Work Event Must Be "Prevailing Factor" in Workers' Comp Claims

Missouri workers' compensation law affords a higher level of protection for employers when it comes to determining the cause of some workplace injuries and illnesses. The law states an employee must demonstrate that a work event "is the prevailing factor" causing a medical condition.

"For example, a person who has had arthritis for 10 years and works extensively with his or her hands would not be eligible for workers' compensation under Missouri law if the condition existed prior to employment," explains Dennis J. Straubinger, DO, MPH, MRO, occupational medicine physician at Saint Francis Medical Center. "Arthritis would be an underlying condition, but not work-related. It is our job to discern that."

Employees of businesses based in Illinois fall under significantly different legal stipulations. Under Illinois state law, work duties in this example might represent an aggravation of the underlying arthritic condition and may qualify for coverage.

Missouri law defines an occupational illness or condition as an event of longer onset, such as carpal tunnel syndrome. An occupational accident is an event that occurs rapidly and is identifiable by a specific time and place. Injuries occurring on property controlled by the employer usually are compensable, but an injury sustained while driving a private vehicle to or from work when not engaged in a work activity is not.

Employees have 30 days to report an injury to an employer and 30 days after identification of an illness as being work-related, such as hearing loss due to exposure to machinery. The employer ultimately determines if an event is work-related, with the help of the employee and an occupational medicine provider. Occupational medicine physicians provide medical diagnosis and opinions to assist employers in determining work-relatedness, and it is important that employers maintain continuing dialogue with clinical staff.

Pre-employment physicals and similar practices can assist in preventing some workplace injuries by identifying pre-existing conditions. Should an injury or illness arise during employment, documentation of pre-existing conditions also makes determining if an injury or illness is work-related easier.

To learn more about dealing with workers' compensation cases or pre-employment practices, call Saint Francis' Services to Business at 573-331-5825.