Publications and Forms by Division

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State government strives to continue to move forward and offer more of our services online, while still working with individuals who might not have access to the technology required. At this time, we’ve standardized many of our forms to be available as PDFs. These PDFs can be viewed and saved using the most recent version of Adobe Reader, which can be downloaded for free by clicking on the Adobe button. If you’re having trouble with the PDF, paper copies are also available upon request.

Department Brochures

Department of Labor Brochure (MODOL-INF-28)
An informational brochure outlining the Missouri Department of Labor and what its responsibilities and tasks are, as well as the areas that it oversees.
Application for Employment (MODOL-2396)
An application form for those seeking employment with the Missouri Department of Labor and Industrial Relations.
Resource Guide for Employers (MODOL-4466)
A resource guide for employers containing information about unemployment insurance, workers compensation, wage and hour standards, discrimination, FMLA, child labor laws, mine and cave safety, and federal requirements.
Required Posters
Complete list of Missouri's Required Posters to be displayed in the Workplace.
2009 Annual Report
The 2009 report contains information about Missouri Department of Labor programs and services, including articles and information detailing improvements, changes and accomplishments throughout the year, as well as important statistics.
2010 Annual Report
The 2010 report contains information about Missouri Department of Labor programs and services, including articles and information detailing improvements, changes and accomplishments throughout the year, as well as important statistics.
2011 Annual Report
The 2011 report contains information about Missouri Department of Labor programs and services, including articles and information detailing improvements, changes and accomplishments throughout the year, as well as important statistics.
2012 Annual Report
The 2012 report contains information about Missouri Department of Labor programs and services, including articles and information detailing improvements, changes and accomplishments throughout the year, as well as important statistics.
2013 Annual Report
The 2013 report contains information about Missouri Department of Labor programs and services, including articles and information detailing improvements, changes and accomplishments throughout the year, as well as important statistics.
2011 Workforce Diversity Plan
The plans and policies of the Department of Labor and Industrial Relations regarding equal employment opportunity to applicants without regard to race, color, religion, sex, age, national origin, political belief, veteran status, and physical or mental disability.
Discrimination Complaint Information (MODOL-4519)
Fill out this form if you think you have been subjected to discrimination under a WIA Title I - financially assisted program or activity within the Department.

Division of Employment Security

Unemployed Workers

What You Need To Know About Unemployment Insurance in Missouri (MODES-INF-170)
Basics of unemployment insurance after a claim is filed, contact information for DES and a list of career centers.
Filing for Unemployment Insurance Benefits in Missouri (MODES-INF-288-5)
Basic facts and procedures for filing for unemployment insurance.
Disaster Unemployment Assistance (MODES-INF-178)
Information helping workers whose jobs have been affected by natural disasters.
Application For Review (MOIC-L-6)
An application to have a decision of an Appeals Tribunal of the DES reviewed by the LIRC.
Information for Appeals Tribunal Hearings (MODES-INF-166)
Information for Appeals Tribunal hearings, including what they are, instructions, and other important facts to know.
Military Unemployment Benefits for Trailing Spouses (MODES-4793)

Information for Missourians who leave their job to relocate to be with a spouse active in the military. Military spouses can file for unemployment benefits for up to 20 weeks.

Are You Off the Books? 1099 Fraud - Worker Misclassification (MODES-4714)
Information related to 1099 Fraud - Worker Misclassification, including consequences, online-assessment and tip reporting.
Work Search Record (MODES-4736)
Use this form to keep a list of all the employers and labor unions you contact each week while claiming unemployment insurance benefits.
Claimant Records Release Authorization (MODES-4384)
An authorization for the release of claimant records.
Obtaining Unemployment Records: Procedures and Practices (MODES-INF-326)
Procedures and prices for obtaining unemployment records.
Report Worker Misclassification/1099 Abuse (MODES-4610)
Report worker misclassification/1099 abuse.
Information for Trade Adjustment Assistance Certified Claimants about the Alternative Trade Adjustment Assistance/Reemployment Trade Adjustment Assistance Program (MODES-4640)
Information for TAA certified claimants about the ATAA/RTAA.
Report Unemployment Insurance (UI) Fraud (MODES-4631)
A form used to report unemployment insurance fraud.
Direct Deposit Authorization/Change Request (Form for Mailing) (MODES-B-6-5)
A form to change or authorize direct deposit.
Missouri Access MasterCard® Card Holder Agreement
Terms and conditions for using the Missouri Access MasterCard.
How to Use Your Missouri Access MasterCard®
Information sent with the new Missouri Access card on how to activate and use the card.
Missouri Access MasterCard® - New Card Carrier
Terms and conditions for using the Missouri Access MasterCard.
Change My Payment Method for Unemployment Insurance On-line Claims
Change payment method for Unemployment Insurance On-Line Claims
Shared Work Program: Information for Employees (MODES-INF-300)
Information about the Shared Work Program relating to employees.
Missouri Access MasterCard®/Debit Card Information (MODES-4606)
Missouri Access MasterCard Debit Card information.
Self-Evaluation & Work Search Record (MODES-4633)
A self-evaluation questionnaire to be completed by an unemployed claimant.
Receiving Unemployment Benefits while Participating in WorkReady Missouri (MODES-4643)
Information regarding the WorkReady Missouri Program.
Trade Adjustment Assistance For Workers (MODES-INF-195)
Information about Trade Adjustment Assistance for workers who have lost their job due to foreign trade.
Authorization for Federal Income Tax Withholding from Unemployment Benefits (MODES-4347-3)
Use this form to withhold federal income taxes from the unemployment benefits you will receive.

