you to stumble because you can't see your feet is work comp. Falling down stairs because you missed your step is not compensable unless you missed the step because you were in a hurry for a work issue; or you were carrying work items and that affected your line of sight. Having to wear certain shoes is work specific if the shoes are awkward and contributed to your fall. James Hoffmann attorney St. Louis workers comp and car accident lawyer 314 361 4300 [email protected]

Response from the owner:Thanks Jerry I have represented numerous first responders in Missouri workers comp and car accidents. Heavy ambulance doors have caused severe post concussion syndrome and TBI's. Lifting victims has caused herniated discs requiring cervical and lumbar fusion surgeries. Glad to help our hero's. Law Office of James Hoffmann 2001 S. Hanley, Suite 325 St. Louis, MO 63144 314 361 4300 [email protected]

Response from the owner:Thanks Jessica. Missouri injury claims are a battleground. Whether its a wrongful death claim, herniated disc, lumbar or cervical fusion, strain/sprain, shoulder surgery, knee surgery, amputation, concussion, dog bite, workers comp, and other injuries, the bottom line is that insurance companies don't want to pay fair and reasonable damages, they want to as little as possible and delay the case so payment is delayed. Attorneys from across Missouri from St. Louis to Kansas City to Springfield, Columbia, Cape Girardeau, etc. need to ready for a fight. Money needs to be spent on experts and the attorney needs to go to trial when the offer is too low. The big law firm advertisers settle everything they can for cheap to meet advertising budgets and attorney quotas. Law Office of James Hoffmann St. Louis personal injury and work comp lawyer. 314 361 4300 [email protected]

Response from the owner:Worsening of prior conditions are a valid Missouri work comp claim: Per Tillotson v. St. Joseph Med. Ctr., 347 S.W. 3d 511 (Mo. App. W.D. 2011) to determine need for treatment, surgery, and treatment after surgery. Treatment need only be reasonably required to cure and relieve the effects of the injury. Id. Section 287.140.1 RSMo states in pertinent part that the Employer shall provide such medical as may “reasonably be required. To be entitled to future medical care the employee must establish that there is a reasonable probability that he will need future medical care. Forshee v. Landmark Exc. & Equip., 165 S.W. 3d 533 (Mo.App. E.D. 2005) An [Employee] does not have to provide evidence of specific medical treatments or procedures which will be necessary in the future in order to receive an award of future medical care. See Chatmon v. St. Charles County Ambulance, 55 S.W.3d 451, 459 (Mo.App. E.D. 2001). Employee has already satisfied the burden of proving a compensable injury. Here, defense's authorized Dr. Spears on 4/26/2010 opined "if she doesn't get improvement in her radicular pain, then the next step is going to be a microscopic transforaminal lumbar interbody fusion to remove the foraminal stenosis." He went on to state the January 2010 incident was a "fall (that) aggravated significantly a pre-existing condition". This is enough under Tillotson, Forshee, and, Chatmon (supra) to award further treatment. Please also see Maness v. City of De Soto, 421 S.W.3d 532 (Mo. App. 2014). The court rejects Employer's contention that the mere existence of degenerative disc disease in the cervical spine and neck symptoms prior to the work accident requires a determination that Claimant's injury is not compensable. See also the following in support: If the evidence establishes that an accident caused a disability or aggravated a preexisting condition or infirmity of an employee, which produces a condition that would not have resulted in a normal, healthy individual, an award is authorized. Fogelsong v. Banquet Foods Corp. 526 S.W.2d 886 (Mo. App., K.C.D. 1975) An aggravation of an existing infirmity caused by an accident or occupational exposure arising out of and in the course of employment is compensable under Chapter 287, RSMo, even if the particular accident (occupational injury) would not have produced such result in a normal and healthy individual. Mashburn v. Chevrolet-Kansas City Division, General Motors Corp., 397 S.W.2d 23 (Mo. App., K.C.D. 1965)

Response from the owner:Thank you Steve. I wish I handled all of the work comp claims, but I do represent many. Whether it's large employers like Boeing, Ford, Emerson, Anheuser Busch, BJC, or smaller employers, we fight hard for injured workers in Missouri. 30 years of experience. 1000's represented. Over $100,000,000 recovered and the battles rage on. We also had personal injury claims as well. We recently recovered $450,000 for an injured worker who was bit by a dog. Law Office of James M. Hoffmann 2001 S. Hanley St. Louis, MO 63144 314 361 4300 [email protected]

