Missouri workers’ Compensation laws are complex and extensive. If you suffer from a workplace injury, you should always consult competent legal counsel who can help you navigate through the workers’ comp claim process.
The statutes often have strict requirements, and an injured worker’s compensation depends on properly complying with the same. If the proper paperwork or proper procedure is not followed, the employee could be left with no remedy.
Below is a general overview of Missouri Workers’ Compensation law as well as a description of occupational disease and how it applies to workers.
This information should be used merely as a resource to familiarize yourself with the Workers’ Comp process:
The information contained in this article and throughout this website should not construed as legal advice. The authors of this website make no representation as to the accuracy, completeness, or applicability of any of the information cited herein. This website does not create an attorney-client relationship.
Always consult with an attorney who can evaluate the specific facts of your case.
Table of Contents
Missouri Workers’ Compensation Law Generally
What are the first steps I should take after a Work Related Accident?
Employees should strongly consider hiring an attorney immediately after a work-related accident occurs. An employee has a short timeline to alert the employer in writing immediately after an injury occurs in the workplace.
An employee has up to 30 days to report from the time the accident occurred.
The applicable statutory section is R.S.Mo. § 287.420 and states the following in relevant part:
“No proceedings for compensation for any accident under this chapter shall be maintained unless written notice of the time, place and nature of the injury, and the name and address of the person injured, has been given to the employer no later than thirty days after the accident, unless the employer was not prejudiced by failure to receive the notice.” R.S.Mo. § 287.420 (2016).
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How is Accident Defined in the Workers’ Compensation Statutes?
Accident is defined as “an unexpected traumatic event or unusual strain identifiable by time and place of occurrence and producing at the time objective symptoms of an injury caused by a specific event during a single work shift.” R.S.Mo. § 287.020.2 (2016).
How is an Injury Defined in the Workers’ Compensation Statutes?
Injury is defined under the Workers’ Comp statutes as: “an injury which has arisen out of and in the course of employment” R.S.Mo. § 287.020.3(1) (2016).
The statute goes further by describing when an injury by accident is compensable: “only if the accident was the prevailing factor in causing both the resulting medical condition and disability.” R.S.Mo. § 287.020.3(1) (2016).
What is an Injury resulting from an Idiopathic Cause?
Idiopathic is defined as an illness or disease in which the cause is uncertain or undetermined.
Are Injuries resulting from an Idiopathic Cause Compensable?
No. In fact, Chapter 287 of the Missouri Revised Statutes, Worker’s Compensation Law, has a specific exclusion for injuries resulting from idiopathic causes. Thus, an injury for which there is no known cause or in which the cause is uncertain would fall under the category of an idiopathic injury and therefore would not qualify as a compensable injury under the Missouri Workers’ Comp Statutes.
The applicable statute plain and simply states: “An injury resulting directly or indirectly from idiopathic causes is not compensable.” R.S.Mo. § 287.020.3(3) (2016).
When does an injury arise out of the Course and Scope of Employment?
An injury arises out of the course and scope of employment when:
“(a) It is reasonably apparent, upon consideration of all the circumstances, that the accident is the prevailing factor in causing the injury; and
(b) It does not come from a hazard or risk unrelated to the employment to which workers would have been equally exposed outside of and unrelated to the employment in normal nonemployment life.” R.S.Mo. § 287.020.3(2) (2016).
Are there Special Rules for Reporting Occupational Disease or Repetitive Trauma Claims?
The date differs from an ordinary workplace accident in that the report needs to be made within 30 days from the date that the condition was diagnosed, rather than from the accident date. R.S.Mo. § 287.420 (2016).
What Happens if the Employee Fails to give Timely Notice of the Injury?
In such a case, the Employer can assert a lack of notice defense. If that happens, the employee has the burden of proving that the lack of notice or delayed notice did not prejudice the employer (or insurance company).
What are the Reasons for the Workers’ Comp Notice Statutes?
There are several reasons, but the following are the most important:
- Give the employer an opportunity to provide medical attention to the employee to mitigate damages;
- Expedite the resolution of any workers’ comp claims by prompting the employer to file an injury report with the Division of Workers’ Compensation;
- Gives the employer notice so that it can investigate the matter.
