The Penalties for Workers’ Compensation Fraud in Missouri

Workers’ compensation insurance is invaluable for workers who work in dangerous environments, suffer injuries, and need to cover their costs and medical bills while they recover.

While workers’ compensation fraud in St. Louis and Missouri is rare, it does happen. Employees may falsify injuries to get money they don’t deserve, or employers may lie about incidents in order to avoid insurance payouts. In some cases, insurance companies may even engage in fraud to try to maintain their profits.

In this article, we’ll look at a few of the penalties that may be incurred as a result of workers’ compensation fraud in Missouri – and why violating the law is such a bad idea!

Penalties For Employee Fraud

If an employee makes a claim for workers’ compensation benefits to which they know they are not entitled – or file multiple claims or the same occurrence – this is a Class E felony. As any St. Louis work injury attorney will tell you, you should absolutely never falsify or make a fraudulent claim for workers’ compensation insurance.

The typical punishment for this is a fine of up to $10,000 or twice the value of the fraud – whichever is larger. Class E felonies can also carry a prison term of up to 4 years. Violating this law again will likely result in a class D felony.

Penalties For Employer Fraud

Employers can also get in serious trouble if they are fraudulent.

If an employer knowingly misrepresents the classification of an employee’s job to save money on insurance, this is a Class A misdemeanor, and further violations may be charged as a Class E felony.

If an employer knowingly makes a false statement about a worker’s entitlement to benefits in order to discourage them from claiming benefits – or falsifies evidence or statements to deny a worker benefits to which they are entitled – this is a class A misdemeanor. Further violations will be charged as Class D felonies.

Employers may be charged up to $10,000 for initial Class A misdemeanor violations, with steeper penalties and potential jail time for further violations.

Penalties For Insurer Fraud

If an insurer knowingly and intentionally fails to meet worker’s compensation obligations to which an employee is legally entitled, they may be charged with a class E felony, with a fine of $10,000 or double the value of fraud, whichever is larger. Further violations may be charged as a class D felony.

Get Help From a St. Louis Workers’ Compensation Attorney!

If you think that your employer or insurer is attempting to lie about your injury and is making fraudulent claims, you will greatly benefit from the help of an experienced St. Louis work injury lawyer. With the help of an experienced workers’ compensation attorney in St. Louis, you can protect your legal right to compensation.

If you’ve been injured on the job in the state of Missouri, give us a call 24/7 at (314) 361-4300 for a FREE case evaluation.

Can You Receive Compensation for a Viral Illness Like the Flu?

Flu season is around the corner, and soon you will be watching out for any signs that could differentiate it from an ordinary cold. Many people miss work because of the flu, and sometimes it can lead to complications and even hospitalization.

If you are worried about what would happen to your job if you would miss work because of it, workers compensation may seem like a plausible option for employees, especially since the vast majority of jobs involve contact with other people.

When Can You Receive Workers Compensation?

First of all, we need to clarify what exactly qualifies for workers compensation. This protective measure is implemented in every state to ensure that employees who suffer injuries or disease because of their workplace will be able to sustain themselves during recovery. Regulations vary from state to state, but the principles of qualifying for workers comp are the same everywhere: one must demonstrate that their injury or illness is caused by conditions at work or by the nature of their job.

There are two conditions that have to be met for a disease or illness to be covered by workers comp:

• It is “occupational”, meaning it arose out of the course and scope of the employment;
• It is caused by conditions “peculiar” to the work.

When it comes to the flu, both tests would be difficult to pass in order to get workers comp. First of all, it is not simple to demonstrate that you have contracted the flu virus while at work, but it is not impossible either. You would have to demonstrate that you didn’t have any symptoms up to a point, you would need to point to the conditions that exposed you to the flu virus. You can see how this is hard information to demonstrate when it comes to the flu, since it can be contracted anywhere there’s a gathering of people.

The second test would be even more difficult to pass. The flu is an ordinary disease that you can get anywhere, it is not a characteristic of a certain workplace or job.

What About Health Workers Who Are More Exposed to Flu?

It is common sense that a health worker is exposed to a wide range of viruses, and the flu is one of the most common of them. This is why employers in the health sector have the obligation to implement a combination of controls to prevent a flu pandemic. Vaccination, giving sick employees free days and limiting the exposure to ill patients are the basic steps an employer must take during flu season.

However, the flu is generally not covered by workers compensation, since it can be transmitted anywhere, not only at the workplace. However, you don’t have to worry about missing work because of it, since any full-time employer generally gets paid medical leave in case he has a contagious airborne disease.

