This Monday, a House committee on Workforce Development discussed a proposed bill that would help to more clearly determine when a work injury is compensable under workers’ compensation law.
Freshman lawmaker Rep. Alex Riley, a Republican from Springfield, is sponsoring the legislation.
HB 1265 clarifies the definition of “prevailing factor,” which would be used to determine when a work injury is compensable under workers’ compensation.
“The primary objective of this bill is to ensure that workers’ compensation is being used only for its intended purpose, which is to provide compensation for specific work-related injuries that employees suffer on the job,” said Rep. Riley.
Currently, the issue is steeped in confusion for employers. A 2011 Western District court opinion is being used to say that the workplace injury does not need to be the “prevailing factor” in determining what type of medical treatment is warranted — rather, all that is required is “a demonstration that certain medical care and treatment is reasonably required to cure and relieve the effects of an injury.”
Take this real-life example: An employee had pre-existing arthritis, and then injured her meniscus in a specific event. The Division of Work Comp and the Labor and Industrial Relations Commission required the employer to pay to repair her meniscus, but not for a total knee replacement. But then the Western District Court disagreed, ruling that the total knee replacement was warranted because the “treatment is reasonably required to cure and relieve the effects of a compensable injury.”
This vague standard results in employers being responsible for medical care beyond what is needed to fix the specific workplace injury. The Missouri Chamber testified in favor of HB 1265 because it better defines “prevailing factor” and clarifies that the accident must be the main reason for the injury, medical condition and the need for treatment.