Requirements
In Missouri, every employer, not in the construction industry, who has five or more employees, whether full time or part time, is required to carry workers compensation insurance. Employers with less than 5 employees may elect to purchase workers compensation. Employers with less than 5 employees and without workers compensation insurance are subject to tort claims from employees who are injured on the job. Employers in the construction industry must provide workers compensation coverage if they have even one employee. Certain employers are exempt from the requirement of having workers compensation insurance coverage. This includes employers of farm labor, domestic servants in a private home, occasional labor performed for a private household, qualified real estate agents and volunteers of a tax-exempt organization. Family members working in the business must be covered unless they elect to opt out.
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To obtain workers compensation coverage in Missouri, the employer has only two options which are:
- Purchasing a workers compensation insurance policy from an insurance company licensed to do business in Missouri.
2. Obtaining approval from the Missouri Department of Labor and Industrial Relations, Division of Workers Compensation to provide self-insurance.
Claim Reporting
The employee must report the injury to the employer within 30 days in writing providing details of where, when and how the accident occurred. The employer must then report the injury to the insurance company or third party administrator within 5 days. The claims office is responsible for reporting the claim to the Missouri Division of Workers Compensation within 30 days of being notified of the injury.
Medical Benefits
The employer selects the medical provider. The employer must provide “medical, surgical, chiropractic, and hospital treatment; including nursing, custodial, ambulance and medicines”. For medical coverage to be provided, the accident must be the prevailing factor in causing the resulting medical condition.
There are no time limitations or monetary limitations on medical care. The medical care will continue as long as the physician deems it necessary. Mileage to and from medical treatment is reimbursed at the rate of $0.50 per mile.
Temporary Total Disability Benefits
The temporary total disability (TTD) benefits are calculated as two-thirds of the employee’s average weekly wage to the injury. The TTD weekly maximum and minimum is adjusted each year on July 1st. The maximum is capped at $811.73 for injuries occurring from July 1, 2011 to June 30, 2012. The weekly minimum TTD amount is $40.00. TTD benefits can be paid for a maximum of 400 weeks.
The first 3 days of disability (the waiting period) is not paid to the injured employee unless the employee is disabled for more than 14 days.
Temporary Partial Disability Benefits
In Missouri, if the employee is able to return to work, but at a lesser rate of pay than the amount the employee was earning prior to the injury or can only work fewer hours, the employee is entitled to temporary partial disability (TPD) benefits. The TPD benefits are paid at two-thirds of the difference between the pre-injury wage and the post-injury wage, but is subject to the maximum TTD rate.
Permanent Partial Disability Benefits
Missouri employees who incur a permanent partial disability (PPD) are entitled to two-thirds of their average weekly wage, not to exceed a per week maximum. The weekly maximum is adjusted each year. The weekly maximum PPD rate for the period of 7-1-11 thru 6-30-12 is $425.19 per week. For non-scheduled injuries, known as Permanent Partial General Disability, the maximum period of payments is 400 weeks. For scheduled injuries, the loss of a body part has a maximum of 232 weeks of benefits for an arm at the shoulder, with the number of weeks declining based on the nature of the body part, down to 14 weeks of benefits for a toe other than the great toe.
Permanent Total Disability Benefits
Permanent total disability (PTD) benefits are paid weekly for life-time of the injured employee. The employee and the insurer are also allowed to negotiate a lump-sum settlement. The weekly benefits are based on two-thirds of the average weekly wage not to exceed the maximum cap set each year.
Death Benefits
The burial expenses in Missouri are covered for a work-related death up to $5,000. The death benefits for a surviving spouse and dependents follow the same guidelines as TTD benefits – two-thirds of the average weekly wage – for one year. The spouse loses the death benefit if the spouse remarries, but the children continue to receive the death benefit. Children can receive the death benefit if they are under 18 years old, or 22 years old if enrolled in accredited educational institution.
Author Rebecca Shafer, JD, President of Amaxx Risk Solutions, Inc. is a national expert in the field of workers compensation. She is a writer, speaker, and website publisher. Her expertise is working with employers to reduce workers compensation costs, and her clients include airlines, healthcare, printing, publishing, pharmaceuticals, retail, hospitality, and manufacturing. See www.LowerWC.com for more information. Contact: RShafer@ReduceYourWorkersComp.com.
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Do not use this information without independent verification. All state laws vary. You should consult with your insurance broker or agent about workers comp issues.
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