WC-86 Instructions

Form WC-86: Self-Insurer's Report of Workers' Compensation Payments, for the reporting year. This report includes all compensation payments made during the reporting year regardless of the accident year. Section I must list the employer’s primary location.

*Please note that the highlighted areas on the forms are areas that MUST be completed (entire form)

Instructions:

  • Make sure that you mark whether your company is under or considering bankrupty
WC-86 Instructions

DISCLAIMER - More Information

The Employers, Insurers, TPAs section of the Workers' Compensation portion of this web site is targeted specifically to employers, insurers and third party administrators and is intended to be a resource throughout the workers' compensation claim process. It is NOT intended to be a substitute for legal representation.

Injured workers seeking information about the workers' compensation process should use the Injured Workers section of the Workers' Compensation web site to find information targeted specifically to them.

Additional information about Missouri Workers' Compensation laws, the Division of Workers Compensation, the Second Injury Fund and more may be found via the Workers' Compensation home page.