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Employers

Posters
Notice To Workers Concerning Unemployment Benefits (MODES-B-2)
A poster to be hung in a workplace notifying employees about unemployment benefits.
Filing Your Quarterly Contribution and Wage Reports (MODES-INF-394)
How to file quarterly reports for employers and other information.
Brochures
Employers' Rights and Responsibilities (MODES-INF-151)
A booklet outlining employers' rights and responsibilities under Missouri Employment Security law.
Missouri Unemployment State Tax Automated Reporting (MODES-INF-395)
Employer information for electronically conducting unemployment insurance tax business.
Shared Work: An Alternative to Laying Off (MODES-4786)
Information regarding the Shared Work Program relating to employers and employees.
Shared Work Program for Employers (MODES-INF-301)
Information about the Shared Work Program relating to employers.
Employer Benefit Charges (MODES-INF-280)
Information regarding the quarterly statement of benefit charges.
Obtaining Information from Division of Employment Security Records (MODES-INF-326)
Information about how to obtain unemployment records and their cost for claimants, employers and other interested parties.
Shared Work Program for Employees (MODES-INF-300)
Information about the Shared Work Program relating to employees.
Are You Off the Books? 1099 Fraud - Worker Misclassification (MODES-4714)
Information related to 1099 Fraud - Worker Misclassification, including consequences, online-assessment and tip reporting.
Classifying Employees for Unemployment Insurance Tax Purposes (MODES-INF-310)
Information for employers regarding classifying employees for unemployment insurance tax purposes.
Unemployment Insurance Claims (MODES-INF-353)
How to file for unemployment.
Payroll Records Required By Law (MODES-31)
A poster containing information about payroll records to be displayed in workplace.
Information for Appeals Tribunal Hearings (MODES-INF-166)
Information for Appeals Tribunal hearings, including what they are, instructions, and other important facts to know.
Unemployment Tax Tips for Employers (MODES-4619)
Unemployment tax tips for employers.
Missouri Unemployment Tax Information for 501(c)(3) Nonprofit Corporations (MODES-INF-389)
An informational brochure regarding unemployment tax information for 501(c)(3) Nonprofit Corporations regarding exemptions, voluntary election of coverage and reporting requirements.
Forms
Taxpayer Power of Attorney Form (MODES-4444)
A form authorizing power of attorney to a business representative.
Employer Records Release Authorization (MODES-4385)
A form authorizing the release of employer records.
Application For Review (MOIC-L-6)
An application to have a decision of an Appeals Tribunal of the DES reviewed by the LIRC.
Online Business Registration for New Employers <— Register for Business Taxes Here
Unemployment Tax Registration (MODES-2699-5)
The Division uses the Unemployment Tax Registration to determine whether an entity is liable for unemployment tax as a new or successor employer. The form must be completed even if the entity is not liable so that the Division can follow up at a time when liability may have been achieved or eliminate the entity from further follow-ups.
Instructions for Completing Unemployment Tax Registration (MODES-2699-9)
Instructions on how to complete the form for employers to register for unemployment tax.
Filing Your Quarterly Contribution and Wage Reports (MODES-INF-394)
How to file quarterly reports for employers and other information.
Internet USTAR <—Report Change in Business/Employment Here
Use the Internet application, USTAR to report that a business has stopped employing workers, or the closure, sale or partial sale of a business online.
Report on Change of Business Operations (MODES-9)
An employer uses the Report on Change of Business Operations to inform the Division when it has sold all or part of its business, closed its business, stopped employing workers, or changed its name or address. The Division evaluates the information from the form to determine whether the employer's account should be updated, closed, transferred, or left unchanged.
Internet USTAR <—File Quarterly Report Here
Use the Internet application, USTAR to report wages and tax for a quarter on-line.
Quarterly Contribution and Wage Report Blank/Print Only Form (MODES-4-7)
Employers use the Quarterly Contribution and Wage Report to report wages of their employees to the Division of Employment Security. Each liable employer is required to file this report each quarter even if it has paid no wages that quarter or if its assigned tax rate is zero.
Quarterly Contribution and Wage Report Spreadsheet (MODES-4-7)
Employers use the Quarterly Contribution and Wage Report to report wages of their employees to the Division of Employment Security. Each liable employer is required to file this report each quarter even if it has paid no wages that quarter or if its assigned tax rate is zero.
Instruction for Quarterly Contribution and Wage Report (MODES-4-5)
Instructions on how to complete the MODES-4-7.
Quarterly Wage Report Continuation Spreadsheet (MODES-10B)
The Division uses the Quarterly Wage Report Continuation Sheet to allow reporting of additional employees when there are more employees than will fit on the Quarterly Contribution and Wage Report (MODES-4). This form MODES-10B should be attached to the MODES-4.
Quarterly Wage Report Continuation Sheet (MODES-10B)
The Division uses the Quarterly Wage Report Continuation Sheet to allow reporting of additional employees when there are more employees than will fit on the Quarterly Contribution and Wage Report (MODES-4). This form MODES-10B should be attached to the MODES-4.
Shared Work Plan Application (MODES-SW-1)
Apply for the Shared Work Program, an alternative to laying off your employees!
Internet USTAR <—File Adjustment Request Here
Adjust wage and tax totals or wages of individual workers that were, or should have been, previously reported on-line using our internet application.
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.
Worker Relationship Questionnaire (MODES-4389)
The Worker Relationship Questionnaire is completed by a business and/or worker regarding the details of the worker's Missouri services performed.
Employer's Election to Cover Multi-State Workers Under the Missouri Employment Security Law (MODES-2019)
A form allowing employers to cover multi-state workers under Missouri Employment Security Law. Part of the Interstate Reciprocal Coverage Arrangement.
Social Security Number Correction (MODES-4427)
Employers use the Social Security Number Correction form to correct the social security number of an employee whose number was erroneously reported. Employers may correct the social security number of one employee on each correction form, but the form may be applicable to more than one calendar quarter. After making the correction, please return to:

Division of Employment Security
Attn: Employer Accounts Unit
P. O. Box 59
Jefferson City, MO 65104-0059
or it can be faxed to 573-751-9705.
Application for Joint Account (MODES-2241)
An employer application for a joint account.
Common Paymaster Law (MODES-4337)
Missouri Employment Security Law - Section 288.090 RSMo.
Common Paymaster Application (MODES-4338)
The Common Paymaster Application is completed by a business that wishes to report the workers of a related business under its own account number. The Division of Employment Security will use the information provided on the application to either approve or deny the request for Common Paymaster reporting. To qualify:
  1. The businesses involved must be corporations or limited liability companies taxed as corporations.
  2. The entities must be related.
  3. The workers reported by the Common Paymaster must perform service for two or more of the related corporations during each calendar quarter.
Voluntary Payment Information and Work Sheet (MODES-2272)
Work sheet and information for employers who wish to make voluntary payments to reduce their contribution rates.
Termination of Coverage Application (MODES-6)
This application is to be completed by an employer that would like to request termination of coverage. Please see the form to learn the necessary qualifications for your specific employer type. This form is effective January 1st and must be filed by February 10th of the year with respect to which the termination is to be effective.
Electronic Reporting
Electronic File Transfer and Magnetic Media Reporting Specifications (MODES-INF-368)
This booklet contains instructions and specifications for electronic file transfer (Internet) or magnetic media reporting (compact disc) to the Missouri Division of Employment Security.
Electronic File Specifications and Record Layout for ACH Credit Payments (MODES-4799)
This booklet contains instructions and file specifications for electronic payments via ACH Credit to the Missouri Division of Employment Security.
Transmittal of Quarterly Wages Reported on Magnetic Media (MODES-4260)
This document is used by employers reporting quarterly contribution and wage information via magnetic media. It lists all the information necessary for the submission and processing of the quarterly magnetic media reports. Effective January 1, 2008, the Division will not accept quarterly unemployment insurance wages on a tape cartridge. Effective July 1, 2012, the Division will not accept quarterly unemployment insurance wages on diskette. Wages may be submitted on the Internet or on a compact disc.

