Chapter 8 types of injuries

"Workers' Compensation in Missouri: Succeeding in Your Injury Claim"

Types of Injuries

There are many types of injuries sustained at work, but a common denominator of all workplace injuries is the difficulty to fully treat and recover while performing the same duties. Often, after an injury is treated, the employee returns to the same job responsibilities and is at even greater risk of re-injuring themselves as they repeat the actions that caused harm originally. We often work to avoid this pattern of re-injury and will fight to get your claim fairly decided from the beginning. Below are a few of the more common workplace injuries and the manner in which those injuries are compensated.

Back and Neck Injuries

Trauma to your spine is life changing. Back and neck injuries are some of the more common issues we handle with workers’ comp claims. Your neck (also referred to as your cervical spine) and back are susceptible to injury from heavy lifting, slips and falls, repetitive movement, car accidents or other occupational hazards. Occasionally, severe spinal injury also results in paralysis or death—we have successfully handled these cases, as well as less acute neck and back injury claims. Your mid back is called your thoracic spine and your lower back is your lumbar spine. These are often permanent injuries leading to lifelong symptoms and disability. The vertebrae themselves can fracture or collapse. The disks between the vertebrae can herniate or bulge and can impinge on the spine. This causes pain in the area of the spine, as well as the parts of the body innervated by that area of the spine.

One of the most important reasons to hire an attorney if you have a spinal injury is so that you are compensated fully for your injury. Unfortunately, many insurance companies rate certain injuries and areas of your body lower than what is deemed fair. They may claim that your disability is only 5% so you would receive a smaller payout for your time off work.

However, our medical experts might find that the same injury has actually rendered you 50% disabled, thus indicating a very different standard of payout for your injury and recovery. Physicians are doubly motivated to rate your disability low. They are paid by the work comp insurance company and want to keep getting that business – a 30% disability rating does not help. They also are inclined to think their amazing surgery or other treatment completely healed their patient (ego). They may turn a blind eye to less than stellar recovery.

Traumatic Brain Injury (TBI), Head Injury, and Psychiatric Disability

TBI and head injuries can be devastating and are sadly one of the most underpaid claims in the Missouri workers’ comp system. We know that these types of injuries are especially debilitating because they impact our thoughts, emotions, and ability to function. Often times, employees experiencing these types of injuries also have accompanying or delayed after-effects that can include depression, headaches, or other psychiatric issues.

Psychiatric problems can occur in non-head injury cases. The physical trauma and pain, financial hardship, challenges to your safety and future and grieving the injury and resultant disability can cause psychiatric injury. Expert physicians and therapists can assess this and opine as to psychiatric disability in order to get an injured worker fully compensated under the law. Getting treatment from mental health providers is often an integral part of care and should not be overlooked.

Eye and Ear Injuries

Injuries to these organs and senses can be life-changing. Injury to an eye frequently entails more than vision loss; in many cases, it causes disfigurement, depression, and other complex problems. In Missouri, the workers’ comp payout is insufficient for most serious eye injuries. As skilled attorneys who know how to negotiate successfully with insurance companies and employers, we understand the importance of securing payment not only for your current inability to work and medical costs, but also for future medical costs, vision loss, and psychiatric issues arising from such an injury.

Hearing Loss and Tinnitus (ringing in the ears)

Recovering for these cases is difficult in Missouri, as the permanent partial disability schedule only owes 49 weeks of pay to an employee who completely loses hearing in one ear.

Occupational Disease and Repetitive Trauma Injuries

These are commonly manifested in conditions such as carpal tunnel syndrome, rotator cuff tears, neuropathies in the elbows and other similar maladies. To be successful in repetitive trauma cases we must enlist medical experts who can determine if the injury is due to work constraints and not as a result of aging or degeneration. But remember that these can be to the back or other areas of the body.

Occupational diseases are conditions which flow as a rational consequence of a risk associated with employment. It must be established to a reasonable degree of probability that the disease or condition occurred as a natural result of an exposure of the employee to a particular risk or hazard which is inherent in the employee’s working conditions and to which the general public is less exposed or to which the public is exposed in a different manner. There must be medical evidence of a direct causal connection between the conditions under which the work is performed and an occupational disease. Sometimes these conditions will not manifest until a worker begins a new job. In such cases, the employer who is liable is the one in whose employment the employee was last exposed to the hazard of the occupational disease prior to evidence of disability.

