Request to DWC for a final award hearing regarding workers compensation claim.

 

Request to DWC for a hardship hearing regarding workers compensation claim.

 

Request to DWC for a mediation regarding workers compensation claim.

 

A form requesting services from a workers' compensation program or the Missouri workers' safety program. Fill out an online version of this form by clicking here.

 

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.