Filing a Workers’ Comp Claim
What is a Formal Claim in the Workers’ Compensation Context?
A formal claim is the document that institutes an employee’s claim with the Division of Workers’ Compensation. It could be compared to a petition in ordinary civil litigation.
It would be well-advised to seek counsel from an experienced attorney when completing the formal claim as it will serve as the framework of the employee’s workers comp claim. Additionally, the formal claim could be subpoenaed in collateral proceedings (i.e., against a liable third party). Thus, a wary attorney will make sure that the claim form is fully completed and that the elements are properly alleged.
A blank sample of the form is available at the Missouri Department of Labor’s website: www.labor.mo.gov/DWC/Forms/WC-21-AI.pdf
What is the Statute of Limitations on a Workers’ Comp Claim?
|Time Limit||Triggering Event|
|2 years||“within two years after the date of injury or death, or the last payment made under this chapter on account of the injury or death” R.S.Mo. § 287.430 (2016).|
|3 years||“[within three years of injury, death, or last payment] if the report of the injury or the death is not filed by the employer as required by section 287.380” R.S.Mo. § 287.430 (2016).|
*The statutes set out a nuance in the triggering event if the workers’ comp claim is for an occupational disease. See below for more information on the statute of limitations for occupational diseases.
Where do I mail a Completed Workers’ Compensation Claim Form in Missouri?
You should mail your completed worker’s comp form and any applicable documentation to the following address:
Division of Worker’s Compensation, P.O. Box 58, Jefferson City, MO 65102
Is an Employee Required to Submit to a Medical Examination if s/he is making a Work Accident Claim?
Yes, if the employer requests that the employee submit to a medical examination.
“After an employee has received an injury he shall from time to time thereafter during disability submit to reasonable medical examination at the request of the employer, the employer’s insurer, the commission, the division, an administrative law judge or the attorney general…” R.S.Mo. § 287.210 (2016).
Where does the Department of Labor and Industrial Relations Commission hold Oral Arguments?
The oral arguments are held in Jefferson City, Missouri, but the Commission may approve oral argument via video conferencing from Kansas City, Springfield, or St. Louis, Missouri.
If I am Seeking a Hardship, Can my Case be Expedited?
In fact, the Missouri Department of Labor and Industrial Relations has a specific procedure in place in which they specifically filter out the hardship cases, prepare the transcript expeditiously, and shorten the amount of time it takes to get the case resolved.
See https://molabor.uservoice.com/knowledgebase/articles/283025-how-does-the-commission-expedite-hardship-cases-in for a more specific description of the process of handling expedited worker’s compensation claims.
Does an Employee have the Right to receive a copy of any Written Statement made by the Employee?
Yes, if the employer wants to use the statement in any hearing or action to recover benefits under Missouri Worker’s Compensation law.
Pursuant to R.S.Mo. § 287.215, the employer must produce the written statement within 30 days of request by the employee, dependents in the case of death, or their attorney. R.S.Mo. § 287.215 (2016).
Does my Employer have to report my Work Accident?
The employer must report the accident or injury within 30 days after it learns of the same (if the injury requires the employer to provide medical aid beyond basic first-aid treatment).
The applicable statutory language is contained in Missouri Revised Statute section 287.380, and states the following, in pertinent part:
“Every employer or his insurer in this state …shall within thirty days after knowledge of the injury, file with the division…a full and complete report …of every injury or death to any employee for which the employer would be liable to furnish medical aid, other than immediate first aid which does not result in further medical treatment or lost time from work…” R.S.Mo. § 287.380 (2016).
What does an Employer have to Include in its Workplace Injury Report to the Division of Workers’ Compensation?
All Injury Reports must include:
- name of person injured,
- date of birth and
- wages of the deceased or injured employee,
- the time and cause of the accident,
- the nature and extent of the injury,
- the name and address of the employee’s and the employer’s or insurer’s attorney of record (if any)
- the medical cost incurred in treating the injured employee,
- the amount of lost work time of the employee as a result of the injury and
- such other information as the director may require. R.S.Mo. 287.380 (2016).
How long does an employer have to report a Workplace Injury to its Insurance Company?
