Legal Question in Workers Comp in Missouri

Workman comp has refused to allow a second opinion, saying that their doctor has given the maximum improvment rating, something we would like to have check given that there is still considerable pain. We have a letter from the workman comp attorny stating this. If we seek a second opinion on our own, can our health insurance company take part of our settlement to offset their costs? If so, can we get reimbursment from workman comp for the second opinion?


Asked on 10/01/10, 2:30 pm

2 Answers from Attorneys

Anthony Smith LawSmith

This agreat question to ask the attorney handliong the WC claim for you. Whether the health insurer can put alioejn on the settlment to satify teh cost of the second opinion is dependnet upon several factors. It is normal for a claimant to get thier own rating doctor to examine them, rqather then just take what the employer's chosen doctor says.

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Answered on 10/06/10, 9:03 pm
Michael Harvath Harvath Law Offices-INJURY case representation

Hi. I am a Missouri injury attorney that focuses my practice on workers' compensation claims throughout the state.

Most attorneys who practice in the area of workers' compensation are familiar with certain physicians who routinely examine injured workers and have experience in preparing the correct type of medical report that will be admissible and will influence the insurance company to considerably increase their offer, and often make them liable to pay for additional medical expenses in the future.

In order to obtain a higher settlement based on a second opinion evaluation, it is also generally necessary for an attorney to present the report to the attorneys for the insurance company and to make the calculations, based on the Missouri workers' compensation statute (sec. 287), of the amount of compensation you are entitled to, based on the medical findings of the second opinion physician.

Some attorneys, including my office, will advance the cost of the second opinion medical evaluation and doctor's report.

It is important to note that a doctor report that finds even a slighly higher level of disability can have a substantial effect on the settlement amount. For example, an increase in the disability level from 5% to just 15% could result in a settlement increase by as much as $15,000.

I hope this at least helps a bit. For convenience, I can be reached via e-mail at [email protected].

Our firm website address is: http://www.harvathmissouriillinoislawyers.com. Thank you.

NOTE: This answer is for educational purposes and does not constitute legal advice. The use of this site does not create an attorney-client relationship or privilege between the user and the attorney responding.

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Answered on 10/07/10, 9:01 pm


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