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Publications and Forms

2017 Public Administration Data Sheet (LS-81)

Analyzing 2017 workplace injuries in the Public Administration sector.

2017 Retail Trade Data Sheet (LS-82)

Analyzing 2017 workplace injuries in the Retail Trade sector.

2017 Transportation and Warehousing Data Sheet (LS-83)

Analyzing 2017 workplace injuries in the Transportation and Warehousing sector.

2017 Trust Self-Insurance Annual Report (WC-135)

A report to be completed annually by a self-insured group trust.

2018 Missouri Prevailing Wage Law Changes Summary

Legislation (HB 1729) passed by the Missouri General Assembly and signed by the governor becomes effective August 28, 2018. This law makes several changes to Missouri's prevailing wage system.

Additional Page for Subunit Information (SBM-LM-1-5)

Attach this form to the Labor Organization Information Report (SBM-LM-1) if additional subunit information space is needed.

Affidavit of Zero Reporting - Commercial Insurers Only (WC-240)

An affidavit of zero reporting may be completed by insurance carriers authorized to write workers’ compensation policies in Missouri but not writing workers’ compensation policies for the calendar year.

Annual Certification Renewal - Safety Consultant/Safety Engineer (WSP-11)

An annual renewal for certification for a safety consultant or safety engineer.

Answer to Claim For Compensation (WC-22)

A form to be completed by the employer, attorney for employer/insurer/Third-Party Administrator, or Missouri Attorney General’s Office when filing an Answer to a claim for workers’ compensation. This Answer form is to be used for injuries occurring prior to January 1, 2014.

Answer to Claim for Compensation (WC-22-A)

Answer to Claim for Compensation form to be completed by the employer, attorney for employer/insurer/Third-Party Administrator, or Missouri Attorney General’s Office when filing an Answer to a claim for workers’ compensation.  This Answer form is to be used for injuries occurring on or after January 1, 2014, based upon the revisions to the Workers’ Compensation Law. 

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