Injured at work

INJURED AT WORK

A work injury is not funded the way an ordinary injury claim is, and in Missouri the difference is written into the statute rather than left to custom.

Missouri carves work injuries out of the medical lien

The Missouri medical lien statute gives clinics and physicians a right to attach a lien to an injured person’s claim against whoever caused the injury. That right is expressly not available against anyone coming under the workers’ compensation law of this state. So the instrument that makes treatment straightforward after a collision is unavailable for a Missouri work injury.

That is a fact about the paperwork. It is not a reason for a cervical radiculopathy to go untreated for eight months, and in practice there are two situations where a work injury still moves.

The two that work

• The adjuster sends you. When care is authorized by the carrier it is handled as authorized care, the ordinary way. This is the cleanest route and it is worth asking your adjuster for it directly.
• The carrier denies the care. A denial changes the footing. At that point the route is usually through your attorney, on much the same basis as any other injury case.

Both of those start with a phone call rather than a form. Ask what has actually been authorized in writing, because “the adjuster said it was fine” and an authorization are different objects.

Illinois is not Missouri

The practice is licensed on both sides of the river and treats patients from both. Illinois handles a work injury much closer to the way a standard medical lien works than Missouri’s carve-out permits.

So the first question at the first appointment is which state the injury happened in, not which state you live in. It changes the paperwork and it changes nothing about the examination or the plan.

And an authorization is still not a payment

This holds for comp as it does for group health. Approval of a procedure is a statement that the payer will consider the claim, not a commitment to pay it. Ask what your exposure is if an authorized service is later denied, and get that answer before the procedure.

What the neck injuries at work actually are

Two patterns dominate, and they are not the same problem. The first is acute: a lift, a fall, a load caught wrong, with symptoms that begin within a day or two. The second accumulates — sustained flexion, a monitor set too low, a headset always on the same shoulder — and it presents as a neck that has been getting worse for a year with no incident to point at.

The second is harder to file and easier to treat, because the loading pattern is still there to be changed. How work-pattern neck pain builds, and what sustained flexion actually does.

What helps your claim, incidentally

The same thing that helps your neck: a diagnosis established rather than asserted. An opinion that says the C5–6 facet joints are the pain generator because blocking their nerve supply abolished the pain is a different document from one that says the neck hurts since the injury. How the block is done and what it proves.

Where to read next

• Work-pattern neck pain
• A pinched nerve in the neck
• When the hands are the problem
• Information for attorneys