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Publications and Forms

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. 

Appeals Rights and Procedures (WC-116)

Appeals rights and procedures in workers' compensation cases.

Application for Certification (WSP-45)

An application for certification by an insurance carrier writing workers' compensation in the state of Missouri.

Application for Employment (MODOL-2396)

An application form for those seeking employment with the Missouri Department of Labor and Industrial Relations.

Application for Membership (WC-81B)

Form to be used by employers applying for membership in a group trust.

Application for Review to the Labor and Industrial Relations Commission (MOIC-2567)

An application to have an award, decision or order reviewed by the LIRC.

Are You Off the Books? 1099 Fraud - Worker Misclassification (MODES-4714)

Information related to 1099 Fraud - Worker Misclassification, including consequences, online-assessment and tip reporting.

Aviso a los trabajadores sobre las prestaciones por desempleo (MODES-B-2-S)

Un cartel para colgar en un lugar de trabajo notificar a los empleados sobre los beneficios de desempleo.

Certificate to Employ a Child 14 or 15 Years of Age During Non-School Term (LS-68)

Certificate to employ a child age 14 or 15 during summer months.