Short answer; no. In the state of Missouri employers with 5 or more employees must carry workers′ compensation insurance. The only exception is for the construction industry. If you are in the construction industry and have one or more employees you are required to carry workers′ compensation insurance. The statute does not differentiate between full-time or part-time employees. Neither does it state that the five employees have to be in Missouri. If an employer has locations in various states, they need to count the total number of employees they have.

Probably not. Texas Mutual Insurance normally covers injuries that occur in Texas or Texas residents working out-of-state. If you are working for any out-of-state employer, it is always wise to contact the insurance company that issued the workers′ compensation policy and verify you are covered. Coverage does not always carry over from one state to the next. If you find out you are working for an employer that is not covered in Missouri, please feel free to call us and we will investigate the matter.

No. The Fraud and Noncompliance Unit was created to investigate criminal violations of Missouri′s workers′ compensation law (RSMo 287). If a complaint is filed, the unit will investigate the matter to determine if a criminal violation has occurred. If the unit is able to substantiate a violation, the Division Director may refer it to the Office of the Attorney General for prosecution. If no violation is substantiated the case is administratively closed. The unit was not intended to nor does it participate in the administrative settlement side of the workers′ compensation system.

If you are an employee and not a subcontractor, it is illegal for an employer in the state of Missouri to charge you for workers′ compensation insurance. In accordance with RSMo 287.290, "No part of the cost of such insurance shall be assessed against, collected from or paid by any employee." Not only is it wrong to shift the burden of workers′ compensation insurance onto employees, it gives the employer an unfair economic advantage over their competitors.

In Missouri, every employer or its insurer is required to file a Report of Injury with the Division of Workers′ Compensation, within 30 days after obtaining knowledge of an injury or death of an employee. If the employer has coverage through an insurance carrier, it has five days to report the injury or death to that carrier and the carrier is then required to report the injury to the Division.

It depends on a number of factors. Merely collecting TTD and working at another job, does not in and of itself, constitute fraud. One of the criminal elements of fraud is a misrepresentation of a material fact (a lie) in order to obtain a benefit. If a claims adjuster, medical provider or an employer asked the injured employee if he or she is working and the employee denies it, then there could be a violation of Missouri′s workers′ compensation statute.

Maybe! Violating a doctor′s work restrictions may or may not be a violation of Missouri′s workers′ compensation laws. For example, an injured worker goes to the doctor and indicates that he or she is in a lot of pain. When asked how severe, the injured employee states, "8 out of 10". You have the employee on videotape building a barn. He or she is carrying 4′ x 4′ posts, bags of cement, hammering, climbing a ladder, etc. This scenario would not be fraud! Why? Where is the lie?

No! First of all, any employer in the construction industry is required to carry workers′ compensation insurance if it has one or more employees. If your employer does not have coverage, it is non-compliant with Missouri′s workers′ compensation law and the Fraud and Noncompliance Unit would investigate that violation. When an employer applies for coverage it is asked about prior accidents. In most situations, if it admits to your injury, it won′t be covered under the policy it purchases on Monday.

No. The employees who are being paid cash will not have taxes taken out of their pay. This will have an effect on their Social Security and unemployment insurance. It also could affect the employer′s workers′ compensation premium. Insurance companies determine how much to charge for workers′ compensation by using three main categories. 

Yes, we would be interested in investigating this. We would check into two areas. First, we would determine if the subcontractor has workers′ compensation insurance. Second, we would investigate its submission of a false or forged certificate of insurance. Submitting an invalid certificate of workers′ compensation insurance is a class E felony. By avoiding its obligation to provide coverage it is denying its employees workers′ compensation benefits in the event they receive a workplace injury.