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Publications and Forms

Workers' Compensation Requirements For the Missouri Construction Industry (WC-259)

A guide as to when construction industry employers are required to purchase workers’ compensation insurance in Missouri.

Workers' Compensation Virtual Drop Box

The Division of Workers’ Compensation accepts the Claim for Compensation and Answer to Claim for Compensation (with cover letter, if submitted) electronically from Law Firms where the attorneys are admitted to practice law in the State of Missouri.

Workers' Compensation: Fraud and Noncompliance (FN-09)

A brochure containing information about workers' compensation fraud and noncompliance.

Answer to Application for Direct Payment (WC-199)

A form to be completed by the employer or insurer responding to the application for direct payment.

Answer to Application for Payment of Additional Reimbursement of Medical Fees (WC-198)

A form to be completed by the employer or insurer responding to the application for payment of additional reimbursement of medical fees (a “reasonableness” case).

Application for Administrative Ruling (WC-214)

A form which may be completed by a health care provider, an employer or insurer in a “reasonableness” medical fee dispute where the amount in dispute does not exceed $1,000.

Application for Certification - Safety Consultant/Safety Engineer (WSP-10)

A form application for certification for a safety consultant or safety engineer.

Application for Direct Payment (WC-MD-01)

A form for use by a health care provider to apply for direct payment in regards to a workers' compensation medical fee dispute—if the health care provider believes that it can show that it was authorized to treat the employee but no payment has been made.

Application for Evidentiary Hearing (WC-MD-03)

A form for use by a health care provider, an employer or an insurer to request an evidentiary hearing in regards to a workers’ compensation medical fee dispute.

Application for Payment of Additional Reimbursement of Medical Fees (WC-MD-02)

A form for use by health care provider applying for payment of additional reimbursement of medical fees in a workers’ compensation medical fee dispute —if a partial payment has been made. (These are called “reasonableness” cases.)

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