2024 Division of Workers' Compensation Annual Report (Text Version)

The 2024 Division of Workers' Compensation Annual Report is displayed below in a text-only version for ease of accessibility. A PDF version is also available.

The figures in this report are Fiscal Year 2024 (July 1, 2023 to June 30, 2024) unless otherwise noted.

Table of Contents

• Organizational Chart
• Leadership
• Assessments and Expenditures
• Modernization Project
• Enterprise Functions
• Case Management
• Injury Processing
• Customer Service
• Medical Fee Dispute
• Adjudication
• Benefits Administration Unit
• Second Injury Fund
• Dispute Management
• Line of Duty Compensation Fund
• Tort Victims’ Compensation Fund
• Self-Insurance
• Workers’ Safety Program (MWSP)
• Fraud and Noncompliance Unit
• Religious Exceptions

Organizational Chart

• Michael L. Parson, Governor
  • Anna S. Hui, Director, Department of Labor & Industrial Relations (DOLIR)
  • Benjamin J. Qualls, Acting Director, Division of Workers' Compensation (DWC)
    • Administration
      • Kalee Baker, Benefits Administration
      • Kate Lange, Case Management
      • Amber Bauer, Enterprise Functions
      • Anthony Ferrell, Fraud & Noncompliance
      • BJ Tripp, Self-Insurance
      • Amanda Kremer, Workers' Safety
    • Adjudication
      • Carl Strange, Chief ALJ, Southern Adjudication Region (Joplin, Springfield, Cape Girardeau)
      • Hannelore Fischer, Chief ALJ, North Central Adjudication Region (Jefferson City)
      • Angela Heffner, Chief ALJ, Western Adjudication Region (Kansas City, St. Joseph)
      • Jason Tilley, Chief ALJ, Eastern Region (St. Louis, St. Charles)

Department & Division Leadership

DIVISION OF WORKERS’ COMPENSATION

The Division of Workers’ Compensation ensures that an employee who suffers a work-related accident, injury, or occupational disease receives medical treatment and other benefits they are entitled to such as disability payments. Options to resolve disputes between injured employees and the employers/insurers, and/or the Second Injury Fund (SIF), including adjudication services, are provided through adjudication offices. The Division regulates individual employers and groups/trusts authorized to self-insure and investigates allegations of workers’ compensation fraud and noncompliance. The Division also authorizes payments and benefits from the SIF and administers the Line of Duty and Tort Victims’ Compensation Programs.

Anna S. Hui

Department of Labor & Industrial Relations Director

Anna Hui was appointed Director of the Missouri Department of Labor and Industrial Relations in March of 2017 and confirmed by the Senate in January 2018, making her the first American of Asian descent to serve in the governor’s cabinet in Missouri history. During her career, she served as Chief of Staff to former U.S. Department of Labor Secretary Elaine Chao and as Acting Director of the Illinois Department of Labor. Anna is the current Board President of the International Association of Industrial Accidents Boards and Commissions. She has also served as the President of the National Association of Government Labor Officials (NAGLO) 2018-2020 and Board President of the National Association of State Workforce Agencies (NASWA) 2019-2020. She received a J.D. from Loyola University Chicago School of Law, an M.S.M. and an M.B.A. from the University of Maryland University College (UMUC) and a B.S. in Psychology from the University of Illinois at Urbana-Champaign (UIUC).

Benjamin J. Qualls

Division of Workers' Compensation Acting Director

Ben Qualls joined the Division of Workers’ Compensation (DWC) in 2004, holding various roles before moving up to a Senior Research/Data Analyst role supporting both the statewide COVID Fusion cell response effort and DWC Modernization Project. He became Deputy Director of DWC in June of 2022 and is currently serving dual roles as Acting Division Director and Deputy Division Director, as of November of 2024. Ben holds a Bachelor’s Degree in Business Administration with an emphasis in Finance and Banking and a Minor in Economics from the University of Missouri-Columbia, as well as industry certifications Professional Scrum Master I – PSM I and Professional Scrum Product Owner I – PSPO I (issued by Scrum.org), Certified Change Practitioner (issued by Prosci, Inc.) and Electronic Data Interchange (EDI) Claims Professional (issued by IAIABC).

Assessments & Expenditures

Workers' Compensation Administrative Fund Tax & Surcharge

Missouri imposes a workers’ compensation administrative tax on all workers’ compensation insurance carriers and self-insured employers and an administrative surcharge on every workers’ compensation deductible plan policyholder. Section 287.690 RSMo authorizes the imposition of an administrative tax not to exceed 2.0% and §287.716 authorizes an administrative surcharge at the same rate as the administrative tax. Administrative tax and administrative surcharge revenues fund administration of the workers‘ compensation law.