An employer has 5 days to report a workplace accident to its insurance company.
The applicable statute states the following, in pertinent part:
“Employers shall report all injuries to their insurance carrier, or third-party administrators, if applicable, within five days of the date of the injury or within five days of the date on which the injury was reported to the employer by the employee, whichever is later.” R.S.Mo. § 287.380 (2016).
If the claim is timely made to the insurer, then the insurer is responsible for preparing the Injury Report to the Division of Workers’ Compensation. R.S.Mo. § 287.380 (2016).
Settlement Agreements in Workers’ Compensation Context
Can an Employer and Employee enter into a Settlement Agreement in a Worker’s Compensation Case?
Yes. However there are certain conditions that must be satisfied for the settlement agreement to be valid and enforceable:
- The administrative law judge must approve the agreement; and
- “No such agreement shall be valid unless made after seven days from the date of the injury or death.” R.S.Mo. § 287.390 (2016).
What are 3 questions an Administrative Law Judge must ask when approving a Settlement Agreement?
- Was the settlement the result of undue influence or fraud?
- Does the employee fully understand his or her rights and benefits?
- Did the employee voluntarily agree to accept the terms of the settlement agreement?
R.S.Mo. § 287.390 (2016).
What is an Occupational Disease?
An occupational disease is defined as: “an identifiable disease arising with or without human fault out of and in the course of the employment.” R.S.Mo. § 287.067.1 (2016).
What are the elements to prove an Occupational Disease in a Workers’ Comp Claim?
There must be some type of causation between the exposure that occurred on the job and the medical condition and disability.
The applicable statute is R.S.Mo. § 287.067.2 (2016), and the operative language is: “if the occupational exposure was the prevailing factor in causing both the resulting medical condition and disability”
How is “Prevailing Factor” defined as it pertains to an Occupational Disease in the Workers’ Comp Context?
Prevailing factor is defined as the “primary factor, in relation to any other factor, causing both the resulting medical condition and disability.” R.S.Mo. § 287.067.3 (2016).
The statute further defines prevailing factor by identifying what is not compensable: “Ordinary, gradual deterioration, or progressive degeneration of the body caused by aging or by the normal activities of day-to-day living [does not provide for a valid workers’ comp claim on the basis of an occupational disease].” R.S.Mo. § 287.067.3 (2016).
What are some Injuries or Disease that are Compensable under Missouri Workers’ Compensation Statutes?
- ACL Tear
- Brain Injury
- Broken Bones
- Burn Injury
- Carpal Tunnel Syndrome (CTS)
- Complex Regional Pain Syndrome (CRPS)
- Contagious and Communicable Disease
- Degenerative Joint Disease (DJD)
- Disease of Lungs or Respiratory Tract
- Electrocution or Electrical Accidents
- Equipment Accidents
- Fatal Accidents
- Head and Neck Injuries
- Hearing Loss
- Heart Attack or Stroke
- Heart Disease
- Hip Injury
- Industrial Disease
- Industrial Plant Accident
- Internal Organ Injuries
- Knee Injuries
- Lacerated Liver, Kidney, or Spleen
- Ligament Tears
- Loss of Hearing Due to Industrial Noise
- MCL Tear
- Musculoskeletal Disorders
- Neck Injury
- Nerve Injuries
- Psychological Damage
- Pulmonary Damage
- Radiation Disability
- Repetitive Stress Injury
- Retrobulbar Neuritis
- Shoulder Injury
- Slip and Fall Injury
- Spinal Cord Injury
- Torn Rotator Cuff
- Toxic Exposure
- Vision Loss
- Work-Related Car Accident
How does the Missouri Department of Labor Determine the Filing Date of your Appeal?
The filing date is whatever date that is postmarked on the appeal. If there is no postmark, it is the date that the appeal is received in the Department of Labor and Industrial Relations office.
How long do I have to Appeal after the Administrative Law Judge’s Award?
After an administrative law judge (“ALJ”) issues a worker’s comp award, you have 20 days to appeal.
Who Reviews the Appeal of the Administrative Law Judge?
The Labor and Industrial Relations Commission will typically rule on your appeal.