PDF
Word
Form WC-199 Answer to Application for Direct Payment - Missouri
What Is Form WC-199?
This is a legal form that was released by the Missouri Department of Labor and Industrial Relations - a government authority operating within Missouri. As of today, no separate filing guidelines for the form are provided by the issuing department.
FAQ
Q: What is Form WC-199?
A: Form WC-199 is an Application for Direct Payment in Missouri.
Q: Who should use Form WC-199?
A: Employees who are injured at work and are seeking direct payment from the employer should use Form WC-199.
Q: What is the purpose of Form WC-199?
A: The purpose of Form WC-199 is to request direct payment from the employer for medical treatment and related expenses for a work-related injury.
Q: What information is needed on Form WC-199?
A: Form WC-199 requires the employee's personal information, details of the injury, medical provider information, and a statement of medical expenses.
Form Details:
- Released on March 1, 2012;
- The latest edition provided by the Missouri Department of Labor and Industrial Relations;
- Easy to use and ready to print;
- Quick to customize;
- Compatible with most PDF-viewing applications;
- Fill out the form in our online filing application.
Download a fillable version of Form WC-199 by clicking the link below or browse more documents and templates provided by the Missouri Department of Labor and Industrial Relations.
