MO Workers’ Comp Guide: Missouri Workers’ Compensation Rules

About 1 in every 100 Missouri employees injured at work in 2023 filed workers’ compensation claims. But how can you tell if you’ll qualify for MO workers’ comp benefits if you’re in a workplace accident? You might not know that if you see your own doctor, then you must pay for that visit yourself. Or that you must report it to your supervisor before you seek care… even if it’s an emergency. Another thing to consider: Your employer might force you to take an on-the-spot drug and alcohol test.

Keep reading to learn about qualifying for workers’ compensation benefits in Missouri and how to get help if your claim’s denied.

MO Workers Comp Guide for Injured Employees: Key Takeaways

• Any illness or injury that happens in the course and scope of your employment may qualify for workers’ compensation benefits.
• Workers’ compensation insurance won’t pay your medical bills if you seek treatment before reporting the injury to your employer.
• Not all employers in this state have workers’ comp coverage, so be sure to check with your supervisor or HR department.
• About half of all people who file claims each year get any paid time off under workers’ comp. In all other reported cases, it only covers medical expenses.
• You can get a free, no-obligation claim evaluation to discuss your legal rights with an attorney.

Which Employers Must Have Missouri Workers’ Compensation Insurance Coverage?

All Missouri employers with five or more employees must carry workers’ comp insurance, according to state law. That means Missouri small business owners may avoid paying for workers’ comp insurance, if they so choose. However, construction industry employers with one or more employees must have MO workers’ comp coverage.

That said, certain types of employees are exempt from these automatic insurance coverage rules, like:

• Domestic servants working in someone’s home
• Certain inmates in work-release programs
• Farm labor and occasional labor workers who work seasonally
• Real estate agents and other direct sellers who work on commission
• Maritime workers and other federal employees
• Independent contractors
• Officials working at student or youth-based sporting events
• Sole proprietors and LLC partnership members

Not sure whether you have coverage? Use the Missouri Department of Labor & Industrial Relations’ online search tool to find your employer. You can also check the Department’s self-insured employer online listings here.

Step-by-Step Instructions for Filing Missouri Workers’ Compensation Claims

If you have coverage, then generally, the steps below are how you’ll apply for workers’ comp benefits in this state:

1. Notify your manager about your workplace accident in writing before seeking any medical care.

You must do this within 30 days or you may lose your right to any workers’ compensation benefits. State law gives your employer the right to direct your medical care and decide which doctor can treat your work-related injury.

If you have a repetitive motion injury like carpal tunnel, you have two years from your diagnosis date to report it.

The same filing deadline (the statute of limitations) applies for reporting occupational diseases, like mesothelioma.

Important: If you go to a doctor or emergency room before you tell your employer, you may have to pay those medical bills yourself.

2. Seek medical treatment from a doctor authorized to treat you under your employer’s insurance plan.

If you have no medical expenses because your injury is minor, then your workers’ comp claim essentially stops here. Otherwise, the doctor who treats you should explain:

• Whether need ongoing care for your workplace injury, what type, and for how long (i.e., physical therapy, surgery, stitches, etc.)
• If you’re unable to return to work, the doctor will tell you this and notify your employer

3. Your employer then has five days to notify the Missouri Division of Workers’ Compensation about your accident.

Your employer’s insurance company usually handles this step using an electronic First Report of Injury Form (FROI). However, the state doesn’t require this step if you only need first aid on site and no time off for your injury.

4. You must be out of work longer than the three-day required waiting period before workers’ comp pays any lost wages.

If approved and you don’t need to miss any work, then your employer’s policy only covers medical bills. Your first three days off after your accident are always unpaid unless you miss more than two weeks of work. If you can’t return to work on day 15, then your employer’s insurer should pay you for those first three days off.

Important: The waiting period in Missouri is three calendar days, not three business days.

5. If you’re denied benefits, contact your employer or the insurance company to resolve any disputes.

In the case that this does not solve your problem, you have three possible ways to appeal:

1. Call 1-573-422-2537 to request mediation from the Division’s Dispute Management Unit in Jefferson City.
2. Request an appeals conference before an administrative law judge within 120 days.
3. Consult a MO workers’ comp lawyer for a free consultation about your case.

Types of Workers’ Compensation Benefits Available in MO

Below are all the different types of workers’ compensation benefits you may be eligible for in Missouri.

