Understanding Missouri’s Workers’ Compensation Requirements

What are Missouri’s Workers’ Compensation Laws?

Workers’ compensation (also known as workers’ comp or work comp) is when an employee receives benefits from their employer after they become ill or are injured on the job. Companies purchased workers’ compensation insurance to provide medical treatment to injured employees and aid employees financially during their recovery.

Many times, employees are unsure of what their company offers in regards to workers’ compensation, and if they are injured on the job or become ill, they may find themselves in a battle against their employer’s insurance company.

To put it simply, Missouri’s workers’ compensation laws require insurance companies will almost always look for the most cost-effective solution to your situation. In other words, they want to make sure your workers’ compensation payout(s) are as small as possible.

Because of this, it is extremely important that employees know what they are entitled to if a work injury requires medical treatment and forces them to miss work.

What is the recommended process after a work injury?

• Immediately report your injury to your employer or a supervisor
• Receive the proper medical care
• Receive the necessary medical benefits
• Speak with a workers’ comp attorney to ensure fair compensation and to make sure you continue to receive the correct benefits

Related: The Most Common Workplace Injuries & Workers’ Comp Claims

What are Missouri’s Workers’ Compensation Laws?

Workers’ compensation is a system that provides certain benefits to employees who are injured or develop an occupational illness because of their work.

Unlike a traditional personal injury lawsuit, workers’ compensation generally does not require an injured employee to prove that their employer was negligent. Instead, the focus is on whether the injury or illness qualifies for benefits under Missouri law.

Workers’ compensation can provide several types of benefits, including:

• Medical treatment for qualifying workplace injuries
• Temporary disability payments while an employee is unable to work
• Compensation for certain permanent disabilities
• Benefits for qualifying surviving family members when an employee dies because of a work-related injury or illness

Not every injury automatically qualifies for workers’ compensation. Missouri has specific requirements for determining whether an accident or occupational disease is covered.

In the US, the requirements for workers’ compensation vary based on things like your state, the industry in which the company operates, and even the size of the company. According to the Missouri Department of Labor, employers in Missouri are required to cover workers’ compensation insurance if they have five or more employees.

Which Missouri Employers Must Carry Workers’ Compensation Insurance?

Most Missouri employers with five or more employees are required to carry workers’ compensation insurance. The requirements are stricter for construction companies. Generally, Missouri construction employers must carry workers’ compensation coverage when they have at least one employee.

Certain employers are exempt, and some may choose to obtain coverage voluntarily. Employers may also qualify to self-insure rather than purchasing a traditional insurance policy. You can learn more about these requirements through the Missouri Division of Workers’ Compensation.

What Medical Treatment Does Missouri Workers’ Compensation Cover?

Under Missouri Revised Statutes Section 287.140, employers are required to provide medical care reasonably necessary to cure and relieve the effects of a compensable workplace injury.

Depending on the nature and severity of the injury, this may include:

• Emergency room visits and hospital care
• Doctor appointments and specialist consultations
• Surgery and other medical procedures
• Physical therapy and rehabilitation
• Prescription medications
• Diagnostic testing, including X-rays and MRIs
• Medical equipment and assistive devices
• Other reasonably necessary authorized treatment

One important benefit of Missouri workers’ compensation is that employees generally do not have to pay a deductible for authorized medical treatment.

The employer or its workers’ compensation insurer is responsible for those medical expenses.

However, this does not mean that every treatment an employee requests will automatically be approved. Disagreements can arise over whether a particular treatment is necessary, whether it is related to the workplace injury, or whether it has been properly authorized.

Can You Choose Your Own Doctor for a Missouri Workers’ Compensation Injury?

This is one of the most common questions injured workers ask. In Missouri, the employer generally has the right to select the doctor or healthcare provider who treats a work-related injury. That responsibility is often handled by the employer’s workers’ compensation insurance company.

You can choose to see a different doctor, but unless the employer or insurer authorizes that treatment or a legal exception applies, you may be responsible for the cost.

