Most Missouri businesses with employees are required to pay for workers’ compensation insurance (WC or workers’ comp insurance). The insurance provides compensation to employees who suffer work-related injuries. Here are some basic facts that you need to know about workers’ comp insurance in Missouri as a business owner and an employer.
In most cases, if your Missouri business has at least five employees, you’re required to carry workers’ compensation insurance. If your business is in the construction industry, you generally are required to carry the insurance if you have just one employee. Certain business owners, such as sole proprietors and partners in partnerships, and corporations with no more than two owners where the owners are the corporation’s only employees, are not required to be covered by workers’ compensation insurance. In addition, certain recognized religious sects also may be exempted from the requirement to carry WC insurance.
The Missouri Division of Workers’ Compensation (DWC) within the state’s Department of Labor (DOL) is the primary state agency that handles workers’ comp claims. Most of the law for WC insurance is contained in Missouri’s Workers’ Compensation Law (Chapter 287 of the Missouri Revised Statutes). In addition to the Act, there are also administrative rules (Division 20, Chapter 3 of the Code of State Regulations) that cover workers’ compensation in Missouri.
In Missouri, workers’ compensation insurance is available through private insurance companies. If your business is unable to obtain coverage through a private insurer, you may be able to get coverage through the so-called residual market, more commonly known as the assigned risk pool. There is also an option to self-insure, but this may not be advisable for smaller businesses, in part because it requires that a lot of money be set aside to cover potential claims.
An injured employee should notify you in writing of the injury, with the written notice including the date, time, and place of the injury. For injuries that require more than immediate first aid or lost time from work, you must report the injury to your workers’ comp carrier within 5 days of being notified, and file an injury report with the DWC within 30 days of being notified. To notify the DWC, you should file Form WC-1-EDI, Report of Injury. There are options to file electronically or online.
You also have the right to select the health care providers for the injured employee. You also may consent to an employee’s request for different providers, but you are not required to do so.
Beyond these initial steps, there are subsequent steps to the WC claims process, not covered here.
If you or your insurer deny WC benefits to an employee who thinks he or she deserves them, the employee may file a Form WC-21-A-2, Claim for Compensation. (In certain cases, the employee also may file a Form WC-183, Request for Pre-Hearing.) In response to the Claim, you or your insurer should file a Form WC-22, Answer to Claim for Compensation.
The DWC provides several options for resolving the dispute. One option is mediation, which is an informal process where a mediator tries to facilitate communication between employer and employee to reach a resolution. Mediations are conducted through the DWC’s Dispute Management Unit. You or the employee can request a mediation by filing a Request for Mediation with the DWC.
Another, more formal option, which is triggered by the Claim and Answer, is a so-called Conference, which is held before an administrative law judge.
If you are not happy with the results of a conference and any further review by the DWC, you can appeal the state Court of Appeals.
If you fail to provide required coverage, you are committing a misdemeanor with a penalty equal to three times the annual premium you should have paid, up to $50,000. In addition, you are liable for the costs of any injuries suffered by your employees. A second violation is a felony. Some of the penalty rules are contained in Section 281.127 of Missouri’s Workers’ Compensation Law.
There are many other workers’ compensation requirements for Missouri employers, such as putting up posters about workers’ compensation coverage where employees can see them. For more information, see the Nolo website section on workers’ compensation and the Missouri Division of Workers’ Compensation website which contains many useful resources.