Missouri Workers’ Comp Benefit Fact Sheet: Key Benefits and Eligibility

When you suffer a workplace injury or job-related illness, you have a limited time to file a workers’ comp claim. Otherwise, you might miss out on the financial benefits you’re entitled to and have to pay for your care and living expenses out of pocket.

Applying for workers’ comp is a complex process that can seem overwhelming, especially when you’re not in good health. But you make things easier by using this Missouri workers’ compensation fact sheet as a quick reference guide for what to expect and what to do next.

For additional support or to arrange legal representation, contact Phalen Law today to arrange a free no-obligation consultation with an experienced Missouri workers’ compensation attorney.

What is workers’ compensation in Missouri?

Workers’ compensation provides financial benefits to people who have been injured on the job or exposed to an occupational illness. It covers:

• Accidents or injuries that occur in the course of work duties
• Illnesses caused by exposure to harmful chemicals or allergens
• Repetitive stress injuries that develop over time, like carpal tunnel syndrome
• Medical benefits for treatments such as surgeries and physical therapy
• Disability benefits if the incident causes permanent or temporary disability
• Lost wages from work missed due to your injury or illness
• Funeral costs if you die in a workplace accident

Missouri workers’ compensation laws are no-fault laws. That means you’re entitled to compensation without needing to prove someone else was responsible for your injury or illness.

Any workers’ compensation benefits you receive are also tax free. But they could reduce your social security benefits. So it’s important to speak with a trusted local work injury lawyer to make sure claiming workers’ comp in Missouri is the right decision for you.

Who is eligible for workers’ comp in Missouri?

In Missouri, any business with at least five employees is required by law to take out a workers’ comp policy. This also applies to construction companies with at least one employee.

All employees are covered by this policy from their first day on the job, including full-time, part-time, temporary, casual, seasonal and family workers.

Any employee of a non-construction company with fewer than five employees, or who is exempt from Missouri workers’ compensation, is advised to take out their own insurance policy.

Who isn’t covered by workers’ comp in Missouri?

Public labor organizations don’t need to offer workers’ comp coverage for certain types of employees. This includes:

• Railroad employees
• Postal employees
• Maritime employees

That’s because these employees receive workers’ comp coverage under federal laws rather than under Missouri workers’ compensation laws.

Other exceptions include:

• Sole proprietors or members of a partnership
• Farm laborers
• Domestic workers in private homes
• Qualified real estate agents
• Direct sellers
• Occasional laborers who work for or relate to a private household
• Unpaid volunteers of tax-exempt organizations operating under the standard of section 501(c)(3) or 501(c)(19) of the federal Internal Revenue Code where such volunteers are not paid wages
• Adjudicators, sports officials or contest workers for interscholastic activity programs or amateur youth groups who aren’t employed by the sponsor of the event

Are freelancers and contractors covered by workers’ compensation?

Freelancers, independent contractors, gig contractors, sole traders, and sole proprietors are legally self-employed. That means they aren’t automatically covered by workers’ comp.

However, there are times in which work performed by these types of workers for a client company is almost indistinguishable from employee status. In these cases, you might qualify for workers’ compensation – and the client company could be penalized for misclassifying workers.

To find out more, read our full blog on whether independent contractors qualify for workers’ compensation.

What benefits are available under Missouri workers’ comp?

Medical treatment

Under Missouri workers’ comp, your employer or their insurance company is required to pay for your medical treatment and care following a workplace injury or job-related illness.

This includes all costs for authorized medical treatment and testing, including:

• Diagnostic studies
• Doctor’s appointments
• Emergency room care
• Hospital stays
• Medical equipment such as crutches or a wheelchair
• Physical rehabilitation
• Prescription medication
• Surgeries

Generally, there are no limits or exclusions to this coverage.

You can also claim transportation to and from your medical appointments. From July 1st 2024 to June 30th 2025, you can claim up to 64 cents per mile. So be sure to keep an accurate record of your transportation costs.

Be aware that the state of Missouri allows employers to choose the healthcare provider for sick or injured workers. If you visit an unauthorized physician, you’ll have to cover the costs yourself. It could also result in your workers’ comp claim being denied.

Disability benefits

Temporary disability

If you’re unable to work following your injury, you may be able to claim weekly salary compensation until your doctor clears you to return to work. This applies to any form of work, not just the job you were doing before your accident.

Temporary Partial Disability (TPD)

You can claim TPD compensation if you’re fit to return to work and expected to make a full recovery.

Your TPD compensation equals two-thirds of the difference between your average weekly wage before your disability and what you can earn while disabled. If you’re working in a lower-paying light-duty role during your recovery, TPD benefits help make up the difference.

You can claim TPD benefits for up to 100 weeks.

Temporary Total Disability (TTD)

You can claim TTD benefits if you’re unable to work following your injury or illness but are expected to make a full recovery.

TTD applies if you’re unable to work for more than three consecutive days. You won’t receive payment for the first three days after your injury. But if you’re unable to work for at least 14 days, those three days will be paid.

