Over my years in practice, I have represented thousands of clients who have used many different terms in order to describe the Workers’ Compensation system. Sometimes there is confusion as to what these terms mean and many times these terms are inadvertently misused. An example of these terms would be: Work Comp Board, (“Workman’s Compensation Board”), Work Comp Division, “Work Comp Checks”, “Second Injury Fund”, Work Disability Fund, “Occupational Disease”, “Repetitive Trauma”, “Self-Insured”and “Work Comp Referee”
I am going to try to clear up the terms in order to more precisely describe the Missouri Workers’ Compensation system. First of all, the correct title for the system which records claims and provides a judicial system is called the “Missouri Workers’ Compensation Division”. The Missouri Workers’ Compensation Division falls under the larger umbrella of the Department of Labor and Industrial Relations. The Missouri Workers’ Compensation Division has its central office in Jefferson City and there are “branch offices” in places like St. Louis, St. Charles, Cape Girardeau, Springfield, etc. The Workers’ Compensation Division does not provide any benefits, but simply provides a system in order to report claims and settle disputes through Workers’ Compensation judges which are referred to as “Administrative Law Judges”.
Benefits are paid by private insurance companies who provide coverage to employers throughout the State of Missouri. An exception can be made for very large companies who post a bond and decide that they are big enough to pay their own claims directly. These are called “self-insured companies”. Large manufacturing companies who elect to become “self-insured companies” are required to place a bond with the State of Missouri in order to make sure that claims are covered.
There is not really a “Workers’ Compensation Board”. However, there is a panel of three “Commissioners” who serve on what is known as the “Labor and Industrial Relations Commission”. When an “award” is written after a hearing, the decision is final, unless the decision is appealed. The appeal goes to the Labor and Industrial Relations Commission who has the power to let the decision stand, or to reverse the decision.
The “Second Injury Fund” is a special state fund that receives its money based on an financial assessment which is made against employers when they pay their premiums to their insurance company. This fund is set up in order to take into account prior injuries or disabilities which may affect an employee’s ability to work. Some people have been confused by the name and will call and say ”I have injured myself a second time, can I file a second injury claim.” This fund, however, is set up to consider previous injuries, not new ones.
An employee may be injured on the job in a number of different ways. First, there can be an “accident” such as a fall down a flight of stairs. There can also be an “occupational illness” caused by exposure to fumes, chemicals, or other elements. Finally, there can be what is often referred to as a “repetitive trauma” which involves injuries which occur gradually from overuse. The most common type of repetitive trauma injury, for example, would be what is known as “carpal tunnel syndrome”. We see these repetitive trauma cases often from secretaries and typists who may work for hours on end at a computer.
As you can see, many of the terms which are used do not really fit our system today. There is no such term ,for example, as a “Work Comp Referee”. Because of the many terms which have been used by people over the years, it is sometimes difficult for the average person to understand Missouri Workers’Compensation. For example, they may make a statement like “Workman’s Compensation is denying my case.” This could mean that a private insurance company has denied their case, a judge heard the case and wrote a decision denying it, or it could mean that the case was appealed to the Industrial Commission where it was denied. Our purpose in writing this article is to describe the precise terms which are presently used in order to avoid unnecessary confusion and help Missouri’s injured workers understand the system.