Response from the owner:Thanks James. Workers' comp, or workman's comp as some say, lawyers need to hire experts such as pain management doctors, or orthopedic doctors who specialize in back surgery, shoulder surgery, knee surgery, neurologists, concussion specialists, and psychiatrists. The political environment in Missouri now favors insurance companies. Work comp claim are no longer simple and informal. They are a jury trial but without a jury. Lawyers need to know how to depose doctors and try a case. Every day we fight for our clients injured at work, injured in car accidents, injured by dog bites, injured medical negligence, and more. James M Hoffmann, attorney 2001 S. Hanley, suite 325 St. Louis, MO 63144 314 361 4300 [email protected]

Response from the owner:Thanks Eric. Workers comp insurance doctors love to blame ongoing pain on pre-existing arthritis even though all of the employee's pain started with the work injury and prior to the work injury the employer had no pain and had never been diagnosed with arthritis. The insurance doctors always refer to prior, non-symptomatic degenerative changes in a joint as being "arthritis." "Itis" means inflammation and pain. The itis is usually due to the joint becoming inflamed and painful from the work injury and surgery. Thus, the "arthritis" is due to the injury and not because a person has prior naturally occurring non-symptomatic degenerative changes. Ask the work comp doc: "you agree that 60 year old tonsils probably have degenerative changes. Would you call 60 year old non-symptomatic tonsils "tonsilitis": NO!; would you call a 60 year old non-symptomatic appendix "appendicitis":NO!; would you call a 60 year non-symptomatic bursa "bursitis": NO!.. that's because the "itis" means inflammation and pain, non of which I had until the work injury!!! I see this all the time with neck injuries, low back injuries, disc herniations, rotator cuff tears, meniscus tears: doctors do surgery under workmans comp and then blame ongoing pain on a made up pre-existing condition. James Hoffmann Your Missouri workers comp and car accident attorney 314 361 4300 [email protected]

Response from the owner:Thank you Jennifer. We just went to trial for a disputed total knee replacement. The work comp doctors always allege the knee replacement is due to pre-existing arthritis yet my client has no prior knee pain, no prior limitations, no prior treatment. He had a 60 year old knee that had natural degenerative changes, but he was pain free. In the word "arthritis", itis means inflammation and pain, neither of which my client had before the injury. The itis started with the work injury. It takes 90 days for a ruling. Law Office of James M. Hoffmann St. Louis, MO car accident and workers compensation lawyer 314 361 4300

Response from the owner:Thanks Payton. Call it work comp, or workers comp, or workman's compensation, it's all the same. A current battle with a work comp insurer concerns "natural consequences." My client had a L5-S1 fusion under work comp. She has at home transitioning from a walker to a cane, per doctor's orders, when she fell fracturing her elbow and damaging her lumbar fusion. The injuries from the fall are part of the work injury as someone falling, due to balance issues from the surgery, while rehabbing is a known and accepted consequence. Of course the work comp insurer is fighting us arguing that her home rehab should only have been indoors and not outdoors where she fell...absurd! The doctor placer no restrictions on where to practice transitioning. She now has a three level lumbar fusion from L3-4. L4-5. and L5-S1. We'll go to trial if not accepted. Glad to fight for the injured worker in Missouri. Law Office of James M. Hoffmann St. Louis, Missouri workers comp, car accident, injury attorney. 314 361 4300 [email protected]

Response from the owner:Thanks Joshua. Unlike the big firms that advertise on TV which have monthly settlement quotas for their attorneys, I spend my money on experts such as orthopedic surgeons, neurosurgeons, pain management doctors, vocational experts, and life care plans. These experts are necessary to prove the permanent damage and wage loss caused by back injuries such as paralysis, disc herniations, disc protrusions, and fractured vertebrae, or shoulder injuries such as rotator cuff tears, labral tears, shoulder replacement surgeries and frozen shoulders; or fractured hips and pelvises that require plates, screws, or hip replacement surgery; or TBI's, traumatic brain injuries, also called concussions, PCS, or post concussion syndrome; ankle fusions; ankle joint replacements; knee joint replacements, PTSD from the injury, and depression and anxiety from chronic pain. It does not take a large law firm to fight an insurance company. It takes a good lawyer. There's a reason why injured insurance adjusters and injured insurance doctors call me to represent them. They know I fight and will not back down. Law Office of James M. Hoffmann St. Louis, MO workers comp and auto accident attorney 314 361 4300 [email protected]

