When a worker suffers a work-related accident, and he or she is unable to return to any reasonable work, then a claim should be evaluated to determine whether the worker is permanently and totally disabled. Section 287.020.6 states "'total disability'...shall mean inability to return to any employment and not merely mean inability to return to the employment in which the employee was engaged at the time of the accident." So, if an injured worker cannot go back to his old job, the question then becomes, can he go back to any job?  To answer this question, you will need the testimony of a physician and, most likely, the help of a vocational rehabilitation expert who support the claim that the workers is permanently and totally disabled.