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Publications and Forms

Application for Consultation Service Form (LS-25)

An application for a Missouri On-Site Safety and Health Consultation.

Application for Group Self-Insurance (WC-81A)

The application to be completed by a group of employers applying to form a self-insured group trust.

Auditing Procedures for Applicants for Individual Self-Insurance (WC-130-AI)

The safety auditing procedures for those employers applying to individually self-insure.

Authorization for Release of Confidential Information (WC-249-3)

An authorization for release of confidential information that must accompany the Irrevocable Letter of Credit (WC-249).

Bond of Employer Carrying His Own Risk (WC-82B)

A Surety Bond; one of three options available to meet the self-insurance security requirement.

Checklist for Individual Self-Insurance Applications (WC-128)

The checklist of required items and information that must accompany the Application for Authority to Self-Insure (WC-81).

Child Labor Complaint Form (LS-53)

A form to submit a complaint about child labor.

Classifying Employees for Unemployment Insurance Tax Purposes (MODES-INF-310)

Information for employers regarding classifying employees for unemployment insurance tax purposes.

Disaster Unemployment Assistance (DUA) Information for Filing a Claim (MODES-DUA-16)

If you are unemployed due to the disaster, you need to file a claim for regular unemployment insurance (UI) benefits.

Division of Workers' Compensation's 2009 Annual Report

This report, as required by §287.680 RSMo, briefly describes each of the programs and units and summarizes the transactions and proceedings undertaken for the year 2009.