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Workers Compensation FAQ

Note: If you are having a problem with a workers compensation claim, medical fee dispute or self-insurance, please contact the Division of Workers Compensation:

Employees: (800) 775-2667
Employers: (888) 837-6069

Construction Employers--You may be able to get a credit on your premiums! Check out the Contractors Credit Premium Adjustment Program page for more information.

To receive a paper copy of this information, please click here.

General Issues

Policy Issues

Contractor Issues

What is workers' compensation?
Workers compensation is a state-mandated, "no-fault" insurance system that pays benefits to workers injured on the job to cover medical care, part of lost wages and permanent disability. In return, employers receive immunity from civil lawsuits by employees over such workplace injuries.

Employers can meet their workers compensation obligation by purchasing insurance or by becoming a state-certified self-insurer.

Missouri's law, originally enacted in 1925, is available at your public library or on the internet.
What state agencies administer the workers compensation system?
The Division of Workers Compensation of the Department of Labor and Industrial Relations oversees the day-to-day operation of the system.  The division receives notifications from employers that they obtained coverage and reports of injuries from employers and insurers.  It also mediates disputes over benefits.  It monitors insurance company safety programs and investigates allegations of fraudulent claims.  Employers can call the division toll free at 1-888-837-6069.

DIFP reviews and approves workers compensation insurance policy forms and rules.  It also monitors workers compensation market competitiveness and oversees the "assigned risk pool" to ensure fair rates and good service. Contact a workers’ compensation specialist toll free at 1-800-394-0964.
Does an employer have to carry workers comp insurance?
Generally, "yes," but there are exceptions. As a general rule, firms with five or more employees must be covered, although contractors with even one employee must also buy coverage. It is important to note that Missouri law does not distinguish between employees of different employment statuses. The statutory definition of "Employee" includes both full and part-time employees, seasonal and even temporary employees.

The Workers' Compensation Act does exempt a very small and very specific group of employees, which includes farm laborers, domestic servants, certain real estate agents and direct sellers and commercial motor-carrier owner-operators.

Sole proprietors and partners are not themselves covered unless they elect to be covered. On the other hand, close family member-employees and members of limited liability companies are presumed to be covered unless they opt out.

Employers that don't have the required number of employees or who have employees in the exempt categories may nevertheless "elect" to come under the law. Exempt employers that decide not to purchase workers compensation insurance or to self-insure remain exposed to civil lawsuits brought by employees who are injured during work.

Interested parties who desire further clarification of these requirements or need direction as to their specific business obligations may contact the Division of Workers' Compensation at 573.751.4231 or toll-free at 888.837.6069.

How do I obtain coverage?
You can purchase workers compensation insurance from a private insurer or, if you can meet the requirements of the Division of Workers Compensation, you can self-insure as an individual business or as a member of a self-insured group.

For employers seeking help finding competitively priced insurance, DIFP has developed an on-line rate checker to give the rates for all carriers. 
You will need to have your 4-digit job classification codes ready.

If you cannot find an insurance company that will sell you workers compensation insurance, you may buy coverage from the state's "assigned risk pool," now operated by Travelers Commercial Casualty Company. Its toll free number is 1-800-842-9346.

If you are seeking certifications as a self-insured employer or joining a self-insured group of employers, contact the Division of Workers' Compensation at 1-573-526-6004.
What benefits do injured workers receive from my workers compensation policy?
Besides medical treatment your employee may receive temporary total disability payments of up to 2/3 of his or her average weekly wage after missing three days of work.  If the employee is off work more than 14 days, the employee then is paid for the first three days of work missed.

Additional payments are required if the employee has a permanent impairment (e.g., loss of a finger) or cannot return to work.  If the injury results in death, benefits are paid to the employee's survivor dependents.
What are my responsibilities as an employer under the workers compensation law?
Maintaining coverage
Failure to provide required coverage is a class A misdemeanor with a penalty equal to three times the annual premium you should have paid, up to $50,000. You also are liable for the costs of any injuries suffered by your employees. A second violation results in a class D felony.

Posting of notice
You must post information identifying your insurance carrier or claim administrator in a conspicuous place so your employees know whom to contact if an injury occurs. You can get a copy of the notice from your insurer or from the Division of Workers Compensation.

Immediate medical care
You must provide immediate medical care for any injured employees. If your employee misses no time from work and all medical bills total less than $1,000, you may pay the bill yourself. You must still notify your insurance company and the Division of Workers' Compensation, but the cost of these "medical only" claims are not included in your experience modification factor.

Injury reporting
You must notify your insurance company as soon as possible after an injury occurs. You must report the injury to the Division of Workers Compensation within 30 days of the incident. Usually your insurer will report for you. Knowingly failing to report an accident is a misdemeanor. For questions about the reporting form, call the division at 1-573-522-1963.
How is workers compensation insurance priced?
Since Jan. 1, 1994, Missouri insurance companies have set rates without approval of DIFP.  Generally, insurance companies base their rates on loss data on each job classification code compiled by the National Council on Compensation Insurance (NCCI).  The NCCI is also responsible for maintaining the job-classification code system and administering the experience rating plan.  The NCCI can be reached at 1-800-622-4123 or via their Web site.
What is an 'experience mod'?
The NCCI calculates your experience modification factor by comparing your actual loss experience to your expected loss experience over the past three years.  If your losses are lower than expected, your experience mod should be less than 1.00, which will reduce your premium.  If you have higher-than-expected losses for your industry, your experience mod should be greater than 1.00, and you will be charged additional premium.