 

If you have been injured on the job call the Law Office of James M. Hoffmann 24/7 at (314) 361-4300 for a FREE consultation.

Can I Speed up My St. Louis Workers Compensation Claim?

When a worker in Missouri gets injured or ill at work, by law they are generally entitled to workers compensation benefits to cover the costs of their treatment. In some cases, time is of the essence, and it’s required for these proceedings to go over as quickly as possible.

However, the consideration date may put a damper on that. Here’s everything you need to know about that.

What Is a Consideration Date?

Once you file a claim for workers compensation, the insurance company and employer have a period of time called consideration date to challenge your claim. Ideally, they will take the claim at face value and allow it to continue in order for you to get the necessary treatment.

However, it’s also possible for them to use this right if they have cause to believe your injury or illness is not a direct cause of your work, and therefore they are not required to pay for your treatment. If this does happen, then you, unfortunately, will have to build a case to defend yourself and your claim. At this time, it’s best to reach out to a St. Louis workers comp lawyer to ensure you gather the necessary evidence to back up your claim and get through this as soon as possible.

Can You Speed the Process?

In these cases, you would expect for everyone to sympathize with the injured worker and not do anything to delay them getting the treatment they need to get better, particularly if they require emergency care.

If this is not the situation you find yourself in, you are not without options. It is in your best interests to speak with an experienced workers compensation attorney as soon as possible. They can help you build a case that shows you are entitled to these benefits, and the insurance company will then have no choice but to greenlight your treatment.

If the lawyer cannot reach a mutually-agreed settlement with the insurance company, then you also have the option of taking the matter to the Missouri Division for workers compensation. Generally, you could ask the state to provide a mediator that would help you reach a conclusion everyone agrees on. If the matter is more urgent, you may be better off going through the Fraud and Noncompliance Unit if your lawyer has proof the insurance company is delaying the process on purpose.

The FNU will then begin to investigate your claim, and may even impose penalties on the insurance company or your employer if it is found they broke the law. Often, the fear of having these matters investigated by the state is enough to convince the insurance company to agree to a fair settlement.

Speak With an Attorney

If your claim is delayed and you can’t get the treatment you need, it is very important that you speak with an experienced attorney if you have not already. Contact an experienced attorney as soon as possible after a work accident to ensure your legal rights are protected right from the start of your claim. Call us 24/7 at (314) 361-4300 for a FREE consulation.

Workers Comp for Firework Injuries on the Job

It’s a time for great celebration in America, but also one that seems to send a lot of people to the emergency room.

Most 4th of July celebrations are nothing without a nice display of fireworks to mark the occasion, but the United States Consumer Product Safety Commission reports there were roughly 9,100 fireworks-related injuries in 2018. Of all, 62% of them happened around the fourth of July mark. If this happens, do you know what your rights are?

What Happens If You Get Hurt?

If you work with fireworks, then you should know that fireworks-related injuries can be compensated, but only under some specific circumstances

1. Firework Malfunction

Here, the company that produces the fireworks may be liable for damages if the firework that got you hurt was defective. As long as you used it according to the indications, and you still got hurt, you may be able to file a personal injury lawsuit against the company.

Note that Missouri allows only 2 periods during the year for purchasing and selling fireworks: June 20—July 10 and December 20—January 2. However, if you bought your fireworks from the black market and not from an approved seller, it may be difficult to sue the manufacturer, as the firework itself may not even be made by them. You may hold the seller responsible, though you are also opening yourself up for liability for purchasing illegal fireworks.

2. Mishandling Fireworks by Another Individual.

If a coworker is handling fireworks inappropriately, fires them, and gets you hurt, then that individual is liable for a lawsuit. It was their negligence that produced you harm, so they may be held responsible for your medical expenses.

If you are reckless in using fireworks and get hurt as a result, then you may have a more difficult case. The insurance company may argue that you got hurt because of your actions and try to make it difficult to offer compensation.

Your Best Strategy Is to Stay Safe

To stay safe, the CPSC issued the following recommendations:

• Ensure the fireworks come from an approved vendor;
• Do not allow children to use or come near fireworks;
• Do not place any body part directly on it;
• Keep your distance;
• Keep some water close in case of fire;
• Do not relight the firework.

Legal Options

If you get injured around the 4th of July because of fireworks, you may be entitled to compensation for your injuries but, as you can see, it greatly depends on the circumstances of your injury, specifically your involvement.

To understand if you are entitled to get compensated, you should reach out to a St. Louis work injury lawyer and talk about your case with them. Your lawyer can tell you if your case has merit, and what you need to do to get coverage for your medical treatments.

