Agency Responsibilities After An Injury Occurs
Upon notification of an injury, determine if medical treatment is necessary.
- Emergency situations: Send employee to the nearest emergency room
- Non-Emergency situations: 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
- Assist the injured employee in seeking authorized medical care and reporting the injury to workers’ compensation pursuant to proper reporting procedures within the agency.
- Conduct proper accident investigation and correct any identified hazards.
Give injured employee the “State Employee Workers’ Compensation Reporting Packet” for completion. This packet contains basic information about workers’ compensation and the Employee Injury Report.
Complete and send CARO forms for each injury, as appropriate.
Enter injury into RESTORE.
For the new RESTORE users, please submit the New User Security Request form.
Report any lost time due to the injury and forward all off work slips from the medical provider to CARO.
Benefit Information
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?
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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?
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All employees, full or part-time.
- What is covered?
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Injury or illness arising out of and in the course of employment.
- Time of coverage?
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Coverage begins the first minute an employee is on the job and continues while the employee is working.
- What about occupational diseases?
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- 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?
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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?
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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.
Medical Treatment
- 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?
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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?
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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?
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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.
Permanent Disability
- 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.