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Publications and Forms

Disability Schedule and Benefit Limits (WC-110)

A visual chart showing the number of weeks of compensation payable for permanent partial disabilities.

Discrimination Complaint Information (MODOL-4519)

Fill out this form if you think you have been subjected to discrimination under a WIA Title I - financially assisted program or activity within the Department. Fill out online.

Discrimination in Employment (MCHR-9)

Every employer, labor organization, employment agency, or other business or establishment covered by Chapter 213, RSMo shall post the Commission's equal employment poster in a place where other employee notices are posted or in a conspicuous place where employees will have access to it. Required by Missouri State Law.​

**For best use, print out the poster either on one sheet of 11 X17 paper or two pieces of 8.5 X 11 (standard size) and tape pieces together, one on top of the other. Printing this poster by using only one 8.5 X 11 paper (tabloid size) makes it challenging for the visually impaired to read.

Discrimination in Housing (MCHR-6)

The Rules and Regulations of the Missouri Commission on Human Rights require employers in the business of sale or rental of housing to post MCHR-6 Discrimination in Housing.

**For best use, print out the poster either on one sheet of 11 x 17 paper or two pieces of 8.5 x 11 (standard size) and tape pieces together, one on top of the other. Printing this poster by using only one 8.5 x 11 paper (tabloid size) makes it challenging for the visually impaired to read.

Discrimination in Public Accommodations (MCHR-7)

The Rules and Regulations of the Missouri Commission on Human Rights require employers doing business in places open to the public to post MCHR-7 Discrimination in Public Accommodations.

**For best use, print out the poster either on one sheet of 11 X17 paper or two pieces of 8.5 X 11 (standard size) and tape pieces together, one on top of the other. Printing this poster by using only one 8.5 X 11 paper (tabloid size) makes it challenging for the visually impaired to read.

Docket Locations Directory (WC-266)

Directory of Missouri Docket locations and addresses.

Eligibility Guidelines for Physical Rehabilitation (WCR-7)

A form outlining eligibility guidelines for the Second Injury Fund.

Employer Change Request (MODES-9)

An employer uses the Employer Change Request to inform the Division when it has sold all or part of its business, closed its business, stopped employing workers, or changed its name or address. The Division evaluates the information from the form to determine whether the employer's account should be updated, closed, transferred, or left unchanged.

Employer Request for an Appeal of Unemployment Insurance Benefits Determination (MODES-4792)

This is the form for employers to appeal an unemployment insurance determination regarding a former employee.

Employers Employing Workers Under the Age of 16 List (LS-43)

A poster required to be hung in a workplace containing employees under the age of 16.

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