In Missouri, you’re entitled to two-thirds of your average weekly wage up to a maximum of 55% of the state average weekly wage.

This figure is based on your gross income (before tax) during the 13 weeks leading up to your injury or diagnosis. If you’ve been at your current employment for fewer than 13 weeks, your average weekly wage is instead based on your total employment.

You can claim TTD benefits until you return to work or reach maximum medical improvement, for a maximum of 400 weeks. 

Losing your temporary disability benefits

There are two situations in which your temporary disability benefits could be cut off before you return to work:

1) You’ll lose your TTD benefits if you apply for and receive unemployment compensation

2) You’ll lose your TPD or TTD benefits if you’re fired for misconduct following your injury (this doesn’t include missing work due to your injuries)

If you believe your temporary disability benefits have been wrongly discontinued, contact Phalen Law to discuss your situation with a trusted workers’ comp attorney.

Permanent disability

If your work-related injury or illness causes permanent disability, you’re entitled to additional compensation on top of any TPD or TTD benefits you receive.

Permanent Partial Disability (PPD)

You’re entitled to PPD benefits if you sustain a lifelong injury but are still able to work. 

In Missouri, PPD benefits are calculated using the following formula:

(Rate of compensation) x (Level) x (Disability percentage) = (Total amount awarded in USD)

Rate of compensation is 55% of your average weekly wage up to two-thirds of the state average weekly wage. 

Level refers to which area of your body has been injured. The Missouri Division of Workers’ Compensation uses a schedule of losses to assign each body part a numerical value representing how many weeks you can claim for. If you lose a body part from severance or loss of use, the number of weeks assigned to that body part increases by 10%.

Disability percentage is a rating of how much your disability affects the injured body part. This is determined by your doctor once you reach maximum medical improvement.

Permanent Total Disability (PTD)

You’re entitled to PTD benefits if your disability means you’re no longer able to work. It doesn’t require you to be completely inactive. But it does mean a judge has determined that no employer could reasonably be expected to hire you due to your condition.

You’ll be considered to have PTD in one of two situations:

• Your injuries make you unemployable in the job market
• A combination of your injuries and pre-existing conditions make you unemployable

If you qualify for PTD benefits, you’ll be paid at the same rate as TTD for the rest of your life. This includes any weeks that were unpaid after reaching maximum medical improvement but before you were determined to be permanently or totally disabled.

Maximum disability compensation in 2025

In the period from July 1st 2024 to June 30th 2025, the Missouri state average weekly wage is calculated as $1,228.04.

The minimum claimable rate is $40 per week.

Type of disability	Fit for work	Full recovery expected	Percentage SAWW compensation	Maximum weekly benefits rates	Maximum payable weeks	Total claimable
Temporary partial	√	√	55%	$643.26	100	$64,326
Temporary total	X	√	105%	$1,228.04	400	$491,216
Permanent partial	√	X	55%	$643.26	400	$257,296
Permanent total	X	X	105%	$1,228.04	Unlimited	Unlimited

Vocational rehabilitation

If you’re severely injured, your employer can authorize you to enroll in a vocational rehabilitation program administered by the Missouri Division of Workers’ compensation. This program is designed to help restore you to suitable and gainful employment.

To be eligible, your workplace incident must have caused a physical or mental problem that affects your ability to work, such as:

• Severe mangling, crushing, amputation, or nerve impairment of a major extremity
• A traumatic injury to the spinal cord that has caused paralysis or severe restriction of movement
• Severe burns
• A serious head injury that affects you neurological or neurophysiological performance
• Loss of sight in one eye or both eyes, loss of hearing in both ears, or loss of speech

Once enrolled, you’ll work with a counselor who’ll develop a plan of action for your rehabilitation. This plan will include the following minimum criteria:

• Estimated earnings at plan completion
• Type of plan:
  1. Same job, same employer
  2. Modified job, same employer
  3. Different job, same employer
  4. Same job, different employer
  5. Modified job, different employer
  6. Different job, different employer
  7. Re-education and training
• Vocational goals
• Consultant responsibilities
• Employee responsibilities
• Time frames

Recommendations on the coordination of physical rehabilitation, work hardening, vocational assessment, vocational counseling, job placement, and occupational skill training, and independent living if appropriate

Death benefits

If a worker dies as a result of their work-related injury or illness, their survivors can claim weekly benefits for the year following your death. This is equal to two-thirds of their average weekly wage up to the state average weekly wage. 

Dependent children can claim death benefits until they reach the age of 18. But they can continue to receive benefits after this age if they:

• Become a fulltime student
• Have served on active duty in the military
• Are incapacitated from wage earning 

A surviving spouse can claim for the rest of their life or until they remarry. If they remarry, they receive a lump sum equal to two years of death benefits.

The employer or their insurer must also pay burial expenses up to $5,000.

How to file a workers’ comp claim in Missouri

How long do I have to file a workers’ comp claim in Missouri?