Your policy must cost more than $7,000 for one year or $3,500 for two consecutive years to qualify for experience rating.
What is schedule rating?
Schedule rating allows insurance companies to adjust an employer's premium for the unique characteristics of your operations, based on a schedule filed with DIFP. Each insurance company's plan is different, but you should receive notice of any schedule rating credits or debits that apply to your policy. The maximum debit/credit allowed in Missouri is 25 percent of premium.  If you think your company has inappropriately removed a credit, increasing the cost of your coverage, call the department at 1-800-394-0964.
As an employer, how can I help reduce the cost of my workers compensation coverage?
  • If you have any doubts, make sure you are required to have coverage in the first place by calling the Division of Workers' Compensation.
  • Check your policy to make sure the job classifications and payroll of your employees are listed correctly.  There is a huge difference between the premium associated with, for example, a clerical worker and a heavy-equipment operator.
  • Shop around.  Also, review your selection every couple of years, or whenever a large rate increase appears on your renewal notice. And don 't overlook using an independent insurance agent (who represents a number of companies) in your search.
  • Keep in mind the possibility of self-insuring or joining a self-insured group.
  • If you 're not large enough to justify self-insuring, consider Missouri Employers Mutual Insurance Company, which was created by state law to provide a competitive source of coverage specifically for smaller businesses.  Since its beginnings in 1995, MEM has become the state 's largest workers compensation insurer.
  • Make the investment necessary in workplace safety to avoid accidents, improve claims histories and lower costs.  Modify operating procedures that unnecessarily expose workers to injury.
  • Consider using a managed care organization that has a working relationship with your insurer to help save on medical treatment costs.
  • Establish a modified duty program to help return workers to productive employment even when they cannot return to their prior jobs.  Doing so can reduce the losses that raise your experience mod.
  • Consider paying medical-only claims of $1,000 or less to avoid increasing your experience mod.Ask your insurer for "loss runs " to see when and where your injuries are occurring and how much they are costing. Also, keep abreast of your company 's handling of all open claims. Make sure your company is acting in your long-term interests.
What is the assigned risk market (also referred to as the "alternative residual market ") and why do I have to be in it?
The assigned risk market is a mechanism that has been set up to ensure that employers can obtain workers ' compensation coverage if they are in good faith entitled to workers ' compensation coverage, but cannot secure such coverage through ordinary means.  Many employers are in this market because they are engaged in an inherently risky industry, have bad loss experience, are too small and/or are just starting a new business.

Policy Issues:

Does workers compensation cover sole proprietors, partners and corporate officers?
Sole proprietors and partners are considered employers, not employees, and are not covered by your policy. However, sole proprietors and partners can be added to the policy by endorsement. As of 7/01/2008 payroll for all sole proprietors and partners will be assessed at $22,200 per year.

Corporate officers are considered employees of the corporation and must be covered. An exception is made for corporations when there are no more than two owners of the corporation who are also the only employees of the corporation.

Currently, payroll for corporate officers is based on actual payroll, subject to a minimum of $426.92 per week and a maximum of $500 per week. Under current rules, LLC members (if they have not individually rejected coverage pursuant to Section 287.037 RSMo.) are treated as corporate officers for premium computation purposes.
My company is a limited liability company. Are the LLC members covered?
Limited liability company members are covered by your workers compensation policy unless they specifically state they do not wish to be covered, using a special endorsement to your policy. Your insurer can provide you with this endorsement.
Does workers compensation cover my family members?
As of August 28, 1998, family members of sole proprietors and partners are covered unless they are specifically excluded on an endorsement (NCCI form WC 00 03 08, Partners, Officers and Others Exclusion Endorsement). However, even if family members are excluded, they are still counted towards the number of employees to determine if you are required by law to carry workers compensation insurance. This provision does not, however, apply to family members of LLCs or corporations.
What are all these adjustments on my policy?
There may be many additional adjustments to your base premium, such as:
All of these adjustments are made to determine your final premium due to the insurer.

If you are not sure about an adjustment, you should call your agent or insurer and ask them to explain the adjustment.
I have a dispute with my insurer regarding my classification, experience modification or interpretation of NCCI rules that are not addressed by department rule or regulation. How do I resolve this?
As with any dispute, you should first try to resolve the problem with your insurer. If you find that you are not getting a satisfactory resolution and you still feel that your position is valid, then you should contact the Insurance Consumer Service Section at 1-800-726-7390 and file a formal complaint. The Department will try to resolve the problem, but if this is not possible and you are still not satisfied, then you can make an appeal to the Missouri Workers' Compensation Determinations Review Board by contacting the Property and Casualty Section at 1-573-751-3365.

Contractors Issues:

How do I know if I am in the construction industry?
If your company erects, demolishes, alters or repairs any structure, you are in construction. This includes earthmovers, concrete contractors, equipment installers, carpenters, painters and telephone installers, to name just a few. See the list of construction classification codes on the Contractors Credit FAQ page.
I am not required by statute to carry workers compensation insurance, but my general contractor says I have to have it. Can he do this?
Yes, he can. Generally, the workers compensation statute says that the general contractor is liable for any injuries to uninsured subcontractors or their uninsured employees. Because of this, the general contractor 's insurer will charge additional premium if you cannot provide proof of coverage, even if you have no employees AND provide proof that you (as an owner) are also covered under the policy . If the general contractor says he won't hire you unless you have a policy and insure yourself, you will need to buy a policy covering your business or yourself or work for a general contractor who does not make this requirement.
What is the Contractors Credit Premium Adjustment Program?
The CCPAP is a program that allows contractors who pay high wages to receive a credit on their workers compensation premiums. See our CCPAP FAQ page for more information.