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Publications and Forms

Request for Pre-Hearing (WC-183)

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

Request for Wage Determination (PW-3)

A form to request a wage determination according to Chapter 290 RSMo.

Resource Guide for Employers (MODOL-4466)

A resource guide for employers containing information about unemployment insurance, workers' compensation, wage and hour standards, discrimination, FMLA, youth employment laws, mine and cave safety, and federal requirements.

Salario Mínimo de Missouri requiere del cartel (LS-52-S)

Cartel para colgar en el lugar de trabajo a Missouri salario mínimo.

Self-Insuring Workers' Compensation Liability Through Trusts (WC-124)

This brochure is to inform employers who are or want to be self-insured for workers' compensation liability through trusts (a way employers that are usually within the same industry or members of the same association can pool their liabilities with other employers).

Shared Work Plan Application (MODES-SW-1)

Apply for the Shared Work Program, an alternative to laying off your employees!

Shared Work: An Alternative to Laying Off (MODES-4786)

Information regarding the Shared Work Program relating to employers and employees.

Showing of Interest Signature Form (SBM-09)

A list to be completed by employees naming their exclusive bargaining representative.

Showing of Interest Signature Form - Decertification Petition Only (SBM-10)

A list to be completed by employees decertifying their exclusive bargaining representative.

Statement of Specific and Aggregate Excess Insurance Coverage (WC-121)

Proof of initial, renewal, or changes to specific and aggregate Missouri only excess insurance coverage.

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