Response from the owner:It's scary because there are employers who go the attack when an employee gets hurt. There are insurance adjusters who deny claims and create hardships. There are insurance doctors who blame pre-existing arthritis even though you had no or little prior issues. If the doctor says that you suffered a compensable injury by accident, then the legal standard for determining employer’s obligation to afford medical care under the Missouri workmans comp law requires the employer to provide treatment reasonably required to cure and relieve the effects of the injury. The prevailing factor standard no longer applies. Further, it is immaterial that treatment may have been required because of the complication of a pre-existing condition or that treatment will benefit both the compensable injury and a pre-existing condition. The fact that medical treatment may also benefit a non-compensable earlier injury or condition is irrelevant. Whether or not claimant may have needed future treatment even if the injury did not occur is irrelevant to the analysis of whether future medical care flows from the injury actually occurred. With respect to permanent partial disability it is immaterial that the employee had a prior condition as an employee is entitled to compensation for disability rising out of the medical treatment reasonably required to treat the injury. With respect to future medical benefits, the claimant need only show reasonable probability because of the work-related injury, future medical treatment will be required. A claimant need not show evidence of the specific nature of the treatment required. In other words, prior conditions, such as arthritis, is irrelevant if the doctor says you suffered a work injury. The employer/insurer must treat both. James Hoffmann St. Louis, Missouri workers comp and car accident lawyer. 314 361 4300 [email protected]

Response from the owner:Thanks Suzanne. Over the past 25 years, we are proud to help families through injuries from car accidents and work accidents in Missouri. James Hoffmann St. Louis, MO auto accident and workers compensation lawyer 314 361 4300

Response from the owner:Thanks Cassie. Although the workers compensation statute in Missouri mandates that the process be simple, informal, and summary, it is anything but. Your attorney should use experts such as orthopedic surgeons for shoulder, hip, hand, and knee injuries, or neurosurgeons for herniated discs and other spine injuries, vocational rehabilitation experts to prove permanent and total disability, and pain management doctors to prove the need for future medical care for life. These experts are expensive, but I risk my money as we need them be successful whether at trial or to get a good settlement. Glad to fight for the injured Missouri worker and those injured on car accidents. James Hoffmann Missouri personal injury attorney 314 361 4300 [email protected],

Response from the owner:Thanks Shane. I have fought for 1000's of injured Missouri workers and car accident victims. Workers compensation doctors and insurance adjusters have hired me to represent them, all saying "you fight for your clients." I hire experts. I take depositions. I try cases. The insurance adjusters know who settles cheap to meet big advertising bills and who fights for their clients. Glad to say I am a fighter. Jim Hoffmann Missouri workers compensation and car accident attorney 314 361 4300 St. Louis, MO

Response from the owner:Thanks Austyn. We represent workers all across the state of Missouri. We've won numerous permanent and total disability trials. We've won numerous hardship trials either for additional treatment and/or wage loss, known as TTD. We've helped construction workers, police officers, warehouse workers, production workers, firemen, workers compensation doctors and insurance adjusters have hired us when they get hurt, salesmen, nurses, and numerous others. Across Missouri from St. Louis , Kansas City, Springfield, Kirksville, Milan, Rolla, St. Joseph, Branson, Kennett, Cape Girardeau and other cities, we have helped people recover damages for auto accidents and Missouri workers compensation injuries. James Hoffmann 314 361 4300 [email protected]

Response from the owner:Thanks Alex. Recently won a hardship where the work comp adjuster and insurance doctor denied treatment for knee injury. My experts convinced the judge that the injury caused meniscus tears, cartilage damage, and traumatic arthritis, thus leading to the need for a knee replacement. My client's knee is now covered for life by workers compensation and all back pay, or TTD, was recovered too. James Hoffmann Missouri workers compensation and auto accident lawyer 314 361 4300 [email protected]