For a more detailed explanation, read our article on choosing your own doctor in a Missouri workers’ compensation claim.

Will Workers’ Compensation Pay for Lost Wages?

Medical bills aren’t the only financial concern following a workplace injury. If your injuries prevent you from working, you may also lose the income you rely on to pay your mortgage, rent, utilities, and other everyday expenses.

Missouri provides several types of disability benefits intended to compensate qualifying employees for some of those financial losses.

When injured, you should receive payment for the wages you lose while you are recovering from your injury or surgery.

Temporary Total Disability (TTD)

Temporary Total Disability (also referred to as “TTD”) is the financial compensation you receive when your doctor says you are not physically or mentally able to work and should continue until he or she says you are able to work or your condition has reached “maximum medical improvement”.

TTD benefits are typically calculated at two-thirds of the employee’s average weekly wage, subject to a maximum amount established by Missouri law.

For injuries occurring between July 1, 2026, and June 30, 2027, the maximum TTD benefit is $1,294.71 per week. For example, if an injured employee earned an average of $900 per week before the accident, the general TTD calculation would be $600 per week. However, the actual amount depends on the employee’s wages, applicable statutory limits, and eligibility for benefits.

TTD payments generally continue until the employee is medically able to return to work or reaches maximum medical improvement, subject to the circumstances of the claim. Maximum medical improvement, often called MMI, means the employee’s condition has stabilized to the point that further significant improvement is not reasonably expected.

Reaching MMI does not necessarily mean an employee has fully recovered or no longer experiences pain.

Temporary Partial Disability (TPD)

What happens if your doctor allows you to return to work, but only with restrictions?

For example, you may be able to work four hours per day instead of your usual eight-hour shift. Or your employer may assign you a less physically demanding position that pays less than your regular job.

In qualifying circumstances, Missouri workers’ compensation provides Temporary Partial Disability benefits. These benefits generally equal two-thirds of the difference between your average pre-injury earnings and the amount you can earn while temporarily disabled, subject to statutory limits.

This helps compensate employees who are able to perform some work but have a reduced earning capacity during their recovery.

Is There a Waiting Period Before You Receive Workers’ Compensation Payments?

Yes.

Missouri has a waiting period for temporary disability compensation. Generally, employees do not receive disability payments for the first three days of disability. However, if the employee remains unable to work for more than 14 days, compensation for the initial waiting period becomes payable.

This is an important distinction because employees who miss only a few days of work may not qualify for temporary disability payments, even when their medical treatment is covered.

Permanent Partial Disability compensation

Some workplace injuries improve with treatment but never fully heal. An employee might return to work after a shoulder injury but continue experiencing restricted movement, weakness, or chronic discomfort. In Missouri, an employee who suffers a lasting disability from a compensable workplace injury may qualify for Permanent Partial Disability benefits.

Importantly, you do not necessarily have to change jobs, reduce your working hours, or lose wages to qualify for PPD benefits.

A worker may be able to return to the same position and still have a compensable permanent disability. PPD compensation depends on several factors, including the part of the body injured, the extent of the permanent disability, the employee’s average weekly wage, and the applicable statutory schedule.

For injuries occurring between July 1, 2026, and June 30, 2027, Missouri’s maximum weekly PPD rate is $678.18.

PPD benefits are frequently resolved through a lump-sum settlement, although the appropriate resolution depends on the individual claim.

Permanent Total Disability compensation

Some workplace injuries are so severe that an employee can no longer maintain employment.

Missouri’s Permanent Total Disability benefits are intended for workers who are permanently unable to perform any employment in the competitive labor market because of their disabling condition. Being unable to return to your previous job does not automatically mean you qualify for PTD. The question is whether you are capable of working in other employment, considering the relevant evidence.

If the most recent compensable workplace injury alone causes permanent total disability, the employer or its insurer may be responsible for lifetime weekly benefits. A negotiated lump-sum settlement may also be possible.

