Missouri employers generally must carry workers’ compensation insurance if they have five or more employees; covered construction employers generally must carry it with one or more employees. Employers must also post the required notice, arrange authorized medical care for covered injuries, and meet separate deadlines for reporting injuries to their insurer or third-party administrator (TPA) and to the state. Exceptions affect some businesses and workers, so the employee-count rule is not a complete coverage test.
Who must carry workers’ compensation coverage in Missouri?
The Missouri Division of Workers’ Compensation says employers with five or more employees generally must insure their workers’ compensation liability. Employers engaged in covered construction work—erecting, demolishing, altering, or repairing improvements—generally need coverage with one or more employees. These are general thresholds, not a determination that every worker or business is covered. Missouri Division of Workers’ Compensation employer guidance (verified October 8, 2026).
Business structure and worker classification can change the result. Sole proprietors and partners are not covered as employees unless they elect coverage. LLC members are presumed covered unless they opt out; close family-member employees are also presumed covered unless they opt out. Statutory exclusions and other exceptions may apply. Confirm a specific business’s status with the Division, its insurer, or legal counsel.
An employer that is exempt but remains uninsured and does not self-insure may be exposed to civil suits by employees injured at work. An exemption from the insurance requirement is not a guarantee against liability.
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How can an employer meet the coverage requirement?
| Route | What it means | What to consider |
|---|---|---|
| Buy an insurance policy | Obtain coverage from an authorized insurer. | Verify that the insurer is authorized in Missouri and that the policy covers the employer’s operations and workforce. |
| Self-insure | Apply to the Division for authority to self-insure. | Self-insurance requires Division authority; it is not simply a decision to pay claims directly. Eligibility and administrative capacity matter. |
These are different compliance routes, not interchangeable products. The Division’s employer resources explain coverage obligations and self-insurance; the right route depends on the employer’s circumstances. Missouri Division of Workers’ Compensation employer guidance.
What should an employer do when an injury is reported?
- Address immediate needs. Provide first aid and arrange further medical care when necessary. For a potentially covered injury, the employer or insurer must provide care reasonably required to cure and relieve its effects, including authorized treatment, prescriptions, and medical devices.
- Record the employee’s notice. Capture the injury date, time, and place; its nature; and the injured person’s name and address. The state’s worker guidance advises reporting an injury immediately and warns that missing the 30-day notice period may jeopardize benefits. That worker-facing notice guidance is useful for employer intake but does not resolve unusual cases. Missouri Division of Workers’ Compensation injured-worker guidance.
- Notify the insurer or TPA. Report the injury within five days of the injury or within five days after the employee reports it, whichever is later. This is the employer-to-carrier/TPA clock; it is separate from the state filing deadline. Missouri Division of Workers’ Compensation injury-reporting guidance.
- Coordinate the state filing. The employer or insurer must report a qualifying injury to the Division within 30 days after knowledge of it. The Division’s guidance describes filing responsibilities for insurers, TPAs, and approved service companies in relevant circumstances. An internal incident report or a notice to a supervisor does not by itself establish that the Division received a First Report of Injury.
- Keep the filing record. Use an authorized electronic filing option and retain the acknowledgment. The Division lists filing through an authorized EDI vendor, direct SFTP, or web-enabled filing. Acknowledgment does not necessarily mean a report is complete: incomplete or invalid data may need correction before the filing is considered properly filed. Missouri Division of Workers’ Compensation injury-reporting guidance.
The Division excludes an injury requiring immediate first aid only when there is no further medical treatment and no lost time from its 30-day reporting requirement. Do not treat that narrow exception as applying when later treatment or lost time occurs.
What if a supervisor refuses to file an injury report?
The Division’s FAQ addresses an employee who informed a supervisor but was told the supervisor would not file a report. The employer’s reporting duty does not disappear because a supervisor refuses or delays. The employee should make sure the injury is reported to the employer and preserve a written record of the notice, including its date and the injury details. The employer should promptly pass the information to its insurer or TPA and follow through on the required state filing rather than treating the supervisor’s refusal as the end of the process. Missouri Division of Workers’ Compensation injury-reporting guidance.
For a disputed claim or uncertainty about notice, contact the Division or seek legal advice. Worker guidance says failure to report within 30 days may jeopardize benefits; that warning is not a reason for an employer to delay its own reporting.
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Who chooses the doctor and pays for treatment?
The employer or insurer has the right to select the treating provider for a covered injury. The Division’s workplace notice states: “The employer has the right to choose the healthcare provider or treating physician.” If an employee selects a different provider without authorization, the employee may be responsible for that cost. Necessary authorized care can include treatment, prescriptions, and medical devices. Missouri Division of Workers’ Compensation poster, form WC-106 (07-19).
What notice must be posted at the workplace?
Employers must post the Missouri workers’ compensation notice where workers can see it. The Division’s WC-106 poster is available free from the agency. Employers can obtain the notice from the Missouri Division of Workers’ Compensation poster page and place it in a visible location for employees.
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What benefits or costs may follow a covered injury or death?
Eligible workers may receive medical and disability benefits for a compensable work-related injury; eligibility and the benefit amount depend on the claim and applicable rules. In a compensable work-related death, certain survivors may qualify for weekly benefits, and the employer or insurer is responsible for funeral expenses up to $5,000. Missouri Division of Workers’ Compensation employer guidance.
Where can employers get help?
Use the Division’s employer resources for coverage information and its injury-reporting guidance for filing procedures. Questions about whether a business, worker, or injury falls within Missouri’s rules may require advice specific to the facts; the Division notes that its employer information is not a substitute for legal representation.
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