Response from the owner:Thanks Dylan. Here are a few things injured Missouri workers should immediately after the injury: report the injury in writing; if the employer says that he/she will fill it out and refuses to let you fill out the injury report, you can prepare a letter about what happened and give it to your boss (keep copies and date it!); ask for treatment: just telling your boss that your back is hurting isn't good enough; say "my back is hurting from breaking up concrete and I'd like to see a work comp doctor:; if your boss refuses, give your boss a letter confirming that you reported a back injury, asked for treatment, and it was refused; when you see the work comp doctor and the front desk gives you intake sheets that don't ask all of the necessary questions about what happened and only what x's and o's: just write anything anywhere you want to so that you explain how you go hurt and what body parts are hurting; on the body chart, circle your low back and write "back pain that shoots down my right leg"; if your employer gives you work that exceeds the light duty restrictions, refuse to do that work and give your boss a letter confirming what has transpired (date it and keep copies); when the work comp doc releases you in pain and blames a pre-existing condition even though you had no prior pain, no prior treatment and no prior limitations; give that doctor a letter :"Dr. No: to confirm, I am very upset that you are releasing me and sending back full duty despite ongoing pain from my work injury. My back pain is still a 4-7/10; it wakes me at night; and light duty was making it worse. You said I've healed from my injury and any ongoing issues are due to pre-existing arthritis. I told you I had no prior pain; no prior treatment; and no prior limitations. All of my pain, treatment, and limitations started with my work injury and have never resolved. If my back gets worse at work working full duty, I will hold you personally responsible."

Response from the owner:Thank you Heather. We represent injured workers and injuries due to car accidents. We frequently retain experts, such as orthopedic surgeons, neurosurgeons, pain management doctors, vocational experts, life care planners, and others to fight for our clients as expert witnesses in court.We represent people across the entire state of Missouri from St. Louis to Kansas City, from Joplin to Kirksville, from Columbia to Kennett. Neck fusions, lumbar fusions, cervical disc replacements, lumbar disc replacements, shoulder replacements, knee replacements, meniscus tears, rotator cuff tears, ankle fusions, loss of limb, paralysis, and death, we have helped many workers and families recover compensation either by settlement or by trial. James Hoffmann, attorney 2001 S. Hanley, suite 325 St. Louis, Mo 63144 314 361 4300

Response from the owner:Lexi Writing a proposed award for an upcoming work comp trial for an injured Missouri worker. L4-S1 lumbar fusion with plates and screws. Pursuing permanent and total disability plus denied medical. Here is the case law on denied medical in MO workers compensation: The employer is held liable for medical treatment procured by the employee only when the employer has notice that the employee needs treatment, or a demand is made on the employer to furnish medical treatment, and the employer refuses or fails to provide the needed treatment. Hawkins v. Emerson Electric Co., 676 S.W.2d 872, 880 (Mo.App.1984). The courts have consistently held that an award of past medical expenses is supported when the employee provides (1) the bills themselves; (2) the medical record reflecting the treatment giving rise to the bill; and (3) testimony identifying the bills. Martin v. Mid-America Farm Lines, Inc., 769 S.W.2d 105, 111-12 (Mo. 1989). The pertinent case law requires employee to prove that the past medical expenses were “due” to support an award of interest. McCormack v. Stewart Enters., 956 S.W.2d 310, 314 (Mo. App. 1997). As explained in McCormack, this means employee must show that he actually paid the bills, or received demands that he pay interest on the bills, or suffered some other loss, such as a doctor refusing to provide additional treatment until employee paid his bill. Id.

Response from the owner:Thanks DJ. When the workers comp doctor treats you for an on the job injury, releases you still in pain, and then blames pre-existing arthritis as the cause of your ongoing knee, hip, shoulder, or back pain, make that doctor answer these questions: Please explain why you allege pre-existing arthritis when, before the injury, I had no knee/neck/shoulder pain; I had no limitations at work; I sought no treatment; I enjoyed xyz activities. All of my pain, my limitations, my need for treatment. started with the work injury and my pain has never stopped. Then say "let's look up the definition of arthritis": arthr means joint and itis means inflammation and pain... I had no inflammation or pain before the work injury. I may have had natural degenerative changes in my joints, but I had no pain, no limitation, no treatment. All of my pain and inflammation started with the work injury.

Response from the owner:Missouri work comp law mandates compensation for either partial disability (PPD) or permanent total disability ( PTD). Employees who can no longer work seek PTD which is either a lump sum by settlement or, if the parties cannot settle, then a trial a weekly check for life is sought, plus back pay and future medical care.