For injuries occurring between July 1, 2026, and June 30, 2027, the maximum weekly PTD benefit is $1,294.71.

Frequently Asked Missouri’s Workers’ Comp Questions

How do you determine if you are getting fair workers’ compensation?

You would not be wrong to assume your employer – or more specifically your employer’s insurance provider – is not necessarily going above and beyond to make sure you are not only receiving all of the treatment you need but also all of the compensation required to take care of you financially.

Understanding the complex nature of workers’ compensation and the State of Missouri’s laws can be a very difficult task. The best way to determine what compensation and medical treatment you need after a workplace injury is to speak with a personal injury attorney. Most injury lawyers offer a free consultation and will examine your injury, your workers’ comp policy, and the treatment you have currently received.

Your workman’s comp lawyer can then give their advice and let you know if you have a case to potentially fight for more compensation.

Can You Receive Reimbursement for Traveling to Medical Appointments?

In certain circumstances, yes. An employee may have to travel outside their local or metropolitan work area to receive authorized medical treatment.

Under Missouri law, an employer may be responsible for necessary and reasonable travel expenses when the employee is required to obtain treatment outside the applicable local or metropolitan area. Missouri also places limits on the distance for which transportation costs must be paid.

For eligible travel occurring during the July 1, 2026, through June 30, 2027, rate period, the published mileage reimbursement rate is 69.5 cents per mile. Not every trip to a doctor’s office automatically qualifies for mileage reimbursement.

If you are traveling long distances for authorized treatment, keep records of the dates, destinations, mileage, and expenses associated with your appointments.

How Long Do You Have to File a Missouri Workers’ Compensation Claim?

One of the biggest mistakes injured employees make is assuming that telling their supervisor about an injury is the same as filing a workers’ compensation claim.

It is not.

Reporting the accident to your employer is an important first step, but a formal Claim for Compensation is a separate filing with the Missouri Division of Workers’ Compensation. Generally, employees must file a claim within two years of the injury or the last payment made on account of the injury.

If the employer or insurer fails to file a timely First Report of Injury with the Division, the applicable filing period may be extended to three years. Different rules can apply in occupational disease cases. Waiting until the deadline approaches can make it more difficult to collect medical records, identify witnesses, and resolve disputes.

You can learn more about the filing process through the Missouri Division of Workers’ Compensation.

What Happens if Your Employer Doesn’t Have Workers’ Compensation Insurance?

Although many Missouri employers are required to maintain workers’ compensation coverage, some fail to do so.

If your employer was legally required to carry coverage but did not, that does not necessarily mean you have no way to recover compensation for your injuries. Depending on the circumstances, an uninsured employer may remain liable for medical expenses and other consequences of a workplace injury. Missouri law may also permit an injured employee to pursue a personal injury action against an employer that failed to maintain legally required workers’ compensation coverage.

Because these situations involve different legal considerations, it is important to investigate the employer’s coverage and available options.

Do I Have to Pay Taxes on Workers’ Compensation Benefits?

Missouri workers’ compensation disability benefits are generally not subject to income tax.

However, certain interactions with other benefits, such as Social Security disability payments, can create additional considerations.

Can I Receive Workers’ Compensation if I Return to Work?

Yes. Returning to work does not automatically eliminate every form of workers’ compensation benefit. Depending on your medical condition, you may still qualify for temporary partial disability, permanent partial disability, or authorized medical treatment.

I work in St. Louis, Missouri have been injured on the job, what now?

You must follow the steps outlined above immediately after a workplace injury.

Regardless of the nature or seriousness of the injury, we advise you to speak with a personal injury attorney that has experience in workers’ compensation cases.

Most personal injury attorneys, and around the United States, offer a free consultation and they will be able to review your case and will be able to answer any questions or determine if you are receiving the proper compensation and benefits for your injury.

If you have questions, please contact Craig Ortwerth for a free consultation.