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Appeals

Information for Appeals Tribunal Hearings (MODES-INF-166)
Information for Appeals Tribunal hearings, including what they are, instructions, and other important facts to know.
Notice of Telephone Hearing Information (MODES-L-20-2)
General information and procedural instructions on how to participate in a telephone hearing conducted by the Division of Employment Security's Appeals Tribunal.
Application For Review (MOIC-L-6)
An application to have a decision of an Appeals Tribunal of the Division of Employment Security reviewed by the Labor and Industrial Relations Commission
Instructions for Unemployment Compensation Notice of Appeal (8-B-Inst)
Instructions on how to complete Unemployment Insurance Notice of Appeal (8-B)
Unemployment Compensation Notice of Appeal (8-B) (Fillable and Printable)
A notice of appeal to the Missouri Court of Appeals.
Claimant Request for Appeal of Unemployment Insurance Determination (MODES-4607)
This is the form for claimants to appeal an unemployment insurance determination.
Employer Request for an Appeal of Unemployment Insurance Determination (MODES-4792)
This is the form for employers to appeal an unemployment insurance determination regarding a former employee.

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Forms for Lessor Employing Units

Quarterly Client List (MODES-4282)
An employer ("lessor") leasing workers to other businesses ("clients") uses the Quarterly Client List to inform the Division of new and former clients. The Division uses the form to maintain responsibility for unemployment tax filing. The Quarterly Client List must be filed by the lessor each quarter per Missouri labor regulations.
Assignment and Escrow Agreement (MODES-4251)
Some employers ("lessors") lease employees to clients. Unless the lessor provides a financial guarantee, such as posting securities, to ensure prompt payment of unemployment liabilities: (1) the lessor must file a separate Quarterly Contribution and Wage Report for the employees leased to each client; and (2) the client is jointly liable for the contributions otherwise due on the workers it leases from the lessor. MODES-4251 must be used for the posting of securities.
Surety Bond (MODES-4252)
Some employers ("lessors") lease employees to clients. Unless the lessor provides a financial guarantee, such as a surety bond, to ensure prompt payment of unemployment liabilities: (1) the lessor must file a separate Quarterly Contribution and Wage Report for the employees leased to each client; and (2) the client is jointly liable for the contributions otherwise due on the workers it leases from the lessor. MODES-4252 must be used for the posting of a surety bond.
Lessor Employing Units Regulation (MODES-4281)
State regulation for lessor employing units.
Lessor Employing Unit/Client Lessee Law (MODES-4267)
The Division of Employment Security may consider an employer who provides, or "leases", employees to another business to be a "lessor employing unit". The business to whom the employees are provided is termed a "client lessee".

The Missouri Employment Security Law states that a lessor employing unit will be responsible for reporting all wages paid and be liable for contributions (tax) due on the wages paid.
  1. The lessor employing unit has the option to make a financial guarantee to the Division to pay contributions due. The lessor may guarantee payment by posting and maintaining a surety bond, depositing securities, providing an irrevocable letter of credit, or obtaining a certificate of deposit. This action will relieve the lessor's clients of any liability. It will also allow the lessor to report all employees on one quarterly return.
  2. If the lessor does not make a financial guarantee to the Division that contributions will be paid, the client lessee will be jointly liable for contributions due on wages paid to the employees provided to it. In order to identify the employees provided to each client lessee, the lessor must file a separate quarterly return for each client lessee.

    To maintain correct records, the Division requires the lessor to submit a quarterly list of its clients.

    NOTE: The above provisions do not apply to private employment agencies who provide their employees to others on a temporary help basis.
Irrevocable Letter Of Credit (MODES-4354)
Letter from financial institution approving a line of credit for an employer.
Authorization For Release Of Confidential Information (MODES-4354-3)
A form to authorize the release of confidential information for irrevocable letter of credit.
Irrevocable Letter Of Credit Regulation (C-248)
Regulation 8 CSR 10-4.170 establishing procedures for complying with the irrevocable letter of credit aspect of section 288.032(2) RSMo.

Forms for Consumer Directed Services Vendors

Quarterly CDS Vendor Consumer List (MODES-4590)
A Consumer Directed Services Vendor uses the Quarterly Client List to inform the Division of new and former consumers. The Division uses the form to maintain responsibility for unemployment tax filing. The Quarterly Client List must be filed by the vendor each quarter.

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Division of Labor Standards

Wage and Hour

Wage and Hour Publications
Workplace Standards- Wages and Hours (LS-29)
A quick reference guide for employers and employees regarding wage and hour standards in Missouri.
Wage and Hour Forms
Wages, Hours and Dismissal Rights (LS-18)
RSMo chapter 290 regarding wages, hours and dismissal rights.

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Minimum Wage

Minimum Wage Forms
Missouri Minimum Wage Required Poster (LS-52)
Poster to be hung in workplace regarding Missouri minimum wage.
Minimum Wage Complaint Form (LS-51)
A complaint form regarding Missouri minimum wage.

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Prevailing Wage

Forms
Request for Wage Determination (PW-3)
A form to request a wage determination according to Chapter 290 RSMo.
Prevailing Wage Complaint Form (PW-6)
A complaint form regarding Missouri prevailing wage.
Missouri Department of Labor Contractors Payroll Form (LS-57)
A form to record contractor payment records on public works projects.
Instruction Sheet for the Contract Payroll Form (LS-57-3)
Instructions on how to complete LS-57.
Public Works Guidebook (LS-62)
A guidebook for public bodies and contractors that assists in complying with the laws surrounding public works projects.
Project Notification - Contractor Information (PW-2)
A project notification containing contractor information.
Affidavit of Compliance with Prevailing Wage Law (PW-4)
An affidavit signifying compliance with the prevailing wage law.
Missouri Public Work Check-Off List (PW-5)
A checklist for public work projects compliance.
Contractor's Check-Off List (PW-8)
A checklist for a contractor on a public works projects to be in compliance.
Contractor's Wage Survey (LS-04)
A report to be completed by a contractor regarding construction wage rates.
Wage Rates for State Highway Construction (General Wage Order No. 54)

Brochures

How the Prevailing Wage is Determined (LS-13)
A brochure containing information about the prevailing wage law in Missouri.