Response from the owner:Thanks Angela. You are correct. You get one chance to win. Injured workers from across Missouri have hire me to represent them. Joplin, Springfield, Cape Girardeau, Kennett, Fenton, Kansas City, Poplar Bluff, St. Louis, Moberly, Kirksville, Columbia, Chillicothe, Sedalia, Moberly, St. Joseph, Nevada, Neosho, West Plan, Sikeston and other Missouri residents have hired me for their work comp or car accident case. Permanent total disability claims are life changing. Your attorney needs to hire experts and be thoroughly prepared for trial. Law Office of James M. Hoffmann 314 361 4300

Response from the owner:Thanks Leisa. We are proud to fight for injured Missouri workers. Our clients have required neck and low back fusions, shoulder replacements; knee replacements; carpal tunnel surgery; amputations, disc replacements, and other various injuries. We fight for future medical care as well as either perm partial or perm total benefits. James Hoffmann, attorney 314 361 4300 [email protected]

Response from the owner:Thanks Hadleigh. I've handled 100 plus trials and 1000's of injury claims for injured workers over the past 25 years across the entire state of Missouri. Unlike these large law firms with their silly ads and their monthly settlement quotas, I hire experts and try cases. I've represented Missouri workers comp claim adjusters and insurance company doctors because they know I fight for injured workers. Gold bless James Hoffmann, attorney 314 361 4300

Response from the owner:I appreciate your kind words ReAnna. I do not hesitate to hire experts for reports from pain management doctors, shoulder specialists, back specialists and life care plans for catastrophic injuries. If a biased work comp doctor releases my client too early and my client wants more treatment, we send the injured worker to our docs for opinions on additional treatment. Whether the injuries are work comp or a car accident, we spend a lot of money on expert witnesses. Law Office of James M Hoffmann St. louis, MO injury attorney 314 361 4300

Response from the owner:Proud to be representing injured Missouri workers and car accident victims for over 25 years. The law firms advertising bigger is better is a bunch of crap. Being in Missouri courts for 25 years, trying cases for 25 years, and taking 1000's of expert depositions for 25 years makes you a good lawyer. James Hoffmann Missouri personal injury and workers comp lawyer. 314 361 4300

Response from the owner:Thank you Gladys. It is my passion to fight for the injured in Missouri. You suffered severe injuries requiring surgery. Insurance companies think injury claims are a game but its not. People have bills to pay and family to provide for. Unlike the "big" law firms that settle cheap to pay for advertising costs, I hire experts and try cases. God bless.

Response from the owner:Very kind of you Sonya. Both workers comp and car accident insurance companies like to play the game of blaming pre-existing degenerative changes even though someone had no prior pain, no prior limitations, and no prior treatment to the body part at issue. This happens a lot with back injuries such as herniated or ruptured lumbar and cervical discs that require a fusion or disc replacement surgery. I have developed an extensive cross examination of the insurance company experts to expose their flawed opinions. Glad to fight for the injured. Jim Hoffmann St. Louis injury attorney 314 361 4300

Response from the owner:Car accidents, work comp, and other injury claims in Missouri are my specialty. But, glad to help anyone in need. If I don't practice in the area, such as discrimination or medical malpractice, I will refer only to the best attorney's who I know and trust.

Response from the owner:Work comp and car accident cases in Missouri for over 25 years. We have sued trucking companies for wrongful death. Our clients have undergone lumbar/cervical fusions, shoulder surgeries,knee surgeries, hip replacements, carpal tunnel, ankle replacements.. we know injuries. We hire experts. We try cases. Thanks Law Office of James M Hoffmann 314 361 4300

Response from the owner:Thank you Edward. Missouri workers compensation has become a battle ground. The insurance companies have taken over Jeff City and the laws are become more employer/insurer friendly. We hire experts, take a lot of depos, and try cases every year. Missouri injury claims are our speciality. Jim Hoffmann

Response from the owner:Thanks Danielle. Whether a work comp case or a car accident injury, people need an injury lawyer to battle the insurance companies. Adjusters claim they are not trained to deny claims, but when deposed they admit to profit sharing retirement plans: more they deny means more profits they share. Thank you for your confidence in my practice. Glad to help those injured in Missouri. Jim Hoffmann

Response from the owner:Fighting insurance companies for injured workers is our passion. Across the state of Missouri, we represent those hurt on the job. Work comp insurance companies are nothing but bullies to injured employees. Thank you for the kind words Jerry!