How to File a Workers' Compensation Claim in Missouri

Learn when and how to file your workers' comp claim in Missouri.

If you have a work-related injury or illness, you may be eligible for Missouri workers’ compensation benefits. These benefits include medical treatment, compensation for wage loss, and other financial assistance. However, to collect benefits, you must report your injury to your employer and make a timely claim for benefits.

How Does the Missouri Workers’ Compensation System Work?

In Missouri, most employers must have workers’ compensation coverage—either by purchasing a workers’ comp policy from a private insurance company or by receiving certification from the state to self-insure. (In general, only large, financially stable employers will qualify to self-insure.) The Missouri Division of Workers’ Compensationoversees all workers’ comp claims in the state.

Like all other states, Missouri has a no-fault workers’ compensation system. This means you do not need to show that your employer was at fault or caused your injury. As long as your injury happened on the job or was caused by your work activities, you will typically be eligible for benefits.

Eligible workers may receive a variety of benefits, including:

  • reasonable and necessary medical care
  • temporary and permanent disability benefits (for lost wages)
  • vocational rehabilitation (training or education for a new line of work), and
  • additional compensation for diseases caused by a toxic exposure (such as mesothelioma).

To receive these benefits, you must follow the claims procedure set out under Missouri workers’ compensation law.

How Do I Report an Injury?

The first step in any workers’ compensation claim is notifying your employer of the injury. In Missouri, you must give your employer written notice within 30 days of suffering a work-related injury. If your injury or illness develops over time, you should give notice within 30 days of discovering that the condition was work-related. If you fail to give 30 days' notice, you may lose some or all of your benefits.

To give written notice, you can use a form provided by your employer or you can use the Division of Workers’ Compensation’s reporting form. When completing the report, provide as much detail as possible, including:

  • when the accident happened
  • how you hurt yourself, and
  • what symptoms you are experiencing.

Do not exaggerate or minimize your injuries on the accident report. Accident reports are frequently used as evidence in disputed claims and any inconsistencies may be used against you. It’s also in your best interest to keep a copy of your accident report for your records.

Despite the 30-day time limit, it's also best to report your injury and get medical treatment as soon as possible. Employers and insurance companies are skeptical of delayed claims and tend to deny them. Giving notice and getting treatment early on will reduce the likelihood of a claim denial.

How Do I Get Medical Treatment?

After you report an injury, your employer should send you to an occupational doctor for medical treatment. Under Missouri law, the insurance company gets to select your treating physician (except for emergency treatment).

It is important to provide the doctor with accurate information about the cause of your injuries and the severity of your symptoms. When evaluating claims, insurance companies rely heavily on medical records of initial treatment. Either downplaying or exaggerating your symptoms may result in a denial of benefits.

What Happens After I Report My Injury?

Once your employer has notice of your injury, it must notify its insurance company and the Division of Workers’ Compensation. The insurance company will then determine your eligibility for benefits. Its investigation may involve:

  • reviewing your medical records
  • analyzing your work experience, education, and wages
  • ordering a medical examination to assess your condition, and
  • sending you for a functional capacity evaluation (an assessment of your ability to perform work duties).

Under Missouri law, the insurance company must promptly pay your workers’ compensation benefits. If your benefits are approved, it may take several weeks to receive your first workers’ comp payment. If the insurance company denies your claim, you should consider filing an appeal.

Appealing a Denied Workers’ Compensation Claim

If your claim is denied—or if you believe you are not receiving all the benefits you deserve—you may file an appeal with the Division of Workers’ Compensation. To start an appeal, you must file a claim for compensation within two years of your date of injury or two years from your last benefit payment, whichever is later. Unless your claim is very simple, you should consider hiring a workers’ compensation lawyer. The insurance company will have a lawyer and you may be at a disadvantage if you proceed without an attorney.

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