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 and employers: 800-775-2667

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.

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General issues

Policy issues

Contractor issues

General 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' comp 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Missouri's law, originally enacted in 1925, is available at your public library or online.

What state agencies administer the workers' comp 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 800-775-2667.

DIFP reviews and approves workers' comp insurance policy forms and rules. It also monitors workers' comp market competitiveness and oversees the "assigned risk pool" to ensure fair rates and good service. Contact a workers’ comp specialist toll-free at 800-394-0964 with questions about forms and rules approval or rate monitoring processes.

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, 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 buy workers' comp insurance or to self-insure remain exposed to civil lawsuits brought by employees who are injured during work.

Interested parties who want 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 800-775-2667.

How do I obtain coverage?
You can buy workers' comp 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 online rate checker to give the rates for all carriers. 
You will need to have your 4-digit job classification codes ready. If you do not know what your 4-digit code is, contact your insurance carrier or the NCCI for help with finding a class code that fits closest to your business operations. Call NCCI at 800-622-4123.
If you cannot find an insurance company that will sell you workers' comp insurance, you may buy coverage from the state's "assigned risk pool," now operated by Travelers Property Casualty Company of America, call 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 573-526-6004.

What benefits do injured workers receive from my workers' comp policy?
Besides medical treatment your employee may receive temporary total disability payments of up to two-thirds 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 (such as loss of a finger) or cannot return to work. If the injury results in death, benefits are paid to the employee's survivor dependents. Contact the Division of Workers' Compensation at 573-775-2667.

What are my responsibilities as an employer under the workers' comp 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 573-522-1963.

How is workers' comp insurance priced?
Since 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. The NCCI is also responsible for maintaining the job-classification code system and administering the experience rating plan. The NCCI can be reached at 800-622-4123 or online.

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.

The NCCI can be reached at 800-622-4123 or online.
 
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, you can file a complaint online or call Consumer Services at 800-726-7390. For general questions about how schedule rating is to be applied, contact a workers' comp specialist at 800-394-0964.
 
As an employer, how can I help reduce the cost of my workers' comp coverage?
  • If you have any doubts, first make sure you are required to have coverage by calling the Division of Workers' Compensation at 800-775-2667.
  • 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. If you need help determining a class code, contact the NCCI at 800-622-4123.
  • 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. An independent agent can be found in your area by checking your local phone directory.
  • 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 Co., 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' comp insurer. MEM can be reached at 800-442-0593.
  • 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. This 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 known 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' comp coverage if they are in good faith entitled to workers' comp 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. Travelers Property Casualty Company of America currently administers the assigned risk market and can be reached at 800-842-9346 (to obtain a quote, press “0” for an operator.

Policy issues

Does workers' comp 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.

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 by filing with the Division of Workers' Compensation, notice of election to be withdrawn. This form can be obtained online or by contacting the Division of Workers' Compensation at 800-775-2667.

Premium determination for executive officers, members of limited liability companies, partners and sole proprietors must be calculated using the following payroll amount:
Effective Jan. 1, 2013:  $36,900
Effective Jan. 1, 2014: $38,000
My company is a limited liability company. Are the LLC members covered?
Limited liability company employees and its members are to be covered by a workers’ comp policy. However, members may individually elect to reject coverage by providing a written notice to the insurance carrier and the employer specifically stating they do not wish to be covered. The written notice should be submitted in a rejection form that has been developed by the department and can be printed from this website.You may also obtain a copy from your insurer.

PLEASE NOTE: This form must be applied to an existing policy only. It is NOT considered an exemption from any coverage requirements. Pursuant to Section 287.030 RSMo., LLCs are included in the definition of employer. Under subsection (3), an employer with five or more employees must be covered; construction industry employers who erect, demolish, alter or repair improvements, although with even one employee must also buy coverage. As an employer, if all employees of the LLC are also members who plan to reject coverage, the LLC is still subject to coverage requirements under the Workers’ Compensation Act. The Division of Workers’ Compensation is the entity that regulates employer’s requirement to carry coverage and could provide guidance as to their interpretation of Missouri law if you are unsure of your obligations. It can be contacted at 800-775-2667.

Does workers' comp cover my family members?
As of Aug. 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 toward the number of employees to determine if you are required by law to carry workers' comp 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, ask your agent or insurer to explain it.

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 do not get a satisfactory resolution and you still think your position is valid, then you should file a formal complaint online or call the Insurance Consumer Services Section at 800-726-7390. 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 573-751-3365.

Contractor 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' comp insurance, but my general contractor says I have to have it. Can he do this?
Yes, he can. Generally, the workers' comp 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 require this.

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.