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Recent Missouri Workers’ Comp Ruling Helps Define Employee’s Rights to Medical Care

As a Missouri workers’ compensation lawyer, I was particularly interested in a recent decision of the Missouri Court of Appeals that found that an injured Missouri worker does not need to prove that his or her work injury is the prevailing factor in the need for specific medical treatment.  The case is Tillotson v. St. Joseph’s Medical Center.

In Tillotson, a worker injured her knee in a Missouri work accident.  The diagnosis was a torn meniscus.  The worker also had preexisting arthritis in the same knee.  Due to the overall condition of the worker’s knee, including her significant arthritic condition, her physicians recommended a total knee replacement.  The workers’ compensation insurance carrier refused to pay for a total knee replacement.  It was their position that the need for the replacement was due to her preexisiting arthritic condition.  Stated differently, their position was that the prevailing factor for the knee replacement was not the work injury.

The Missouri Labor and Industrial Relations Commission agreed with the insurer’s position.  The Commission interpreted §287.140.1 of the Missouri Workers’ Compensation Act as requiring that the work injury be the prevailing factor in the need for a total knee replacement.  The Missouri Court of Appeals reversed this decision holding that § 287.140.1  sets forth that the legal standard for determining an employer’s obligation to provide medical care is whether the treatment is reasonably required to cure and relieve the effects of the injury.   The Court pointed out that there is no mention of the “prevailing factor” test in this Section of the statute.

Under Tillotson, Missouri accident attorneys representing injured Missouri workers may be able to obtain more complete treatment to cure the effects of a work injury without having to establish that the work injury was the prevailing factor in causing the need for some specific treatment.

 

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