 

Law Office of James M. Hoffmann

2001 S Hanley Rd #325

St. Louis, MO

63144

Phone: (314) 361-4300

Private Investigator Hired After Work Injury – St. Louis Workers Comp Attorney

If you recently filed for a workers compensation claim, you may now you feel like someone’s following you. Well, it may not just be in your head. Many employers or insurance companies go to investigators to check up on people who’ve filled these types of claims to see if what they’re saying about their injuries is actually true. They are also looking for things that could potentially dismiss the claim.

Many workers are understandably outraged by this practice. In terms of its legality, however, it is unfortunately legal for employers to do so, under certain conditions.

There’s a Fine Line

Per the Missouri law, private investigators have the right to follow and take pictures or videos of you as long as you’re in public spaces. As such, any materials they gather while you’re in a park, public institutions, certain parking lots, or the street, for instance, can, unfortunately, be used by the insurance company.

They cannot, however, violate your rights for privacy. If you’re on private property (your home or at a friend’s house, for instance), then your St. Louis workers compensation lawyer can move to dismiss any images taken from these areas.

Another common practice these investigators might freely do is talk to people who know you, and see if the medical condition you mention in your workers’ compensation claim checks out. For instance, if you say the injury prevents you from being on your feet, and the investigator finds out from one of your friends that you played tennis with them just last week, that can prove you lied in your claim, and the insurance company can dismiss it.

If You Feel Unsafe, Act

Many workers don’t know what an investigator can legally do or not, and often these individuals may take advantage of that. As a result, it’s possible for some workers to feel unsafe, or uncomfortable knowing everything they do is being tracked.

If you feel like the investigator is overstepping, you should contact the police and file a report. They can remove the individual of the property, and you can even file a report against them. The investigator can even be arrested if they are breaking the law. Document all the practices of the investigator and hand them to your St. Louis work injury lawyer, as they can use it in the settlement proceedings to potentially negotiate a better deal.

Speak With an Attorney

Unfortunately, you may feel uncomfortable even if the investigator is acting within the legal limits. The truth is, it’s your responsibility to be careful at this time, and not partake in any activity that might jeopardize your workers’ compensation claims.

Speak with an experienced attorney as soon as possible after a work injury. They can help you understand what these activities are. Your lawyer will also move to dismiss any evidence taken by the investigators illegally and advise the right course of action if you feel in danger because of this practice.

Call the Law Office of James M. Hoffmann 24/7 for a FREE case evaluation :: (314) 361-4300

Common Work Injuries Among St. Louis Office Workers – Workers Comp Attorney

When you think about work-related injuries, you may picture construction work that has horribly gone wrong, or chefs cutting their fingers, utility climbers lacking safety equipment, etc. Maybe you have an office job and you feel relatively safe in your thermoregulated cubicle, where everything is in place and the only thing to worry about is the monthly reports that keep you doing overtime this week.

 

If you relate to our description, then you might be surprised by the actual statistics about work-related injuries. Office workers are also prone to injuries. How?

 

Even though these injuries may not be as immediately serious as construction site injuries, for instance, they are more prevalent. Many people work in an office and these little injuries happen quite often.

 

Let’s see what are the most common office injuries.

 

Falling

Falling is one of the most common causes of injury reported by office workers. Loose carpeting, electrical cables that aren’t secured properly, spills and office furniture can make you slip, trip and fall. Falls can be quite serious, some leading to many days off work for medical treatment.

 

Non-Ergonomic Office Furniture

Long-term injuries are often related to working stations that are not ergonomic. They are either improper for prolonged use or just unfit for the individual worker’s proportions. That can lead to back and neck injuries, carpal tunnel syndrome, leg and knee pain, etc. Combined with long working hours and overtime, sitting at an improper working station can quickly take a toll on the office workers.

 

Electrocution

Office workers are surrounded by electronics, and many incidents happen when safety regulations are ignored or there is a fault in the equipment’s functioning. Spilling liquids and foods around the office can also be dangerous and expose the workers to electrocutions through contact with the electronics or with cables.

 

Building Sickness

Other injuries and conditions that are often related to office jobs are those that affect the respiratory system due to the poor quality of indoor air. Many office buildings rely solely on the HVAC system to provide fresh air to the offices. If the venting system is damaged, it can lead to poor indoor air quality, allergies and other conditions derived from that.

 

Damage to the Eyes

Another consequence of office work is having your eyesight affected. Long hours of working in front of a computer can leave your eyes strained, dry and prone to infections.

 

If you suffer from a condition or injury that is related to the nature of your work, contact an experienced St. Louis workers compensation attorney and see if you can get any workers comp benefits for your injuries. Give us a call 24/7 at (314) 361-4300 for a FREE consultation.

