Interviewer: Why does someone require a lawyer for workers compensation?
Represented Claimants Receive More Benefits from Workers Compensation than Unrepresented Workers
Kevin Roach: There has actually been a study done in Missouri. It is proven that represented injured workers, or claimants as they are commonly called, receive substantially more benefits than unrepresented workers or claimants. In Missouri, there was tort reform in 2005 which really changed things.
In Missouri, Judges Can No Longer Recommend What Amount a Claimant Should Receive
Prior to 2005 a lot of the pro se or unrepresented claimants could go to the Division and could attend the mediation, just the same as when they would be represented by an attorney and the judge would give a recommendation. The judge would say, "Well, I think your case is worth X amount." After the 2005 tort reform, the law changed. Actually, the administrative law judges in Missouri are bound from making any kind of recommendation on your claim if you're not represented.
The judge’s hands are really tied. Let's assume you receive your treatment and you've been released from treatment, and you go into mediation unrepresented. You are at the defense attorney's mercy. Not having the background knowledge of what you’re entitled to can only hurt you.
Experienced Workers Compensation Attorneys Are Better Suited to Judge the Value a Case
The judges, if they are following the rules, cannot make a recommendation. They can't say, "I think your case is worth X amount" to an unrepresented claimant. As you can imagine, that is an extreme disadvantage because the way that cases are valued in Missouri, it's confusing. Most attorneys, unless he or she has extensive experience in handling workers compensation as I do, do not know the value of the case.
You only know the value of the case after you've reviewed the medical records and after you've had years of experience handling these claims over and over again. Most people when they're injured at work, it's the first time in their life that they have sustained a major injury. They've never been through this experience before.
They may have a lumbar fusion or carpal tunnel. They have no idea what their case is worth. The only way to know the value of their case is to retain an attorney who regularly practices in that area of law.
Unrepresented Claimants Are More Likely to Not Receive the Full Extent of Appropriate Medical Treatment
Also, unrepresented claimants or injured workers in Missouri don't typically receive proper medical benefits and/or treatment. In almost every case, the workers comp adjuster tries to send people back to work when they're not ready. What we do is file a hardship motion with the Division and/or demand additional treatment be authorized and provided by the insurance company.
Represented Claimants Have the Benefit of an Attorney to Advocate for Their Medical Care
That's usually a large portion of what we do, is trying to get people the treatment that they are entitled to. When you're unrepresented, you have no way of really doing this. You can't go in and talk to the judge. You can't file a motion with the court. As you can imagine, you're not going to receive the benefits that someone that is represented would receive.