Youth Employment

Child Labor Publications
Youth on the Job - Missouri Laws Protecting Young Workers (LS-56)
A resource to help understand the laws surrounding youth in the workforce.
Chapter 294-Child Labor (LS-15)
The Missouri Revised Statutes regarding Child Labor.
Entertainment Work Permit (LS-37)
An entertainment work permit for youth under 16 years of age.
Mo Child Labor Law for School Officials (LS-26)
A guide to the child labor law for school officials.
Child Labor Forms
Certificate to Employ a Child 14 or 15 Years of Age During School Term (LS-67)
Certificate to employ a child age 14 or 15 during school months.
Certificate to Employ a Child 14 or 15 Years of Age During Non-School Term (LS-68)
Certificate to employ a child age 14 or 15 during summer months.
Employers Employing Workers Under the Age of 16 List (LS-43)
A poster required to be hung in a workplace containing employees under the age of 16.
Entertainment Work Permit Request (LS-37)
An entertainment work permit for youth under 16 years of age.
Child Labor Complaint Form (LS-53)
A form to submit a complaint about child labor.

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Workplace Safety

Missouri On-Site Safety and Health Consultation Program (LS-10)
Information series regarding a no-cost confidential service for employers to help achieve OSHA compliance and increase workplace safety.
The Safety and Health Achievement Recognition Program (SHARP) (LS-54)
A brochure detailing the necessary steps to join SHARP and the benefits
Application for Consultation Service Form (LS-25)
An application for a Missouri On-Site Safety and Health Consultation.

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Mine and Cave Safety
Mo Mine and Cave Safety and Health Program (LS-14)
A brochure outlining the Mine & Cave Safety and Health Program.
Notice of Opening or Closure of Mines (LS-66)
A form to notify the Mine and Cave Safety Program when a Missouri mine or cave is opening or closing. Report Online

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Division of Workers' Compensation

Required Posters

Injured Workers

Authorization to Release Information (WC-126) and Instructions
This form allows a job applicant to grant a prospective employer access to the job applicant’s workers’ compensation record in Missouri.
Claim for Compensation (WC-21)
A form to be completed by the injured worker or by his or her attorney when making a claim for workers' compensation for injuries occurring prior to January 1, 2014.
Claim for Compensation (WC-21-A)
A form to be completed by the injured worker or by his or her attorney when making a claim for workers' compensation for injuries occurring on or after January 1, 2014, based upon the revisions to the Workers’ Compensation Law made by Senate Bill 1.
Request for Conference (WC-182)
Request to DWC for conference regarding workers’ compensation case.
Request for Pre-Hearing (WC-183)
Request to DWC for a pre-hearing regarding workers compensation claim.
Request for Mediation (WC-184)
Request to DWC for a mediation regarding workers compensation claim.
Request for Hardship Hearing and/or Section 287.203 Hardship Hearing (WC-185)
Request to DWC for a hardship hearing regarding workers compensation claim.
Request for Hearing-Final Award (WC-186)
Request to DWC for a final award hearing regarding workers compensation claim.
Stipulation for Compromise Settlement (WC-G-11)
A form submitted to an Administrative Law Judge for approval of the settlement of a workers' compensation case.
Eligibility Guidelines for Second Injury Rehab Benefits (WCR-7)
A form outlining eligibility guidelines for the Second Injury Fund.
Claim for Compensation for Line of Duty Compensation Benefits (WCLoD-1)
A claim to be filed regarding a payment to the estate of an Air Ambulance Pilot, an Air Ambulance Registered Professional Nurse, an Emergency Medical Technician, a Firefighter, or a Law Enforcement Officer who was killed in the line of duty.
Application for Review to the Labor and Industrial Relations Commission (MOIC-2567)
An application to have an award, decision or order reviewed by the LIRC.
Noncompliance Referral Form (WC-258)
Complete the form to report a business for not carrying workers' compensation insurance.
Report Your Workplace Injury/Occupational Disease or Repetitive Trauma Injury (WC-280)
This form allows employees to provide proper written notification to their employer when a workplace injury/occupational disease occurs.

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Brochures

Facts For Injured Workers (WC-101)
A brochure outlining facts for injured workers regarding workers’ compensation in Missouri.
Missouri's Second Injury Fund (WC-120)
Information regarding the Missouri Second Injury Fund.
Workers' Compensation: Fraud and Noncompliance (FN-09)
A brochure containing information about workers' compensation fraud and noncompliance.
Survivors' Benefits: For Family Members of Missouri's Fallen Workforce (WCLoD-15)
A brochure outlining the benefits provided by the Missouri Workers’ Compensation Law in the event of a compensable fatal accident or fatal occupational disease.
Workers' Compensation Requirements For the Missouri Construction Industry (WC-259)
A guide as to when construction industry employers are required to purchase workers’ compensation insurance in Missouri.
Appeals Rights and Procedures Brochure (WC-116)
Appeals rights and procedures in workers' compensation cases.
Division of Workers' Compensation's 2010 Annual Report
This report, as required by §287.680 RSMo, briefly describes each of the programs and units and summarizes the transactions and proceedings undertaken for the year 2010.

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Forms

Employers Insurers and Third Party Administrators (TPAs)
Attorneys
Injured Workers
Healthcare Providers
Line of Duty Compensation Benefits
Religious Exception
Physical Rehabilitation
Second Injury Fund Surcharge
Self-Insurance
Tort Victims

Employers Insurers and Third Party Administrators (TPAs)

Workers' Compensation (WC-106 Letter)
Roles and responsibilities for Employers and Employees; required in workplace.
Workers' Compensation (WC-106 Tabloid)
Roles and responsibilities for Employers and Employees; required in workplace.
EDI & Web-enabled Filings
Report of Injury (WC-1-EDI)
A form to be completed by the insurance company or third party administrator in the event of worker injury or death.
Electronic Partnering/Confidentiality Agreement (FROI) (WC-250)
A form to be completed by the employer/insurer regarding the electronic filing of First Reports of Injury.
Electronic Data Interchange (EDI)
EDI Missouri Specific Requirements (WC-EDI-206)
Missouri specific requirements to supplement the International Association of Industrial Accident Boards and Commission (IAIABC) Electronic Data Interchange.
EDI Secure File Transfer Protocol (FTP) (WC-EDI-207)
Information regarding the secure file transfer protocol (FTP) for the transmission of electronic data interchange (EDI) transactions.
EDI Project Agreement (WC-EDI-210)
A form for self-insured, self-administered employers, insurance companies or third-party administrators regarding electronic data interchanges (EDI) project agreement.
EDI Receivers Specifications (WC-EDI-256)
A Missouri electronic transmission profile receiver's specifications.
EDI Senders Response (WC-EDI-257)
A transmission profile- sender's response.
EDI Master Trading Partner Profile (WC-EDI-213)
A profile of the master trading partner including contact information.
EDI Sender Trading Partner Profile - List of Insurers (WC-EDI-260)
A list of insurers for a sender's trading partner profile
EDI Sender Trading Partner Profile (WC-EDI-261)
A sender's trading partner profile.
EDI Missouri Data Dictionary (WC-EDI-219)
A dictionary of Missouri IAIABC data definitions.
EDI File Matrix (WC-EDI-262)
EDI File Matrix, IAIBC release first report of injury.
EDI Cause of Injury, Nature of Injury and Body Parts Codes
Definitions for workers compensation injuries- injury codes, definitions for parts of body codes, definitions for nature of injury codes, and occupational disease or cumulative injuries.
International Association of Industrial Accident Boards and Commissions
Link to International Association of Industrial Accident Boards and Commissions' site