Signs of Workplace Violence and How to Protect Your Rights

Almost 2 million Americans report being victims of workplace violence each year. These unfortunate episodes often involve unstable colleagues or disgruntled employees, and in some industries like healthcare, it can even be the leading cause of injury for workers.

Not all violent outbursts in the workplace are preventable. Though the employer may work hard to ensure a safe environment for everyone, the reality is that workplace violence likely isn’t going anywhere.

What Counts as Workplace Violence?

Workplace violence can take different forms, but it is mostly considered any action or outburst made by one employee that could hurt/affect another. Some of these actions include:

 

• Threats;

• Destroying property;

• Harassment;

• Verbal abuse;

• Assaults.

 

Essentially, just about any action taken by someone to make others feel unsafe in the workplace is violent behavior.

Warning Signs

It’s important to know the warning signs of workplace violence so that employees and employers alike could act in time and possibly avoid anyone getting hurt.

 

The signs of violence often have to do with a worker’s mental state, which is the root of the violent outburst. The worker could be going through a stressful time, or even suffer from a mental disorder.

 

Some red flags that may tell you to take actions are:

 

• A sudden change in behavior;

• Uncontrollable impulses – crying, temper tantrums;

• Being disrespectful;

• Reduced quality of work, not paying attention;

• Being aggressive when criticized;

• Not connecting to the group;

• Displaying inappropriate behavior.

 

It’s important to note that if you see these signs, it doesn’t necessarily mean the worker is bound to have a violent episode. Actually, these are often signals that the worker is in need of assistance, and if employers act fast when they see these signals they can prevent any violent episodes.

 

How to Keep Yourself Safe

If you notice any of the signs in one of your coworkers, you should notify a supervisor as soon as you can. Particularly if the violent behavior is directed at you, you should ask your supervisor to transfer you to a different team and try to minimize your contact with the other employee.

 

Even if the behavior is not violent, you still have to make your employer aware of any inappropriate conduct any worker might have. It’s often the only thing you can do to prevent a violent outburst.

I’ve Been Hurt. What Now?

If you’ve been injured by a coworker, then you may be entitled to workers compensation benefits, though it greatly depends on the case. You will most likely have to fight to get this compensation, which is why you should consider hiring a St. Louis workers compensation attorney at this time.

 

Give us a call 24/7 at (314) 361-4300 for a FREE Case Evaluation.

Forced Retirement Due to Disability – St. Louis, Mo

A work injury means more than just the physical pain you endure. Being forced to stay home, isolated from your coworkers and the work environment can take a toll on one’s mental health.

Although workers compensation can give you the peace of mind that you will have the funds to support yourself, the process isn’t that easy either. You have to report your injuries, have them checked by a doctor, talk to witnesses, file reports, and so on. The documentation can be quite lengthy and tiring, but a good St. Louis workers compensation attorney can make things easier for you.

Let’s say that, on top of that, you find out that your employer is forcing you to resign after your work-related injury. What happens now?

First of all, know that injured workers are protected by the law. If you suffer a work-related injury, your employer is partially or fully responsible for not offering a safe environment for you to perform your work duties. If you are eligible for workers compensation, it is clear that your employer owes you protection, benefits and is obliged to respect your rights.

Firing versus Forced Resignation

An employer who is trying to intimidate you into resigning or is firing you for filing a workers comp claim or being injured can be sued for wrongful termination. If they would straight-out fire you, it would be clear that they should expect a wrongful termination suit, but what if they force you to resign? Let this be clear: if your employer creates hostile working conditions that are forcing you to resign, they are basically firing you.

Since a forced resignation is treated as a termination, you will have legal options that allow you to claim benefits to cover your work-related injuries and damage.

How to Prove a Forced Resignation

It may not be easy to prove that you were intimidated and forced to resign, especially if a paper with your signature says that you quit your job. If you did, indeed, sign a resignation, you must be able to provide evidence that your employer compelled you to quit your job. Attention! If you will not be able to prove that your employer compelled you to resign and it will be decided that you quit voluntarily, you will not be eligible for workers compensation benefits.

Depending on what exactly they do to force your resignation, you can use video evidence, audio recordings, text messages, witness depositions, and so on. Linking your employer’s behavior to your work injury can also be difficult.

If you find yourself in this situation, it is important to speak with an experienced St. Louis work injury lawyer. They will be able to help you build a strong case and fight for your workers’ compensation benefits. Call 24/7 for a FREE Consultation  – (314) 361-4300

Can I Take a Vacation While Collecting Workers Comp?

