Google Translate

Search by form number, title, or keyword

Publications and Forms

Division of Workers' Compensation's 2015 Annual Report

This report, as required by §287.680 RSMo, briefly describes each of the programs and units and summarizes the transactions and proceedings undertaken for the year 2015.

EDI Master Trading Partner Profile (WC-EDI-213)

A profile of the master trading partner including contact information.

EDI Missouri Specific Requirements (WC-EDI-206)

Missouri specific requirements to supplement the International Association of Industrial Accident Boards and Commission (IAIABC) Electronic Data Interchange.

EDI Project Agreement (WC-EDI-210)

A form for self-insured, self-administered employers, insurance companies or third-party administrators regarding electronic data interchanges (EDI) project agreement.

EDI Receivers Specifications (WC-EDI-256)

A Missouri electronic transmission profile receiver's specifications.

EDI Secure File Transfer Protocol (FTP) (WC-EDI-207)

Information regarding the secure file transfer protocol (FTP) for the transmission of electronic data interchange (EDI) transactions.

EDI Sender Trading Partner Profile (WC-EDI-261)

A sender's trading partner profile.

EDI Sender Trading Partner Profile - List of Insurers (WC-EDI-260)

A list of insurers for a sender's trading partner profile.

EDI Senders Response (WC-EDI-257)

A transmission profile- sender's response.

Electronic Fund Transfer Enrollment Form (WC-132)

This form must be used by the Workers' Compensation Insurance Carriers, the Self-Insured Employers and the Self-Insured Groups or trusts who would like to make Second Injury Fund surcharge payments to the Missouri Division of Workers' Compensation through an Electronic Fund Transfer.