Web Enabled Filings

Supplemental Reports to be Filed
Notice of Commencement/Termination of Compensation Spreadsheet (WC-2)
A notice of commencement/termination of compensation to be filled out by a self-insured/self-administered employer, insurance company, or third party administrator.
Notice of Commencement/Termination of Compensation (WC-2)
A notice of commencement/termination of compensation to be filled out by a self-insured/self-administered employer, insurance company, or third party administrator.
Medical Treatment Form (WC-9)
A form to be completed by a physician when treating a worker involved in a workers' compensation claim.
Answer to Claim For Compensation (WC-22)
A form to be completed by the employer, attorney for employer/insurer/Third-Party Administrator, or Missouri Attorney General’s Office when filing an Answer to a claim for workers’ compensation.  This Answer form is to be used for injuries occurring prior to January 1, 2014.   
Answer to Claim for Compensation (WC-22-A)
A form to be completed by the employer, attorney for employer/insurer/Third-Party Administrator, or Missouri Attorney General’s Office when filing an Answer to a claim for workers’ compensation.  This Answer form is to be used for injuries occurring on or after January 1, 2014, based upon the revisions to the Workers’ Compensation Law made by Senate Bill 1.
Physicians Report on Eye Injuries (WC-241)
A form to be completed by physician examining a workers compensation eye injury.
Docketing & Adjudication
Stipulation for Compromise Settlement (WC-G-11)
A form submitted to an Administration Law Judge for approval of the settlement of a workers' compensation case.
Request for Conference (WC-182)
Request to DWC for conference regarding workers’ compensation case.
Request for Pre-Hearing (WC-183)
Request to DWC for a pre-hearing regarding workers compensation claim.
Request for Mediation (WC-184)
Request to DWC for a mediation regarding workers compensation claim.
Other Forms
Disability Schedule and Benefit Limits (WC-110)
A visual chart showing the number of weeks of compensation payable for permanent partial disabilities.
Affidavit of Exemption for Workers' Compensation Insurance (WC-134)
An affidavit that construction industry business owners who are not required to purchase workers’ compensation insurance may use to aid them in obtaining business licenses from some cities and counties.  Note: This form should not be sent to the Division of Workers’ Compensation.
Authorization to Inspect and/or Copy Medical Records (WC-43-AI)
An authorization form to inspect and/or copy medical records pertaining to a workers’ compensation case.
Application for Review to the Labor and Industrial Relations Commission (MOIC-2567)
An application to have an award, decision or order reviewed by the LIRC.
Noncompliance Referral Form (WC-258)
Complete the form to report a business for not carrying workers' compensation insurance.

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Attorneys
Claim for Compensation (WC-21)
A form to be completed by the injured worker or by his or her attorney when making a claim for workers' compensation for injuries occurring prior to January 1, 2014.
Claim for Compensation (WC-21-A)
A form to be completed by the injured worker or by his or her attorney when making a claim for workers' compensation for injuries occurring on or after January 1, 2014, based upon the revisions to the Workers’ Compensation Law made by Senate Bill 1.
Answer to Claim For Compensation (WC-22)
A form to be completed by the employer, attorney for employer/insurer/Third-Party Administrator, or Missouri Attorney General’s Office when filing an Answer to a claim for workers’ compensation.  This Answer form is to be used for injuries occurring prior to January 1, 2014.   
Answer to Claim for Compensation (WC-22-A)
A form to be completed by the employer, attorney for employer/insurer/Third-Party Administrator, or Missouri Attorney General’s Office when filing an Answer to a claim for workers’ compensation.  This Answer form is to be used for injuries occurring on or after January 1, 2014, based upon the revisions to the Workers’ Compensation Law made by Senate Bill 1.
Authorization to Inspect and/or Copy Medical Records (WC-43-AI)
An authorization form to inspect and/or copy medical records pertaining to a workers’ compensation case.
Disability Schedule and Benefit Limits (WC-110)
A visual chart showing the number of weeks of compensation payable for permanent partial disabilities.
Entry of Appearance (WC-235)
A form for an attorney to make an entry of appearance in a workers' compensation case.
Motion for Leave to Withdraw (WC-236)
A motion to withdraw an attorney in regards to a workers' compensation case.
Substitution of Counsel (WC-237)
A request for substitution of counsel in a workers' compensation case.
Application for Review to the Labor and Industrial Relations Commission (MOIC-2567)
An application to have an award, decision or order reviewed by the LIRC.
Stipulation for Compromise Settlement (WC-G-11-AI)
A form submitted to an Administration Law Judge for approval of the settlement of a workers' compensation case.
Request for Conference (WC-182)
Request to DWC for conference regarding workers’ compensation case.
Request for Pre-Hearing (WC-183)
Request to DWC for a pre-hearing regarding workers compensation claim.
Request for Mediation (WC-184)
Request to DWC for a mediation regarding workers compensation claim.
Request for Hearing-Hardship or Section 287.203 RSMo Hardship Hearing (WC-185)
Request to DWC for a hardship hearing regarding workers compensation claim.
Request for Hearing-Final Award (WC-186)
Request to DWC for a final award hearing regarding workers compensation claim.
Missouri Docket Map (PDF)
Map of Missouri Docket Locations
Docket Locations Directory (WC-266)
Directory of Missouri Docket locations and addresses.
Joint Motion for Change of Venue (WC-281)
This form allows attorneys that are parties to a case to jointly submit a motion for change of venue.  All parties must agree to the change of venue. 
Medical Fee Disputes
Application for Direct Payment (WC-MD-01)
A form for use by a health care provider to apply for direct payment in regards to a workers' compensation medical fee dispute—if the health care provider believes that it can show that it was authorized to treat the employee but no payment has been made.
Application for Payment of Additional Reimbursement of Medical Fees (WC-MD-02)
A form for use by health care provider applying for payment of additional reimbursement of medical fees in a workers’ compensation medical fee dispute —if a partial payment has been made. (These are called “reasonableness” cases.)
Application for Evidentiary Hearing (WC-MD-03)
A form for use by a health care provider, an employer or an insurer to request an evidentiary hearing in regards to a workers’ compensation medical fee dispute.
Request for Dismissal of Application for Payment of Additional Reimbursement of Medical Fees (WC-MD-05)
A form for use by a health care provider requesting the dismissal of an application for payment of additional reimbursement of medical fees in a workers’ compensation “reasonableness” medical fee dispute.
Request for Dismissal of Application for Direct Payment (WC-MD-10)
A form for use by a health care provider requesting the dismissal of an application for direct payment in a workers’ compensation medical fee dispute.
Request by a Health Care Provider for Case Status Information to file a Medical Fee Dispute Application (WC-194)
A form for use by health care provider to determine case status information to file a medical fee dispute application.
Answer to Application for Payment of Additional Reimbursement of Medical Fees (WC-198)
A form to be completed by the employer or insurer responding to the application for payment of additional reimbursement of medical fees (a “reasonableness” case).
Answer to Application for Direct Payment (WC-199)
A form to be completed by the employer or insurer responding to the application for direct payment.
Entry of Appearance (WC-200)
A form for an attorney to enter his or her appearance in a workers' compensation medical fee dispute.
Request for Award on Undisputed Facts in Regard to Application for Direct Payment (WC-201)
A request by an employer or insurer for an award on undisputed facts in regard to application for a direct payment medical fee dispute.
Health Care Provider's Response to Request for Award on Undisputed Facts in Regard to Application for Direct Payment (WC-202)
A health care provider’s response to a request for an award on undisputed facts in regard to an application for direct payment medical fee dispute.
Request for Award on Undisputed Facts in Regard to Application for Payment of Additional Reimbursement of Medical Fees (WC-297)
A request by an employer or insurer for an award on undisputed facts in regard to application for payment of additional reimbursement of medical fees on the ground that the Application was not filed within the limitation period set forth in §287.140.4, RSMo, or that the charges were paid in full or any ground that negates liability for payment.
Application for Administrative Ruling (WC-214)
A form which may be completed by a health care provider, an employer or insurer in a “reasonableness” medical fee dispute where the amount in dispute does not exceed $1,000.
Forms for Subpoenas
Workers' Compensation Subpoena (WC-25-AI) (Fillable and Printable)
A subpoena for a workers compensation case requiring the attendance of an individual at a hearing.
Workers' Compensation Subpoena Duces Tecum (WC-25-A-AI) (Fillable and Printable)
A subpoena for a workers compensation case requiring the attendance of an individual—along with specified documents or other evidence—at a hearing.
Workers' Compensation Subpoena For Deposition (WC-25-B-AI) (Fillable and Printable)
A subpoena for a workers compensation case requiring the attendance of an individual at a deposition.
Workers' Compensation Subpoena Duces Tecum For Deposition (WC-25-C-AI) (Fillable and Printable)
A subpoena for a workers compensation case requiring the attendance of an individual—along with specified documents or other evidence—at a deposition.