Medical Treatment Benefits

If your claim’s approved, all medical bills related to your workplace injury or illness should go directly to your employer’s insurer. You should not receive any medical expenses or pay them out of your own pocket. This type of benefit covers things like:

• Doctor’s appointments
• Tests, bloodwork, and other required assessments
• X-rays, CT scans, MRIs, or other scans needed in order to render appropriate medical care
• Physical therapy
• Vocational rehabilitation therapy
• Prescription medication costs
• Travel expenses (i.e., mileage reimbursement, toll fees, etc.) required to treat your injury
• Temporary mobility devices (i.e., a cane, crutches, or wheelchair) while you recover

Disability Benefits to Help Cover Lost Wages

Generally, your wage replacement benefits equal two-thirds of your gross average weekly wage (AWW). However, this benefit is also subject to Missouri’s maximum and minimum amounts for the current calendar year. You may receive any of the following disability payments, depending on the extent and severity of your injury:

• Temporary Total Disability benefits (TTD benefits). You can receive these payments for up to 400 weeks or until you can return to work in any capacity. This means if your employer offers you light duty or part-time work, you cannot turn it down. Otherwise, you won’t qualify for weekly TTD benefit payments.
• Temporary Partial Disability benefits (TPD benefits). If you can go back to work but not full time or your usual job duties, then you may qualify for TPD payments. These equal two-thirds of the difference between your pre-injury and post-injury work income for up to 100 weeks. You’ll only get these payments if you’re earning less money than you usually do after your accident.
• Permanent partial disability benefits (PPD benefits). If your job accident permanently injures you in some way but you can still work, you may qualify for PPD benefits. These fall into two categories: Scheduled and non-scheduled injuries. For a scheduled injury, you can get up to 232 weeks’ worth of TPD payments in a lump-sum settlement. For non-scheduled injuries, you can get no more than 400 weeks total of TPD payments.
• Total permanent disability benefits (TPD benefits). If you can’t work at all in any job after your work accident, then you may qualify for these payments. TPD benefits equal two-thirds of your AWW on the date of your accident paid for life, or until you negotiate a lump-sum settlement.

Death Benefits

If a worker dies in a workplace accident, then his or her family members may qualify for death benefits. These can include:

• $5,000 to put towards funeral and burial expenses.
• Weekly benefits equal to two-thirds of the deceased worker’s AWW in the year prior to the fatal accident. These usually go to the worker’s dependent spouse and children until the spouse remarries or dies. The widowed spouse can receive two years of death benefits in a lump-sum payment upon remarriage.

Answers to Frequently Asked Questions About Workman’s Comp

When does my MO workers’ comp insurance coverage begin?

It starts on your first day at work, provided your employer paid for this type of insurance policy.

Does workers’ comp pay for pain and suffering?

Generally, no. It is a no-fault system that provides appropriate medical care and in some cases, lost wages to injured workers.

Do I have to pay for workers’ comp insurance to receive these benefits?

No, your employer pays 100% of the insurance premium cost and you have no deductibles to pay for medical care.

If I’m undocumented, can I get workers’ comp in Missouri?

Maybe. State law does not expressly state whether undocumented workers have the right to such benefits, so it’s unclear.

Can I sue my employer if I’m getting workers’ compensation benefits?

No. By accepting any benefits from your employer’s insurer, you automatically waive your right to sue your employer for negligence.

Can my employer fire me for filing a workers’ comp claim?

No, this is illegal. Federal laws protect workers from retaliation in cases involving occupational illnesses, injuries, or reporting workplace safety violations.

Will filing a workman’s comp claim make future employers less likely to hire me?

No. Employers cannot access these types of records until after you accept a new job offer, so that’s not possible or legal.

How to Get a Free Consultation from a MO Workers’ Comp Attorney

Still not sure if you qualify for workers’ comp benefits in Missouri? We recommend that you talk to an attorney about your claim for free. If you don’t know where to find someone willing to give you a free consultation, we can help with that, too.

Every attorney in our network offers them, and they also work on contingency. That means you pay $0 if a lawyer can’t help you get a workers’ comp settlement.

You are not obligated to do anything else, including work with the attorney you speak with or move forward with your claim.

Want to know how much your work injury may be worth? Click the button below or call 1-888-927-3080 to start your free claim evaluation and get the help you deserve today: