Employee Reporting Guidelines
- Report all injuries immediately to your supervisor or Human Resource Department. Complete the Employee Injury Report Form. Document the time, place, name(s) of witnesses, and nature of the injury in a written report.
- Contact 1-800-624-2354, 24 hours a day to speak to a registered nurse and receive a referral if necessary, prior to seeking treatment. A pharmacy card may be issued if medications are necessary as prescribed by the authorized treating physician. The State of Missouri will not pay for medical treatment you receive if you do not utilize authorized medical providers. However, you may seek your own medical care with the provider of your choice at your own expense.
- Unless it is an emergency, do not seek aid without informing your employer contacting 800-624-2354 to speak with a nurse regarding your injury.
- If it is an emergency, seek initial treatment at the nearest hospital emergency room or medical clinic. Then notify your supervisor or Human Resource Department as soon as possible. Contact CARO at 888-622-7694 for follow up treatment instructions.
- Notify the hospital or clinic that your injury is a workers' compensation injury and give them CARO's address and phone number (PO Box 809, Jefferson City, MO 65102; 888-622-7694).
- Complete an Authorization to Release Medical Records and return it to your supervisor or Human Resource Department.
- Surgeries and the purchase or rental of medical equipment must be preapproved by CARO.
- Mileage may be submitted to CARO for treatment outside of the local or metropolitan area from the employee's principal place of employment. Mileage Reimbursement Form
- Provide work slips from physician to supervisor or Human Resource Department.
Workers' Compensation benefits may be reduced for injuries sustained in conjunction with the use of alcohol or controlled, nonprescribed drugs. Benefits may be forfeited if shown that the use of alcohol or controlled, nonprescribed drugs was the proximate cause of the injury.
Avoid unnecessary delays or denials by notifying your employer immediately of an injury.
Additional information on rights and benefits under workers' compensation may be found at the Divison of Worker's Compensation website.
Explanation of Benefits
- What is Workers' Compensation?
Benefits payable to an employee by his or her employer without regard to liability in the case of injury, disability, or death as the result of occupational hazards.
- Who is covered?
All employees, full or part-time.
- What is covered?
Injury or illness arising out of and in the course of employment.
- Time of coverage?
Coverage begins the first minute an employee is on the job and continues while the employee is working.
- What about occupational diseases?
- It must arise out of and in the course of the employment.
- It cannot be an "ordinary disease of life," unless it follows an incident of an occupational disease.
- It must clearly be work related.
- What are the Workers' Compensation benefits?
Medical care to cure and relieve the effects of the injury. This includes doctor's fees, hospital costs, lab tests, X-rays, pharmacy charges, prosthetic devices, etc.
Payments based on lost wages. These payments are for "temporary disability," or inability to work, authorized by a physician. Payments may also be made if there is a permanent disability-for example, the loss of an eye or the amputation of a finger or limb.
Rehabilitation services. Often this is physical therapy, but should an injury keep you from returning to your usual job, you may qualify for retraining and vocational rehabilitation.
- Any Problems?
Most injuries are handled routinely. However, if you think you have not received all the benefits due you, contact your employer or the Central Accident Reporting Office (CARO). Most questions can be resolved with a single telephone call.
If questions or concerns cannot be resolved by CARO, you may wish to obtain advice from any office of the Missouri Department of Labor and Industrial Relations, Division of Workers' Compensation. If the problem cannot be resolved, you may wish to file a Claim for Compensation with the Division. You may desire to obtain an attorney, however contacting CARO or the Division may resolve your claim. If not, your claim may be heard by an administrative law judge.
- What are the medical benefits?
Medical benefits for an employee who suffers a work related injury include medical treatment to cure the injury. This includes doctor's fees, hospital costs, lab tests, X-rays, pharmacy charges, prosthetic devices, etc. CARO will select the health care provider.
- What is the procedure for accessing authorized medical care?
In the event of an emergency, the employee should proceed to the nearest emergency room. Non-emergency treatment is directed through the CARO nurse triage service. The employee should contact 1-800-624-2354 to speak with a nurse to obtain a medical referral.
- How are workers' compensation physicians selected?
CARO continuously evaluates the quality of services provided by physicians. CARO utilizes a Preferred Provider Organization (PPO) to provide quality, cost-effective medical care. Injured employees will be directed to a PPO provider if one is available in their area.
- What if the employee wants to select his/her own medical provider?
Employees may select their own medical provider at their own expense.
- How are medical providers paid?
Invoices should be sent to CARO for consideration. Injured employees should not be billed for medical treatment. If the employee is billed, they should notify the health care provider that this is a workers’ compensation injury and that the invoice should be sent to CARO.
For more information, visit the Division of Workers' Compensation FAQs.
Payment for Lost Wages
- What are temporary total disability (TTD) benefits?
Temporary total disability (TTD) is compensation for the time an authorized physician determines an employee is unable to work because of the injury. Temporary total disability benefits cease when the doctor says the employee is able to return to work or has reached maximum medical benefit. TTD benefit wages are not taxed.
- What is the waiting period?
Temporary total disability cannot be paid for the first three days (waiting period) during which the employer is open and operating for business unless the disability exceeds fourteen days.
- How are TTD benefits calculated?
TTD is based on two-thirds of the injured worker's average weekly wage, up to the statutory maximum set by law.
- What documentation does CARO need to consider payment of TTD benefits?
CARO will confirm with the agency that the employee is off work due to the injury. CARO also requires documentation of the employee’s off work status from the authorized medical provider(s). This documentation may be in the form of off work slips, etc. Agencies may fax documentation to CARO at 573-751-5262 or 573-526-0820, or email the documentation directly to the assigned claims adjuster.
- May sick leave be used?
Effective October 2, 1998, an Administrative Rule went into effect stating that state employees off work for a work-related injury may only use their sick leave to supplement their workers’ compensation time lost benefits to make up the difference and receive full pay. Therefore, employees may only elect workers’ compensation leave without pay or annual leave.
CARO provides agencies with monthly reports detailing payments made to each employee. Agencies can use this report to calculate the number of hours needed to supplement the employee's pay with sick leave.
- What if the doctor releases an employee to temporary modified duty?
Effective March 1, 2002, the State of Missouri launched the Early Return to Work Program. Employees who are eligible for temporary modified duty will enter their agency's Early Return to Work Program and return to the agency payroll. CARO will contact agencies regarding the status of temporary total or temporary partial disability benefits upon notification from the physician that the employee can return to work in a temporary modified duty status.
For more information, visit the Division of Workers' Compensation Benefits Available.
- What are permanent total disability (PTD) or permanent partial disability (PPD) benefits?
Once a doctor has done all they feel can be done medically to help an employee, and the employee is not as physically able as they were before the injury, then there is a disability. And if there isn't anything else the doctor can do to make the employee any better, the disability will be "permanent", meaning the employee will suffer the effect of the injury from that point on. That disability will either be "total" meaning the employee is unable to perform any work or After a physician has finished medical treatment and released an employee to return to work, they may be able to evaluate the employees level of permanent partial disability. Once a disability rating is received from the physician, CARO will request the claim to be set for a conference at the Division of Workers' Compensation. A conference is a setting whereby the injured employee, the CARO representative and the Administrative Law Judge from the Division of Workers' Compensation work to bring the claim to conclusion. CARO initiates payment for PPD upon receipt of a settlement agreement signed by the Administrative Law Judge."partial" which means the employee is able to work but there are limitations or restrictions as to what they are able to do. If the employee is determined to be permanently and totally disabled, benefits will continue for the rest of their life. If the disability is a permanent partial disability (PPD), the legislature has established a formula to convert that disability into a dollar amount. The maximum weekly wage amount for a permanent partial disability is less than the maximum for the temporary total disability because the disability is partial instead of total. Compensation is for the disability only. The law does not provide compensation for pain and suffering.
- When are PPD benefits paid?
After a physician has finished medical treatment and released an employee to return to work, they may be able to evaluate the employees level of permanent partial disability. Once a disability rating is received from the physician, CARO will request the claim to be set for a conference at the Division of Workers' Compensation. A conference is a setting whereby the injured employee, the CARO representative and the Administrative Law Judge from the Division of Workers' Compensation work to bring the claim to conclusion. CARO initiates payment for PPD upon receipt of a settlement agreement signed by the Administrative Law Judge.
Early Return to Work Program
- If the authorized treating physician indicates you have temporary physical restrictions that will not allow you to perform your regular job duties, consideration will be given to modifying your job tasks within the restrictions.
- Promptly provide your supervisor and Human Resource Department any written documentation from your physician of temporary or permanent work restrictions
- You must maintain regular contact with your supervisor and Human Resource Department.
- Promptly provide your supervisor and Human Resource Department documentation from the treating physician releasing you to full work status.
- The temporary modified duty assignment will continue until such time as the authorized treating physician determines you are released to full duty, that you have permanent restrictions or when the employer should cease the assignment.
Pursuant to 287.140 RSMo., when an employee is required to submit to medical examination or necessary medical treatment at a place outside of the local or metropolitan area from the employees principal place of employment, the employee shall receive reasonable reimbursement.
The Mileage Reimbursement Form provides documentation of miles traveled to seek authorized medical care for a work-related injury. This form can be submitted to CARO by the injured employee or state agency.
To be completed by employee:
Name and address of the employee
CARO case number (if known)
Date of Injury
Name of State Agency
The employee should indicate the dates traveled, the city they are departing from and what city they are traveling to seek medical care due to the injury. The employee should also indicate the number of round trip miles traveled. The form should be completed with the employee's signature.
To be completed by the medical provider:
To confirm mileage traveled, the employee should have the medical provider complete this portion of the form at the time the treatment is rendered. The medical provider should provide their name, address, and sign and date the form.
To be completed by CARO:
If mileage is determined to be due, this portion of the form is completed by CARO at the time payments is processed based upon the state mileage allowance rate in effect on the date the employee traveled to the medical provider.
CARO forms may be sent via e-mail, mail or fax.
- Authorization to Release Medical Records - Completed by injured employees. Allows CARO access to medical records.
- Mileage Reimbursement Request - Completed by an injured employee requesting mileage reimbursement to and from medical treatment.
- Time Lost Report for Workers' Compensation Injuries - Used by state agencies to report days away from work as a result of workers' compensation injuries.
- Employee Injury Report - Completed by the employee after an injury.
- Supervisor Statement - Completed by the supervisor after an injury.
- Witness Statement- Completed by any witnesses to an injury.
- Eyeglasses Report - Completed in the event there is damage to an employee's eyeglasses.
- Physical Assessment Form - Completed by the medical provider.
- Duty Assessment Form - Optional form available to agencies. Used during modified duty assignments.
How to Report Fraud
The Missouri Workers’ Compensation Law provides that any person convicted of fraud shall be guilty of a Class D felony and fined an amount up to $10,000, or double the value of the fraud, whichever is greater. Subsequent violations shall be guilty of a Class C felony.
If you suspect someone may have committed fraud, please call the Fraud and Noncompliance Unit at 1-800-592-6003 or write to:Department of Labor and Industrial Relations
Division of Workers’ Compensation
Fraud and Noncompliance Unit
P.O. Box 1009
Jefferson City, MO 65102-1009
All investigations conducted by the Fraud and Noncompliance Unit are strictly confidential.
For more information, visit the Division of Workers' Compensation Fraud and Noncompliance.