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Publications and Forms

Contribution and Wage Adjustment Report (MODES-4A)

Employers use the Contribution and Wage Adjustment Report to adjust summary total and wage data previously reported. A separate report is to be used for each quarter to be adjusted and for each separate account number assigned.

Crime Victim Petition for Review to the LIRC (MOIC-2568)

A petition for review by the LIRC of a decision made by a workers compensation administrative law judge.

Datos para Trabajadores Lesionados (WC-101-S)

Un folleto delineando hechos para los trabajadores lesionados en materia de indemnización de los trabajadores en Missouri.

Decertification Showing of Interest (SBM-10)

A list to be completed by employees decertifying their exclusive bargaining representative.

Department Overview - Economic Resource Guide (MODOL-4532)

We are partnering with companies and workers to lower costs, mitigate risk, and create healthy working environments.

Disability Schedule and Benefit Limits (WC-110)

A visual chart showing the number of weeks of compensation payable for permanent partial disabilities.

Discrimination in Employment (MCHR-9)

Every employer, labor organization, employment agency, or other business or establishment covered by Chapter 213, RSMo shall post the Commission's equal employment poster in a place where other employee notices are posted or in a conspicuous place where employees will have access to it. Required by Missouri State Law.​

Discrimination in Housing (MCHR-6)

The Rules and Regulations of the Missouri Commission on Human Rights require employers in the business of sale or rental of housing to post MCHR-6 Discrimination in Housing.

Discrimination in Public Accommodations (MCHR-7)

The Rules and Regulations of the Missouri Commission on Human Rights require employers doing business in places open to the public to post MCHR-7 Discrimination in Public Accommodations.

Division of Workers' Compensation's 2017 Annual Report

This report, as required by §287.680 RSMo, briefly describes each of the programs and units with the Division of Workers' Compensation and summarizes the transactions and proceedings undertaken for the year 2017.

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