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Healthcare Providers

Medical Fee Disputes
Application for Direct Payment (WC-MD-01)
A form for use by a health care provider to apply for direct payment in regards to a workers' compensation medical fee dispute—if the health care provider believes that it can show that it was authorized to treat the employee but no payment has been made.
Application for Payment of Additional Reimbursement of Medical Fees (WC-MD-02)
A form for use by health care provider applying for payment of additional reimbursement of medical fees in a workers’ compensation medical fee dispute —if a partial payment has been made. (These are called “reasonableness” cases.)
Application for Evidentiary Hearing (WC-MD-03)
A form for use by a health care provider, an employer or an insurer to request an evidentiary hearing in regards to a workers’ compensation medical fee dispute.
Request for Dismissal of Application for Payment of Additional Reimbursement of Medical Fees (WC-MD-05)
A form for use by a health care provider requesting the dismissal of an application for payment of additional reimbursement of medical fees in a workers’ compensation “reasonableness” medical fee dispute.
Request for Dismissal of Application for Direct Payment (WC-MD-10)
A form for use by a health care provider requesting the dismissal of an application for direct payment in a workers’ compensation medical fee dispute.
Request by a Health Care Provider for Case Status Information to file a Medical Fee Dispute Application (WC-194)
A form for use by health care provider to determine case status information to file a medical fee dispute application.
Answer to Application for Payment of Additional Reimbursement of Medical Fees (WC-198)
A form to be completed by the employer or insurer responding to the application for payment of additional reimbursement of medical fees (a “reasonableness” case).
Answer to Application for Direct Payment (WC-199)
A form to be completed by the employer or insurer responding to the application for direct payment.
Entry of Appearance (WC-200)
A form for an attorney to enter his or her appearance in a workers' compensation medical fee dispute.
Request for Award on Undisputed Facts in Regard to Application for Direct Payment (WC-201)
A request by an employer or insurer for an award on undisputed facts in regard to application for a direct payment medical fee dispute.
Health Care Provider's Response to Request for Award on Undisputed Facts in Regard to Application for Direct Payment (WC-202)
A health care provider’s response to a request for an award on undisputed facts in regard to an application for direct payment medical fee dispute.
Request for Award on Undisputed Facts in Regard to Application for Payment of Additional Reimbursement of Medical Fees (WC-297)
A request by an employer or insurer for an award on undisputed facts in regard to application for payment of additional reimbursement of medical fees on the ground that the Application was not filed within the limitation period set forth in §287.140.4, RSMo, or that the charges were paid in full or any ground that negates liability for payment.
Application for Administrative Ruling (WC-214)
A form which may be completed by a health care provider, an employer or insurer in a “reasonableness” medical fee dispute where the amount in dispute does not exceed $1,000.

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Religious Exception

Employees and employers who wish to learn more about the exemption from the Missouri workers' compensation law because of religious reasons should read and heed all five of the following forms:

Religious Exception Information (WC-138-A)
Information regarding employees who wish to be exempt from workers' compensation law because of religious reasons.
Religious Exception Application and Affidavit Instructions (WC-138-7)
Instructions for completing the application, affidavit and waiver of workers compensation benefits.
Employee's Application for Religious Exception (WC-138)
The form to be completed by an employee request to be exempt from workers' compensation due to religious reasons.
Employee's Religious Exception Affidavit and Waiver (WC-138-3)
The affidavit to be completed by an employee request to be exempt from workers' compensation due to religious reasons.
Employer's Affidavit for Religious Exception (WC-138-5)
The affidavit to be completed by an employer when requesting for an employee to be exempt from workers' compensation due to religious reasons.