This is a question many injured workers struggle with, and it’s easy to see why. After all, taking a few days off to relax might be what the doctor prescribed after you’ve been injured at work. However, is it right to do so if you’re collecting workers compensation?

 

What Does the Law Say?

Nothing. Missouri law, particularly the framework regarding workers compensation, does not restrict anyone’s desire to go on vacation while receiving workers compensation. However, you should know that under state law, employers are not required to offer vacation pay, but they are free to do so at their discretion.

 

As such, if you’re planning to go on vacation, check to see if you are entitled to vacation pay under your contract. If you do, under some circumstances you may be legally allowed to take said pay even if you are already on workers compensation.

 

Things You Should Keep in Mind

Even if the government has no problems with you taking a vacation on workers compensation, you should still be careful.

 

Workers compensation is essentially an insurance policy. So, if you get injured at work, you will receive some money that’ll go into your medical bills, recovery, and account for any lost wages. Therefore, there are specific conditions based on which a person gets workers compensation, and these conditions are upheld even after the claim is approved.

 

As such, when of on vacation you should also consider:

 

 Your Recovery

Workers compensation is designed to help you while you recover from a work injury. As such, you have a particular treatment plan you should follow. That can vary based on the type of injuries you sustain but can include anything from medication to regular doctor’s appointments. Failing to keep up with this treatment because you’re off on holiday can be grounds to take you off workers compensation.

 

Instead, it’s best to talk with your medic about the fact that you are considering taking a vacation and follow their recommendations.

 

The Insurance Company

Insurance companies will often check up on the people they’re giving workers compensation payments to see if there is a cause for making these payments or not. Now, you don’t have to worry about people following you. Something as small as a photo on Facebook or Instagram from your vacation can let the insurance company know your condition may not actually warrant further payments.

Of course, that is only applicable under certain circumstances. For instance, if they detect you are performing an activity that goes against doctors’ orders, then they may argue your condition is not serious enough for workers compensation. Though your doctor may clear you to take a vacation, it’s generally best to avoid posting anything on social media as it may give the wrong impression.

 

If you’ve lost your workers compensation earning because you went on a vacation, it could be a direct violation of your rights. Speak with a workers comp lawyer to find out what your legal options are. Vacation time generally shouldn’t affect getting properly compensated for your work injuries.

 

How Much Do Workers Compensation Lawyers Usually Charge?

Injured workers have a list of crucial decisions they need to make after they sustain their damages. One of the most important of them is whether or not to hire a workers compensation attorney. Doing so will significantly increase their chances of winning a fair settlement, but many don’t due to perceived “financial risk”. As you’ll soon learn, this fear is unfounded.

 

The Typical Lawyer Fee Structure

The typical lawyer fee structure is charging you hourly. What that usually means is that business billing you for every hour they work on your case, meet with you, and talk to you on the phone. At the end of some period, you will receive a bill and have to pay it to keep getting that service. A common example of this structure is divorce lawyers, who usually charge a few hundred dollars per hour. As you can imagine, divorces can be incredibly expensive for both parties.

 

How Most Workers’ Compensation Lawyers are Different

What makes most work injury lawyers different is that they take a percentage of your winnings, rather than charging by the hour. Those in the legal system call this a contingency fee, and it is common in cases that involve injuries. It has a variety of benefits and experts generally consider it to be very friendly to clients.

 

What it Means For You

Contingency fees are beneficial to injured workers for the following three reasons.

• Limited Downside – Though you will likely provide a small retainer fee up front, you will likely avoid paying any attorney bills throughout the process. People that hire hourly lawyers cannot say the same thing.
• No Massive Bills – One of the most stressful aspects of hiring an hourly lawyer is getting bills every week. If you don’t pay them, your attorney will stop working, and you’ll be out of luck. Those that work for a contingency fee will continue to be an advocate for you and won’t send you a bill until the case is resolved.
• Paying For Itself – Lastly, you might find that your legal provider pays for themselves by getting you a much better deal. As an example, you might give that business a percentage of your settlement, but since their skillful negotiating leads to an overall increase in the total amount you could actually make money by hiring a professional.

One of the best things you can do after a work injury is hire a lawyer to assist you. Now that you understand the typical work injury attorney’s fee structure, we hope that you make that decision without any doubt. Ultimately, legal professionals will not only help you win your case, but might even negotiate such a high settlement offer that they pay for themselves. That kind of win-win situation is why enlisting a workers’ compensation lawyers should be at the top of your to-do list after an injury.

 

Law Office of James M. Hoffmann

2001 S Hanley Rd #325

St. Louis, MO

63144

Phone: (314) 361-4300