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Get MO DWC WC-21 2015-2024

Ng the Claim form online, by typing the information needed in each field, printing the form, and mailing it to the Division’s Jefferson City office or filing it in one of the adjudication offices. 4. Amended Claim: If the Claim, including the Claim that is being filed against the Second Injury Fund, is being amended, the Box containing the amended information must be identified in the Box “ITEM NUMBER(S) AMENDED” in order for the Division to process the amendments to the Claim. 5. Copies: .

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