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Physical Rehabilitation
Physician's Rehabilitation Information Sheet (WCR-1A)
A form to be completed by the insurance carrier regarding the eligibility of an injured worker for the physical rehabilitation benefit available through the Second Injury Fund.
Verification of Rehabilitation Treatment (WCR-4A)
A form to be completed by a health care provider in regards to verifying rehabilitation treatment.
Bi-Weekly Report on Physical Rehabilitation (WCR-5A)
A bi-weekly form to be completed by the healthcare provider to provide dates of physical rehabilitation treatments for an injured worker eligible for the physical rehabilitation benefit through the Second Injury Fund.
Report of Serious Injury Referral Form (WCR-6)
A form to be completed by any party to refer a seriously injured worker who may possibly qualify for physical rehabilitation benefits through the Second Injury Fund.
Eligibility Guidelines for Physical Rehabilitation (WCR-7)
A form outlining eligibility guidelines for the Second Injury Fund.
Request for Certification of Rehabilitation Providers (WCR-8)
A form to be completed by a health care provider requesting certification as a rehabilitation facility.

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Second Injury Fund Surcharge
Affidavit of Zero Reporting - Commercial Insurers Only (WC-240)
An affidavit of zero reporting may be completed by insurance carriers authorized to write workers’ compensation policies in Missouri but not writing workers’ compensation policies for the calendar year.
Memorandum to Commercial Insurers (WC-240-3)
A memo regarding the affidavit of zero reporting for commercial insurers.
Electronic Partnering/Confidentiality Agreement (Second Injury Fund Surcharge) (WC-276)
A form to be completed by the employer/insurer regarding the electronic filing of the quarterly Second Injury Fund Surcharge Report Forms.
Electronic Fund Transfer Enrollment Form (WC-132)
This form must be used by the Workers' Compensation Insurance Carriers, the Self-Insured Employers and the Self-Insured Groups or trusts who would like to make Second Injury Fund surcharge payments to the Missouri Divison of Workers' Compensation through an Electronic Fund Transfer.

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Self-Insurance

Individual Forms
Application
Application for Authority to Self-Insure (WC-81)
The application to be completed by an employer applying to individually self-insure.
Checklist for Individual Self-Insurance Applications (WC-128)
The checklist of required items and information that must accompany the Application for Authority to Self-Insure (WC-81).
Auditing Procedures for Applicants for Individual Self-Insurance (WC-130-AI)
The safety auditing procedures for those employers applying to individually self-insure.
Security
Bond of Employer Carrying His Own Risk (WC-82B)
A Surety Bond; one of three options available to meet the self-insurance security requirement.
Escrow Agreement (WC-82E)
An Escrow Agreement; one of three options available to meet the self-insurance security requirement.
Irrevocable Letter of Credit (WC-249)
An Irrevocable Letter of Credit; one of three options available to meet the self-insurance security requirement.
Authorization for Release of Confidential Information (WC-249-3)
An authorization for release of confidential information that must accompany the Irrevocable Letter of Credit (WC-249).
Affidavit for Security Release (WC-264)
A sample affidavit for former self-insured employers requesting release of security.
Miscellaneous
Statement of Specific and Aggregate Excess Insurance Coverage (WC-121)
Proof of initial, renewal, or changes to specific and aggregate Missouri only excess insurance coverage.
Guaranty to Satisfy Compensation Claims Under Workers’ Compensation Law of Missouri (WC-82A)
A guaranty of a third party to satisfy an individually self-insured employer’s workers’ compensation obligations under Missouri law.
Annual Reports
Individual Self Insured Employer Information Sheet (WC-131)
Current contact information to be submitted by self-insured employers on an annual basis and as needed.
Self-Insurer’s Statement of Outstanding Losses (WC-83)
An annual report of an individually self-insured employer’s outstanding losses.
Self-Insurer’s Payroll Report (WC-84)
An annual report of an individually self-insured employer’s Missouri payroll by class code and employee count by Missouri location.
Self-Insurer’s Annual Financial Statement (WC-85)
An annual report of an individually self-insured employer’s audited financial statements.
Self-Insurer’s Report of Compensation Payments (WC-86)
An annual report of an individually self-insured employer’s Missouri compensation payments for the prior calendar year.
Group Forms
Trust Application
Application for Group Self-Insurance (WC-81A)
The application to be completed by a group of employers applying to form a self-insured group trust.
Self-Insured Trust Safety Program Initial Certification Procedures (WC-129-AI)
Certification procedures for a self-insured group trust’s safety program.
Self-Insurance By-Laws - Sample (WC-238)
A sample of by-laws that may be used as a reference when forming a new group trust.
Indemnity (Trust) Agreement (WC-267)
A sample indemnity agreement that may be used as a reference when forming a new group trust.
Group Insurance Checklist (WC-239)
The checklist of required items and information that must accompany the Application for Self-Insurance Trust (WC-81A).
Member Application
Application for Membership (WC-81B)
Form to be used by employers applying for membership in a group trust.
Group Trust New Member Application Checklist (WC-269)
The checklist of required items and information that must accompany the Application for Membership (WC-81B).
Security
Bond of Employer Carrying His Own Risk (WC-82B)
A Surety Bond; one of three options available to meet the self-insurance security requirement.
Escrow Agreement (WC-82E)
An Escrow Agreement; one of three options available to meet the self-insurance security requirement.
Irrevocable Letter of Credit (WC-249)
An Irrevocable Letter of Credit; one of three options available to meet the self-insurance security requirement.
Authorization for Release of Confidential Information (WC-249-3)
An authorization for release of confidential information that must accompany the Irrevocable Letter of Credit (WC-249).
Trust Annual Reports
2013 Annual Report/Claim Development Reports (WC-135)
A report to be completed annually by a self-insured group trust.
Rate Filing and Surplus Request
Proposed Rates for Group Trust Self-Insurance (WC-127)
A form to submit proposed rates for a self-insured group trust.
Surplus Distribution Request (WC-265)
A form requesting authority to distribute surplus monies of a self-insured group trust.
Miscellaneous
Group Trust Member Information Update (WC-270)
A form used to report a group trust members name and/or address change.
Statement of Specific and Aggregate Excess Insurance Coverage (WC-121)
Proof of initial, renewal, or changes to specific and aggregate Missouri only excess insurance coverage.
Trust Quick Reference Due Dates (WC-193)
A quick reference for group trust reporting requirements.

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Tort Victims

The Tort Victims’ Compensation Fund exists to help compensate those who have been injured due to the negligence or recklessness of another (such as in a motor vehicle collision or a hunting accident), and who have been unable to obtain full compensation because the part at fault (the “tortfeasor”) had no insurance, or inadequate insurance, or has filed for bankruptcy, or for other reasons specified by the law.