The Division is modernizing its legacy system, a mix of in-house, custom-developed applications limited in the ability to handle advancements in technology, legislative mandates, and the changing needs of DWC stakeholders. The new system, Work Comp Connect, will have self-service options for injured workers, attorneys, healthcare providers, self-insured companies, employers, carriers and third party administrators.

Work Comp Connect will be implemented in three phases. Phase 1 includes efficiencies in docket scheduling and hearing notification for adjudication offices and Labor and Industrial Relations Commission. The division will also migrate to EDI 3.1 accepting both First Reports of Injury Filed (FROI) and Subsequent Report of Injury (SROI) reporting.

Each year, the DWC Director estimates the amount of revenue required to administer the workers’ compensation program and determines the rate for the following calendar year. If the estimated available balance of the fund on Dec. 31 of the year the tax rate determination is made falls below 110% of the previous year’s expenses plus any additional revenue required due to new statutory requirements given the division by the general assembly, the Director shall impose a tax not to exceed 2.0%. For calendar year 2025, the administrative tax and surcharge will be 1.5%

• 2024: 1.5% Tax & Surcharge WC Assessment Rate
• 2025: 1.5% Tax & Surcharge WC Assessment Rate

Cash Balance (Jan. 1, 2024): $19,032,929

Revenue:

• Tax & Surcharge Collections: $29,162,312
• Interest: $682,961
• Miscellaneous Receipts: $123,069
• Total Revenue: $29,968,341

Expenditures:

• Administrative Costs: $25,047,645
• Total Expenditures: $25,047,645

Cash Balance (Dec. 31, 2024): $23,953,625

Second Injury Fund Surcharge & Supplemental Surcharge

Section 287.715 RSMo, authorizes the imposition of a Second Injury Fund (SIF) Surcharge that shall not exceed 3.0%. Section 287.715.6, RSMo, (Supp. 2023) authorizes the imposition of a SIF supplemental surcharge not to exceed 1% through calendar year 2026.

The revenue generated by the SIF surcharge and the SIF supplemental surcharge is used to pay benefit and expense liabilities of the fund. For calendar year 2025, the SIF surcharge will be 3.0% and the SIF supplemental surcharge will not be required and set at 0.0%.

Second Injury Fund Balance and Expenditures

Cash Balance (Jan. 1, 2024): $54,357,373

Revenue:

• Surcharge Collections: $57,477,082
• Interest: $1,875,308
• Miscellaneous Receipts: $99,368
• Total Revenue: $59,451,758

Expenditures:

• Benefit Disbursements: $60,199,231
• Administrative Costs: $5,516,803
• Total Expenditures: $65,716,034

Cash Balance (Dec. 31, 2024): $48,093,098

• 2024
  • 3% Surcharge SIF Assessment Rate
  • 0% Supplemental Surcharge SIF Assessment Rate
• 2025
  • 3% Surcharge SIF Assessment Rate
  • 0% Supplemental Surcharge SIF Assessment Rate

Modernization Project

During 2024, the Division worked closely with Objectstream, Inc. (Phase 1 implementation) and CSG Independent Verfication & Validation (IV&V) advisor, making significant progress on Work Comp Connect (WCC) in Analysis and Design as well as Application Development. After rejoining the team in September, Verisk (EDI 3.1 implementation) has supported the EDI upgrade. 

Within the WCC application, design completion is occurring for all business areas. Over the year, design for Case Management, Medical Fee Dispute, Adjudication, Benefits Administration, and Order Entry was completed. In addition, design is complete for Master Data Management, Operational Data Store, and Data Bridging and Synchronization. Due to the complexities involved in the design of Case Management and Adjudication, and the delays associated with the EDI 3.1 Implementation Vendor procurement, the Go-Live date for Phase 1 was adjusted to Dec. 16, 2025. 

In April, Objectstream began application development using an Agile framework, completing work in iterations (sprints). Each sprint consists of 1) development, 2) demo and release and 3) testing. Testing early and fixing defects will occur prior to System Integration Testing (SIT), where the primary focus will be testing of end-to-end scenarios. Sprints for Self-service Portal, Enterprise Functions, Case Management, and Medical Fee Dispute have been completed. Sprints for Adjudication and Benefit Administration will be released before the end of the year 2025. Several sprints have also been completed for Master Data Management and Data Migration.

First Reports of Injury Filed by Body Part

First Reports of Injury Filed by Age Group

First Reports of Injury Filed by Industry (Top 10)

Claims for Compensation

An employee may contact the Dispute Management Unit for assistance and/or file a Claim for Compensation with the Division if they believe they are not receiving benefits they are entitled to under the Workers‘ Compensation Law. An employee may opt to obtain legal representation to file a Claim for Compensation with the Division.