Under Missouri workers’ compensation law, you must report your workplace injury to your employer within 30 days of when it occurred. For slow-developing conditions such as carpal tunnel syndrome, you must report your condition within 30 days of diagnosis.

If you choose to file a claim for workers’ compensation, you must do so within two years of the date of injury.

This statute of limitations is extended to three years if your employer or their insurance company doesn’t file the first Report of Injury with the Division of Workers’ Compensation in a timely manner.

The period for occupational illnesses doesn’t begin to run down until the illness becomes reasonably discoverable.

Steps for filing a claim

You must first notify your employer or your injury or illness in writing. This written notice must include:

• Your name and address
• The date, time, and place of the injury
• The nature of the injury

Your employer may give you an injury report form to complete. If they don’t, you can use the online template from the Missouri Division of Workers’ Compensation.

After you report your injury, your employer is responsible for notifying the Division within 30 days of being notified. They must also report it to their insurance carrier within five days of the report.

Once this step is complete, you can begin your workers’ comp claim process. For full details, follow our steps for filing a workers’ comp lawsuit in Missouri.

Common reasons for denied claims and what to do

Missed deadlines

To qualify for workers’ compensation, you must submit your claim within the state’s deadline. In Missouri, you have 30 days to file a report with your employer.

Be sure to report your workplace injury or illness as soon as possible to avoid your workers’ comp claim being denied.

Non-work-related injuries and illnesses

Your employer or their insurer might try to avoid paying a workers’ compensation settlement by claiming your injury or illness wasn’t work related.

Common excuses include:

• You weren’t working at the time of your injury
• You were injured due to misconduct
• Your injury or illness was caused by a pre-existing medical condition 

To avoid this accusation, it’s important to gather as much evidence as possible of your injury and the incident that caused it to support your claim.

This can be a challenge when you’re recovering from injury or illness. But the knowledgeable and experienced workers’ comp lawyers at Phalen Law can help gather suitable evidence for you. That way, we can build a strong case for your compensation while focusing on relaxation and recovery.

Unauthorized medical care

Immediate medical attention should be your first priority following a workplace injury or illness. But you must receive care from a healthcare professional authorized by your employer or their insurer to qualify for medical benefits under workers’ compensation.

If you use an unauthorized provider, it’s likely you’ll need to pay for your treatment out of pocket. This could also put your workers’ comp claim at risk of denial.

Drug or alcohol use

As a no-fault insurance policy, workers’ comp typically applies even if your workplace injury or occupational illness was caused by your own negligence.

However, this doesn’t apply if you were under the influence of drugs or alcohol at the time the incident occurred.

Your employer has the right to request alcohol and drug tests following the incident if they believe you were intoxicated. While you’re free to reject these tests, doing so is almost certain to invalidate your workers’ comp claim.

How to appeal a denied workers’ comp claim in Missouri

1) Request a written reason for the denial

If your workers’ comp claim is denied, your first step should be to request a written explanation from your employer’s insurance company. Fully understanding the reason for the denial helps you prepare your workers’ comp appeal.

2) Gather evidence to support your appeal

Once you know the reason for the denial of your claim, you need to produce evidence against it. This could include CCTV footage, photographs, accident reports, and witness statements.

Your workers’ comp attorney can advise you on the types of evidence that will best support your appeal.

3) File a formal claim

You need to file a written application requesting a review of your claim with the Missouri Labor and Industrial Relations Commission. This must be done within 20 days of receiving notification that your claim was denied.

If this application is denied, you can send a notice of appeal to the Missouri Court of Appeals within 30 days of that denial.

Should I hire a Missouri workers’ comp lawyer?

In the simplest of cases, in which there’s clear evidence of your injury and your employer supports you application, you might be able to handle your workers’ comp claim yourself.

Just be aware that you’ll need to complete your claims paperwork thoroughly, including evidence, within the state’s deadline. Failure to do so could result in the denial of your claim.

In more complex cases, it’s highly recommended that you partner with a trusted specialist workers’ comp law firm in your local area. This is absolutely essential if:

• Your case has been denied
• Your suspect employer retaliation
• You’re being offered a low settlement

Working with a local workers’ comp attorney ensures that all your paperwork is filed correctly and on time, with minimal effort on your part. And claimants who work with an attorney are shown to receive up to seven times more settlement money than those who don’t.

To ensure you make the right decision for your case, it’s important to consider all the pros and cons of hiring a workers’ comp attorney.

Book your free no-obligation consultation with Phalen Law

For more than 50 years, injured workers throughout Kansas and Missouri have relied on Phalen Law to get the compensation they deserve.

When you get in touch, we assign you an experienced trial lawyer to handle your claim on your behalf. As well as building a strong case for compensation, we can defend you against the tactics insurers use to reduce or deny your claim. With our support, you can get full compensation while you focus on recovery.

Call us now toll free or fill out our Free Case Evaluation form online to arrange your free no-obligation consultation and begin your workers’ compensation claim.