Publications and Forms
A form requesting services from a workers' compensation program or the Missouri workers' safety program.
An annual report of an individually self-insured employer’s audited financial statements.
An annual report of an individually self-insured employer’s Missouri payroll by class code and employee count by Missouri location.
An annual report of an individually self-insured employer’s Missouri compensation payments for the prior calendar year.
An annual report of an individually self-insured employer’s outstanding losses.
A form submitted to an Administration Law Judge for approval of the settlement of a workers' compensation case.
A request for substitution of counsel in a workers' compensation case.
Some employers ("lessors") lease employees to clients. Unless the lessor provides a financial guarantee, such as a surety bond, to ensure prompt payment of unemployment liabilities: (1) the lessor must file a separate Quarterly Contribution and Wage Report for the employees leased to each client; and (2) the client is jointly liable for the contributions otherwise due on the workers it leases from the lessor. MODES-4252 must be used for the posting of a surety bond.
A form requesting authority to distribute surplus monies of a self-insured group trust.