Repetitive motion injuries are considered a type of occupational disease. They are medical conditions resulting from the continued trauma of repetitive body movements required on the job. If the chronic trauma causes an employee to sustain a loss of earning capacity, the employee is entitled to compensation. The employee must pove (1) that the condition arose out of and in the course of employment; (2) that the condition was caused by employment-related activities; and (3) the nature and extent of the disability caused by the condition. R.S.Mo §287.067.

Regarding new employment: if the exposure to the on-the-job trauma with the new employer is for less than three months, and the evidence demonstrates that the exposure to the repetitive motion with the immediate prior employer was the prevailing factor in causing the injury, the prior employer is liable. If the exposure continues with the new employer beyond three months, the new employer is liable. Endicott v. Display Techs., Inc., 77 S.W.3d 612, 626 (Mo. 2002).

Importantly, like any on-the-job injury, you have a responsibility to inform your employer of an occupational disease/condition or repetitive motion injury. However, in such cases, you’re only obligated to file a report with your employer within 30 days of your diagnosis with the disease or condition.

Hip, Knee, and Ankle Injuries

Our bodies tend to wear out in these joints to injuries to them are very common. The body also fails at these places. These injuries can include hip fracture or replacement, tibia and fibula fractures, ligament damage, and even severance of the limb. One of the most common claims we handle are injuries to the knee. Many times, insurance companies assert that meniscus surgeries or tears equal a 0% disability. We believe that since a portion of the knee is removed permanently that this should result in compensation for a permanent partial disability.

Broken Bones, Crush Injuries and Loss of Body Parts

Depending on your job, your bones may be subject to breaks or even crush injuries. Broken fingers, arms and ankles are common injuries which can occur at work. Recovery amounts are based upon statutorily set values for respective body parts. Crush injuries involve severe trauma to a particular body part, resulting in the part becoming “crushed.” Crush injuries can result in serious permanent disability. Similarly, lost body parts cause permanent disabilities. A lost body part is compensated at a 100% disability rate.

Partial or Total Loss of Teeth

Loss of teeth may be compensable beyond just the loss of the teeth themselves, due to disfigurement. The loss of one tooth is valued at 1.25 “weeks” of compensation. Each molar or grinding tooth, however, is counted as two teeth (2.5 weeks). Teeth are compensable at the partial or total levels. The maximum rate of loss for all 48 teeth is 60 weeks.

Amputation Injuries

Whenever a worker has a complete amputation of any of the body parts specifically described in the work comp statute (see 287.190.1 for the statutory list; see also Appendix One at the end of this book, for a body chart), they are compensated for the total number of weeks for that body part plus an additional 10% of that part's value. (287.190.2). So for example, if an employee loses the tip of his index finger at the 30 week level, that employee would be entitled to 33 weeks of compensation.

Idiopathic Injuries

Idiopathic injuries involve an injury that results from a pathological condition that is unrelated to the employment but that may contribute to causing an injury.

One example, would be if an employee suffers injury during an epileptic seizure. When it is clear that the seizure or other idiopathic event was caused by a personal condition wholly unrelated to the workers employment, injury resulting from the idiopathic episode is unavailable. Howard v. Ford Motor Co., 363 S.W.2d 61 (Mo. App. W.D. 1962).

Calculating Multiple Permanent Partial Disabilities

The injury you suffer in a workplace accident may cause you multiple permanent disabilities. For example, in a fall on the job, you may have broken both your arm and your leg and you may suffer from permanent diminished usage of both appendages as a result. In such situations, you are entitled to be compensated for both losses, added together. Some injuries may also cause you greater disability than the same injuries would have caused had they occurred separately. This is called the “multiplicity factor.” However, the total compensation rate for these disabilities cannot exceed the maximum 400-week maximum limit.

Importantly, if you injure a body part on the job, which you had previously injured on the job, and for which you were previously paid PPD, your employer is not permitted to deduct this prior payment amount from your more recent injury to the same body part.

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