When a Workers’ Comp Employer Refuses Treatment, Who Gets Reimbursed?

When an employer refuses additional medical treatment after a workplace injury, a basic question follows: if the worker pays for treatment another way, who is supposed to make that worker whole? That question sits at the center of Chick v. City of Centralia, No. WD88273 (Mo. Ct. App. W.D. Mar. 24, 2026), a Missouri workers’ compensation decision with a very practical lesson about medical bills, insurance, and attorney fees.

For injured workers, the issue is easy to understand. It is one thing for an employer to argue about the scope of treatment. It is another to refuse care, force the worker to find treatment on his own, and then try to avoid reimbursing him the ordinary way once that treatment is later found compensable.

What Happened to the Worker

Russell Chick worked for the City of Centralia as an equipment operator. In February 2014, he slipped on ice while walking to a maintenance shop and caught himself with his right arm. According to the opinion, he soon developed numbness, pain running from his right shoulder into his forearm and fingers, and difficulty writing.

Chick was initially sent for treatment, and providers suggested testing for a brachial plexus injury. But after some referrals, the City refused to authorize further treatment. Chick then sought care on his own. He was eventually treated by Dr. Mackinnon, who recommended and performed surgery, and later a second surgery.

Chick continued to deal with pain, numbness, and depression. His workers’ compensation claim sought medical care, disability benefits, disfigurement, and other relief tied to the 2014 injury.

What the Commission Decided

The Labor and Industrial Relations Commission found that Chick was entitled to reimbursement for treatment from Dr. Mackinnon related to the brachial plexus injury caused by the work accident. The Commission found he had established $32,526.48 in past medical charges tied to that compensable injury.

But the Commission did not order the City to pay that amount directly to Chick. Instead, because Chick’s private health insurance had paid most of those charges, the Commission ordered the employer to resolve the charges directly with the providers and hold Chick harmless from collection efforts. The Commission also excluded those past medical amounts from the attorney-fee lien.

Chick appealed, arguing that this approach was wrong and that it effectively gave the employer the benefit of payments made by collateral sources like his own private insurance.

What the Court of Appeals Held

The Western District agreed with Chick on that issue. The court explained that when an employer wrongfully refuses treatment it was required to provide, and the employee then obtains that treatment independently, the employer cannot satisfy its obligation by treating the worker’s own insurance payments as a credit.

The opinion emphasized that Missouri law does not allow the employer to benefit from collateral sources independent of the employer. In practical terms, the court held that the Commission erred by directing payment to medical providers instead of reimbursing Chick himself for the past medical expenses he incurred after the City refused further treatment.

The court also sent the issue of attorney fees back to the Commission. The appellate court said the Commission’s handling of fees appeared intertwined with its mistaken approach to reimbursement, so the fee question had to be reconsidered under the proper legal standards.

What the Worker Did Not Win

Chick did not win everything on appeal. The court upheld the Commission’s finding that he was not permanently and totally disabled, even though there was evidence that could have supported a different result. The court also rejected his spoliation argument concerning allegedly edited surveillance footage.

Why This Case Matters

This decision matters because medical treatment is often one of the most immediate and expensive parts of any injury case, including workers’ compensation claims. If an employer denies care and the injured person turns to personal health insurance, deductibles, co-pays, or other out-of-pocket costs can follow. Chick is a reminder that those payments should not simply become a discount for the party that should have paid in the first place.

It also underscores a larger principle that injury clients often understand immediately: if someone else was legally obligated to provide treatment, your own insurance should not automatically let them off the hook.