Application for Tort Victims' Compensation (WCT-1)
An application for tort victims compensation.
Questions and Affidavit Regarding Benefit Sources and Payments - Affidavit Form A (WCT-2)
Questions and affidavit for claimant regarding benefit sources and payments, form A.
Questions and Affidavit Regarding Lost Income - Affidavit Form B (WCT-3)
Questions and affidavit for claimant regarding lost income, form B.
Questions and Affidavit Regarding Waiver of Final Judgment and Requirement - Affidavit Form C (WCT-4)
Questions and affidavit for claimant regarding waiver of final judgment and requirement, form C.
Questions and Affidavit Regarding Due Diligence in Enforcing the Judgment - Affidavit Form D (WCT-5)
Questions and affidavit for claimant regarding due diligence in enforcing the judgment, form D.
Questions and Affidavit Regarding Completeness of Medical Information Submitted - Affidavit Form E (WCT-6)
Questions and affidavit for claimant regarding completeness of medical information submitted, form E.

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Workers' Safety Program

Request for Services from the Missouri Workers' Safety Program (WSP-6)
A form requesting services from a workers' compensation program or the Missouri workers' safety program.
Application for Certification - Safety Consultant/Safety Engineer (WSP-10)
A form application for certification for a safety consultant or safety engineer.
Annual Certification Renewal - Safety Consultant/Safety Engineer (WSP-11)
An annual renewal for certification for a safety consultant or safety engineer.
Application for Certification (WSP-45)
An application for certification by an insurance carrier writing workers' compensation in the state of Missouri.

Labor and Industrial Relations Commission

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.
Form 8-C Notice of Appeal (8-C)
An appeal filed to the Missouri Court of Appeals.
Unemployment Insurance Application for Review (L-6)
An application to have a decision of an Appeals Tribunal of the Division of Employment Security reviewed by the Labor and Industrial Relations Commission.
8-B Unemployment Insurance Notice of Appeal (Fillable and Printable) (8-B)
A notice of appeal to the Missouri Court of Appeals.
Instructions for completing the Form 8-B (8-B Instructions)
Instructions on how to complete form 8-B.
Tort Victim Petition for Review to the LIRC (T-2568)
A petition for review by the LIRC of a decision made by a workers compensation administrative law judge.
Workers' Compensation Application for Review to the LIRC (MOIC-2567)
An application to have an award, decision or order reviewed by the LIRC.

Missouri Commission on Human Rights

Required Posters
Brochures
Forms

Required MCHR Posters

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.

Brochures

Know Your Rights - Discrimination Training & Education (MCHR-39)
A brochure covering discrimination education and training offered by MCHR.
Fair Housing - Promoting Discrimination-Free Neighborhoods (MCHR-41)
A guide on the fair housing rights and responsibilities of homeowners, landlords, and those looking to purchase or rent a home or apartment.
Fighting Discrimination (MCHR-42)
Learn about the laws the protect you from discrimination in the workplace, in a place of public accommodation, or while buying or renting a house or apartment and what to do if you have been a victim of discrimination.
 
Fair Housing: Disability and Families (MCHR-51)
Discrimination in housing rental, sales, and lending is prohibited by state and federal laws. This brochure details the fair housing protections offered specifically to persons with disabilities and families (households with a child under the age of 18).
Fair Housing Consumer Guide (MCHR-53)
In this informational brochure find out about your fair housing rights.

Forms

Complaint Intake Questionnaire - Employment (MCHR-44)
An intake questionnaire regarding employment complaints.
Complaint Intake Questionnaire - Public Accommodations (MCHR-45)
An intake questionnaire regarding public accommodations complaints.
Complaint Intake Questionnaire - Housing (MCHR-46)
An intake questionnaire regarding housing complaints.

State Board of Mediation

Petition Form (SBM-06)
Petition form for the State Board of Mediation along with instructions for completing the petition.
Showing of Interest Signature Form (SBM-09)
A list to be completed by employees naming their exclusive bargaining representative.
Showing of Interest Signature Form - Decertification Petition Only (SBM-10)
A list to be completed by employees decertifying their exclusive bargaining representative.

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Folletos en Español (Spanish Brochures)

Departamento de Trabajo Folleto (MODOL-INF-28-S)
Un folleto informativo esbozar el departamento de Missouri de Trabajo y cuáles son sus responsabilidades y tareas que son, así como las áreas que lo supervisa.
Lo que necesita saber sobre el Seguro por Desempleo de Missouri (MODES-INF-170-S)
Aspectos básicos del seguro de desempleo, información de contacto para DES y una lista de centros profesionales.
Para tramitar beneficios de Seguro por Desempleo en Missouri (MODES-INF-288-5-S)
Datos básicos y los procedimientos para la presentación del seguro de desempleo.
Aviso a los trabajadores sobre las prestaciones por desempleo (MODES-B-2-S)
Un cartel para colgar en un lugar de trabajo notificar a los empleados sobre los beneficios de desempleo.
Reclamaciones de Seguro por Desempleo (MODES-INF-353)
Cómo presentar para el desempleo.
¿Está usted Fuerade Nómina? Fraude del 1099 - Clasificación Errónea de trabjadores (MODES-4714-S)
Información relacionada con el fraude 1099 - clasificación errónea de los trabajadores, incluidas las consecuencias, en línea de evaluación y reporte de propinas.
Salario Minimo para Missouri (LS-52-S)
Cartel para colgar en el lugar de trabajo a Missouri salario mínimo.
Jóvenes en el empleo - Las leyes de Missouri protegen a los trabajadores jóvenes (LS-56-S)
Un recurso para ayudar a entender las leyes relativas a los jóvenes en la fuerza laboral.
Datos para Trabajadores Lesionados (WC-101-S)
Un folleto delineando hechos para los trabajadores lesionados en materia de indemnización de los trabajadores en Missouri.
Ley sobre Indemnización al Trabajador (WC-106-S Letter)
Funciones y responsabilidades de los empleadores y los empleados (Letter tamaño)
La Discriminación en la Vivienda Está Prohibida (MCHR-6)
Un cartel sobre la discriminación en materia de vivienda: requerido.
La Discriminación en los Lugares Públicos Está Prohibida (MCHR-7)
Un cartel sobre la discriminación en lugares públicos: requerido.
La Discriminación en el Empleo Está Prohibida (MCHR-9)
Un cartel sobre la discriminación en el empleo, es necesario.
Conozca sus Derechos Capacitacion y orientatcion sobre la discriminacion (MCHR-39-S)
Un folleto de la discriminación que abarque la educación y la formación ofrecida por MCHR.
Vivienda Justa - La promoción de vecindarios libres de discriminación (MCHR-41-S)
Guía sobre cómo prevenir la discriminación en la vivienda para propietarios, arrendadores y quienes busquen comprar o alquilar una casa o apartamento.
Vivienda Justa - Guía del Consumidor (MCHR-53-S)
En este folleto informativo averiguar acerca de sus derechos de vivienda justa.
Aviso sobre la Ley de Ausencia Familiar y Médica
Cartel del Salario Federal Minimo bajo la Ley de Normas Justas de Trabajo