The filing of a Claim initiates a contested case proceeding where the Administrative Law Judge (ALJ) has the authority to determine the issues in dispute. As of Dec. 31, 2024, a total of 23,719 Claims for Compensation were pending before the Division.

Claims for Compensation Filed by Year

Claims for Compensation Filed by Body Part

Claims may be resolved through the issuance of an award, a compromise settlement, or a dismissal. Case resolution time frames vary based on multiple factors including body part injured, employment, disability plan, treatment plan and for each resolution type. Each adjudication office provides prehearing and mediation services throughout the life of a Claim.

Claims for Compensation by Industry (Top 10)

Claims for Compensation Resolutions

Occupational Diseases

Section 287.067.1 RSMo defines an occupational disease (OD) as an identifiable disease arising with or without human fault out of and in the course of employment. To be compensable under Chapter 287, the occupational exposure must be the prevailing factor in causing both the resulting medical condition and disability. In 2024, 718 claims were filed for occupational diseases.

• 718 total occupational disease claims

OD Claims by Industry (Top 10)

OD Claims by Nature of Injury (Top 10)

OD Due to Toxic Exposure as Set Forth in §287.020.11 RSMo

• 21 asbestosis
• 5 mesothelioma
• 1 silicosis

Workers' Compensation Primary Injury Funnel

Statistics below portray an injury’s resolution through the workers’ compensation process.

• 90,815 First Reports of Injury
• 16,381 settlements
• 12,784 Claims for Compensation
• 524 hearings
• 222 awards

Customer Service

The Division is required to maintain a public information program that provides assistance to all parties including injured workers, employers, insurers, and lawyers. The Division’s Customer Service Representatives received a total of 17,547 calls in 2024 beyond those calls received by Docket Clerks in our Adjudication offices.

The Unit may also process requests for assistance coming through the Division’s website to include Sunshine Law requests, constituent requests from the legislature or Governor‘s office, and requests for Proof of Coverage.

• 17,547 customer service calls received

Medical Fee Dispute

The Medical Fee Dispute Program allows health care providers to file an application for reimbursement of disputed, outstanding charges and fees relating to treatment and services provided to injured employees. In 2024, the Unit processed 77 applications for direct payment and 2,284 applications for payment of additional reimbursement. The Medical Fee Dispute Program received 248 applications for “reasonableness” disputes, defined as under $1,000, during the calendar year 2024. Requests for an Administrative Ruling were submitted in 16 cases.

Medical Fee Dispute Documents Processed

• 2,284 applications for payment of additional reimbursement
• 248 "reasonableness" dispute applications <$1,000
• 77 applications processed for direct payment
• 16 requests for administrative rulings submitted

Fatalities

An employer must report fatalities to the Division through the filing of a FROI within 30 days. A Claim for Compensation may be filed by other parties to the Claim. The injury may or may not be determined to be a compensable injury that caused the death of the injured worker. An ALJ has jurisdiction to determine compensability of an injury resulting in death based upon evidence presented.

Fatalities by Age Group

Fatalities by Industry (Top 10)

Adjudication

The Division’s statutory responsibility to adjudicate and resolve disputes under the law is fulfilled by the four Chief Administrative Law Judges with oversight of eight physical adjudication offices in four Adjudication Regions spread throughout the State of Missouri. The Administrative Law Judges, Court Reporters and Docket Clerks provide services to the parties to a Claim or case.

The Division is able to place voluntary settlement conferences, mediations, hardship hearings and dismissal settings on their dockets to be held by phone, virtually and in person. The prehearing status calls are required by the Administrative Law Judges during the life of a Claim.

4-Region Adjudication Office Map

• WESTERN REGION - Chief ALJ: Angie Heffner
  • Kansas City
    • Kenneth Cain
    • Emily Fowler
    • Lawrence Rebman
    • Mark Siedlik
    • Kevin Thomas
  • St. Joseph
    • Ryan Asbridge
• NORTH/CENTRAL REGION - Chief ALJ: Hannelore Fischer
  • Jefferson City
    • Bruce Farmer
    • Melodie Powell
• SOUTHERN REGION - Chief ALJ: Carl Strange
  • Cape Girardeau
    • Maureen Byrne
    • Amy Young
  • Joplin
    • Karen Fisher
  • Springfield
    • Skyler Burks
    • Kevin Elmer
• EASTERN REGION - Chief ALJ: Jason Tilley
  • St. Louis
    • Karla Boresi
    • Suzette Flowers
    • Kathleen Hart
    • Joseph Keaveny
    • John Ottenad
    • Cole Rosenblum
  • St. Charles
    • Melissa Gilliam
    • Edwin Kohner

Docket Settings

Benefits Administration Unit

The Benefits Administration Unit is responsible for tasks associated with the Second Injury Fund, Dispute Management, the Line of Duty Compensation Fund, and the Tort Victims’ Compensation Fund.

