Free Workers Compensation Study Guide
Missouri Casualty exam — Workers Compensation.
The national Workers' Compensation guide explains the system and the standard policy. This guide covers Missouri's Workers' Compensation Law (RSMo chapter 287). It is administered by the Division of Workers' Compensation in the Department of Labor and Industrial Relations. Missouri isn't a monopolistic state. Employers insure with authorized carriers or self-insure, individually or as a group.
Who is an employer (287.030–287.090)
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An employer with 5 or more employees must provide coverage. In the construction industry, the threshold is 1 or more.
- Family members within the third degree count toward the number.
- Smaller employers may elect coverage.
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Sole proprietors and partners are covered only if they elect it (287.035).
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LLC members are covered but may reject coverage in writing. An S corporation shareholder owning 40% or more may also reject it (287.037).
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Exempt (287.090):
- farm labor
- domestic servants in a private home
- occasional household labor
- qualified real estate agents and direct sellers
- unpaid volunteers of 501(c)(3) organizations (not paid staff)
An exempt employer may elect coverage by buying a policy.
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Statutory employer: a person who has work done by contractors in the usual course of its business is liable to their injured workers. The immediate employer is liable first (287.040).
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Contractors provide a certificate of insurance or an exemption affidavit (287.061).
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All minors are employees, even if employed illegally.
Securing coverage (287.280)
- Every subject employer must insure its entire liability with an authorized carrier, or satisfy the Division that it can self-insure.
- A noncomplying employer can be sued by the injured employee. It can't use the defenses of fellow-servant negligence, assumption of risk or the employee's own negligence.
The bargain (287.120)
- The employer is liable without regard to negligence for injury or death by accident or occupational disease arising out of and in the course of employment. That remedy is exclusive.
- An accident is compensable only if it was the prevailing factor (the primary factor) in causing both the condition and the disability (287.020).
Benefit adjustments (287.120)
| Situation | Effect on benefits |
|---|---|
| The employer violated a statute or lawful order | +15% |
| The employee failed to use safety devices or follow safety rules | −25% to −50% |
| The employee used alcohol or nonprescribed drugs in violation of policy | −50%, and forfeited if the use was the proximate cause |
| Intentional self-inflicted injury | Not compensable. The employer bears the burden of proof. |
Benefits
| Benefit | Missouri rule |
|---|---|
| Waiting period | 3 days, paid back if the disability lasts more than 14 days (287.160) |
| Payment timing | As wages were paid, and at least every 2 weeks. Late uncontested payments add 10% interest. |
| Temporary total disability | 66 2/3% of average weekly earnings, up to 105% of the state average weekly wage, for up to 400 weeks. Not paid for any week the employee receives unemployment (287.170). |
| Permanent total disability | For life, from maximum medical improvement. Unaccrued payments end at death (287.200). |
| Medical | Reasonable treatment furnished by the employer. An employee may choose his or her own doctor at his or her own expense (287.140). |
| Burial | Up to $5,000 (287.240) |
Notice and posting
- Written notice of the time, place and nature of the injury is due within 30 days, unless the employer wasn't prejudiced (287.420).
- Employers post a notice telling employees to report injuries immediately, and that compensation may be lost if they don't report within 30 days. The carrier supplies the notice within 30 days of the policy's start (287.127).
- Carriers offer safety engineering services on request (287.123).
- Insurers file a memorandum of each policy, renewal and cancellation with the Division (287.090).
Fraud (287.128)
- Knowingly presenting a false claim is a class E felony, with fines up to $10,000 or double the fraud.
- Issuing an invalid certificate of insurance is also a class E felony.
- Misrepresenting facts to get a lower rate is a class A misdemeanor.
Insurer service standards (20 CSR 500-6.500, 6.600)
- Issue the policy within 60 days of the application.
- Mail certificates of insurance within 5 working days of a request.
- Complete and bill audits, and return premium, within 120 days of expiration.
- The insured may ask for reconsideration within 3 years.
- Experience modification: an increase can't be retroactive. A mid-term increase takes effect 60 days after notice. A decrease is retroactive to inception.
- The Workers' Compensation Determinations Review Board reviews classification and experience modification disputes (287.335).
Common exam traps
- Coverage required at 5+ employees. Construction: 1+.
- Waiting period: 3 days, paid back after 14 days.
- TTD: 66 2/3%, up to 105% of the state average weekly wage, for 400 weeks.
- The accident must be the prevailing factor.
- Safety-rule violations cut benefits 25–50%. An employer's statutory violation adds 15%.
- Burial: $5,000. Injury notice: 30 days.
Practice Workers Compensation questions All Casualty topics
Practice questions are study aids generated for exam preparation and are not actual exam questions. Content is provided for educational purposes and is not legal advice. Verify current statutes, rules, and exam specifications with the Insurance Department and the exam administrator before relying on it.
