Publications and Forms
A form for use by health care provider to determine case status information to file a medical fee dispute application.
A request by an employer or insurer for an award on undisputed facts in regard to application for a direct payment medical fee dispute.
A form to be completed by a health care provider requesting certification as a rehabilitation facility.
A form for use by a health care provider requesting the dismissal of an application for direct payment in a workers’ compensation medical fee dispute.
A form for use by a health care provider requesting the dismissal of an application for payment of additional reimbursement of medical fees in a workers’ compensation “reasonableness” medical fee dispute.
Request to DWC for a final award hearing regarding workers compensation claim.
Request to DWC for a hardship hearing regarding workers compensation claim.
A form requesting services from a workers' compensation program or the Missouri workers' safety program.