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Publications and Forms

Ley sobre Indemnización al Trabajador (WC-106-S Tabloid Size)

Información de los trabajadores acerca de la indemnización de los trabajadores; requerida en el lugar de trabajo.

Medical Treatment Form (WC-9)

A form to be completed by a physician when treating a worker involved in a workers' compensation claim.

Missouri Docket Map (PDF)

Map of Missouri Docket Locations

Missouri Workers' Safety Program (WSP-50)

The Missouri Workers' Safety Program helps businesses improve workplace safety and reduce workers' compensation insurance costs.  The brochure is a brief overview of the program and what they offer.  

Missouri's Second Injury Fund (WC-120)

Information regarding the Missouri Second Injury Fund.

Notice of Commencement/Termination of Compensation (WC-2)

A notice of commencement/termination of compensation to be filled out by a self-insured/self-administered employer, insurance company, or third party administrator.

Notice of Commencement/Termination of Compensation Spreadsheet (WC-2)

A notice of commencement/termination of compensation to be filled out by a self-insured/self-administered employer, insurance company, or third party administrator.

Report of Injury (WC-1-EDI)

A form to be completed by the insurance company or third party administrator in the event of worker injury or death.

Request for Award on Undisputed Facts in Regard to Application for Payment of Additional Reimbursement of Medical Fees (WC-297)

A request by an employer or insurer for an award on undisputed facts in regard to application for payment of additional reimbursement of medical fees on the ground that the Application was not filed within the limitation period set forth in §287.140.4, RSMo, or that the charges were paid in full or any ground that negates liability for payment.

Request for Pre-Hearing (WC-183)

Request to DWC for a pre-hearing regarding workers compensation claim.

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