Claims Kit

Reporting of Claim by Employer 287.380

The employer must report the injury to the insurance company or Third Party Administrator (TPA) within five (5) days of the date of injury or within five days of the date on which the injury was reported to the employer by the employee.

Accident--duty of division--employer. 287.400

Upon receipt of notice of any accident for which compensation other than that provided in section 287.140 is payable, the division will inform the employee generally of his rights. The employer will notify the division as soon as payment of compensation is commenced and when terminated, and will file with the division, at the time of notice of termination, a physician's report. In the event a dispute arises between the employer and the employee regarding the payment of compensation, the division will assist the employee in filing a claim and securing an early adjudication.

Penalties for Late Reporting 287.380

Any employer or insurer who knowingly fails to report any accident is guilty of a misdemeanor and on conviction shall be punished by a fine of not less than fifty nor more than five hundred dollars, or by imprisonment in the county jail for not less than one week nor more than one year, or by both the fine and imprisonment.

Posting Requirements 287.127

All employers must post a notice at their place of employment, in a sufficient number of places on the premises to assure that the notice will reasonably be seen by all employees. An employer who has employees who may not reasonably be expected to see a posted notice must notify each employee in writing of the contents of the notice.

The notice must include:

(1) That the employer is operating under and subject to the provisions of the Missouri workers' compensation law;

(2) That employees must report all injuries immediately to the employer by advising the employer personally, the employer's designated individual or the employee's immediate boss, supervisor or foreman and that the employee may lose the right to receive compensation if the injury or illness is not reported within 30 days or in the case of occupational illness or disease, within 30 days of the time he or she is reasonably aware of work relatedness of the injury or illness; employees who fail to notify their employer within 30 days may jeopardize their ability to receive compensation, and any other benefits under this chapter;

(3) The name, address and telephone number of the insurer, if insured. If self-insured, the name, address and telephone number of the employer's designated individual responsible for reporting injuries or the name, address and telephone number of the adjusting company or service company designated by the employer to handle workers' compensation matters;

(4) The name, address and the toll-free telephone number of the division of workers' compensation;

(5) That the employer will supply, upon request, additional information provided by the division of workers' compensation;

(6) That a fraudulent action by the employer, employee or any other person is unlawful

Poster - English

Poster - Spanish

Any employer who willfully violates the provisions of this section is guilty of a class A misdemeanor and can be punished by a fine of not less than $50 nor more than $1,000, or by imprisonment in the county jail for not more than 6 months or by both fine and imprisonment, and each violation or each day the violation continues will be deemed a separate offense

Physician Selection 287.140 RSMo.

Missouri law allows employers to select the physician or health care provider to treat their injured employees.

In many case the employer allows the insurance carrier to make the choice. Most employers choose a general practitioner or an occupational health physician as their primary care physician. Either of these physicians is capable of treating most injuries and referring serious injuries to proper medical specialists. Employers may choose specific medical specialists such as an orthopedic surgeon. A primary care physician should be notified in advance if referrals to individual specialists are desired. The employer/insurer does have a qualified right to select or authorize a change in physician if the employer/insurer disagrees with the authorized treating physician.

It is important to note that while the employer usually delegates the right to select the health care providers to the insurance company, it is the employer's right. Therefore, if the employer and the insurance company disagree on this matter, the employer's wishes should prevail.

If the employee desires, he has the right to select his own physician, surgeon, or other such requirement at his own expense.