Second Injury Fund

The Second Injury Fund (SIF) liability is set forth in §287.220, RSMo. When the SIF statute is applicable, the employer is liable only for the amount of disability caused by the employee’s current or last injury, and the SIF is liable for the amount of the increase in disability caused by the synergistic effect of the two injuries. As a result, the SIF provides the employers with protection in hiring an employee who has a preexisting disability.

For Claims filed for injuries after Jan. 1, 2014 (or post-2014 injury), the employee has to prove that a qualifying preexisting disability, combined with the disability from the primary injury, results in permanent total disability. Claims for Compensation filed against the SIF are resolved by dismissal, settlement, or issuance of an award. All awards issued by ALJs are issued after a hearing and may determine whether the claimant is eligible for SIF benefits under the statute or is not eligible for SIF benefits based on the evidence presented at the hearing. All awards are subject to appeal as provided by law. As of Dec. 31, 2024, there were 9,871 open SIF claims pending before the Division.

Section 287.715 provides for the collection of an annual surcharge not to exceed three percent from every authorized self-insurer and every workers’ compensation policyholder insured in Missouri. To address the solvency issues facing the SIF, §287.715.6 authorizes the Division Director to collect a supplemental SIF surcharge not to exceed one percent through calendar year 2026.

Second Injury Fund Claims for Compensation Filed

Second Injury Fund Resolutions

The charts below depict the aggregated payments made by benefit type and the number of recipients receiving said benefits, by calendar year.

PTD Lifetime

PTD Lump Sum

PPD

The charts below depict the aggregated payments made by benefit type and the number of recipients receiving said benefits, by calendar year.

Death

Rehabilitation

Lost Wage

Medical

Dispute Management

The Dispute Management Unit (DMU) program offers voluntary early intervention services to mediate disputes that arise between the parties after a workplace injury occurs and before a Claim for Compensation is filed. This process is designed to benefit all parties by allowing an exchange of information and records to resolve issues without incurring litigation costs. Agreements that are reached between the parties remain confidential.

Because Dispute Management is voluntary, when mediation is rejected or fails, the party originally requesting mediation services is advised that further adjudication steps are available including filing of a Claim and determination by an Administrative Law Judge (ALJ). Once a written claim is filed, Dispute Management is no longer available to either party as the case has become a contested proceeding.

Line of Duty Compensation Fund

The Line of Duty Compensation Act provides for benefits, separate and apart from workers’ compensation death benefits, paid from the Line of Duty Compensation Fund to the survivors of certain individuals who are killed in the line of duty. These individuals include air ambulance pilots, air ambulance registered professional nurses, emergency medical technicians, firefighters, law enforcement officers, and volunteer firefighters. Effective Aug. 28, 2018, the Missouri Legislature expanded the class of individuals who are entitled to line of duty benefits. There were 8 Line of Duty Claims received and 8 Line of Duty awards issued in 2024.

• 8 Line of Duty claims received
• 8 Line of Duty awards issued

Tort Victims' Compensation Fund

Chapter 537, RSMo., requires the Division of Workers’ Compensation to administer the Tort Victims‘ Compensation Fund which was created to support those injured due to another‘s negligence or recklessness who are unable to obtain full compensation for their injuries.

Awards are limited to $300,000, and payments are prorated based on monies appropriated by the legislature. Currently, the Division is unable to make any payments from the Fund pursuant to a court issued injunction.

Self-Insurance

The Division’s Self-Insurance Unit is responsible for authorizing and regulating all self-insured employers in Missouri. The Self-Insurance Unit oversees roughly 30% of the workers’ compensation insurance market (based on premium) as many employers utilize the option to self-insure their obligations. The Unit must ensure that all self-insured employers comply with Chapter 287, RSMo, and follow 8 CSR 50-3.010. The Unit’s primary functions consist of evaluating applications to self-insure submitted by employers and, providing oversight and assistance to current self-insured entities. Oversight requirements include filing timely self-insurer annual reports, posting appropriate levels of security, and complying and meeting claims best practices and safety obligations.

Self-Insurance Counts

• 211 individual self-insurers
• 20 group trusts
• 2,441 individual member employers in group trusts
• 710,453 covered self-insurer employees*
• $36,075,450,100 covered self-insurer payroll*

*Numbers provided are based on counts as of January 1 of the indicated year.

Self-Insurers by Industry

Missouri Workers' Safety Program (MWSP)