Mo labor application 2026

1. Click ‘Get Form’ to open the mo labor application in the editor.
2. Begin by filling in your personal information in the 'Employee' section, including your name and any dependents if applicable.
3. Enter the 'Injury Number' or 'Medical Fee Dispute Number' as required, followed by your employer's name and the date of injury.
4. Provide details about the insurer and check the box if the Second Injury Fund is involved in your application.
5. In the 'APPLICATION FOR REVIEW' section, specify the reasons for your review request. You may attach additional sheets if necessary.
6. Complete the signature section, including your Missouri Bar Number if you are represented by an attorney, and provide your contact information.
7. Finally, ensure that you understand that this application must be filed within twenty days from the decision date. Review all entries for accuracy before submission.

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