Mo. Code Regs. Ann. tit. 8, § 20-3.010
PURPOSE: This rule states powers, duties, and functions delegated to the division and separates jurisdiction of the division and commission in contested cases and settlements.
(1) The Division of Workers’ Compensation shall have and exercise the following powers, duties and functions on behalf of the commission in the administration of the Workers’ Compensation Law, section 287.410, RSMo:
(2) Original Hearings—Administrative Law Judges, Authority and Power.
(3) Original Hearings—Compromise Settlements.
benefits, and will also be responsible for providing to the commission, with the motion, contact information for the employee, and/or each dependent affected by the motion, including current addresses. Moving parties are advised that if the commission is unable to provide due notice of the sought modification to each interested party, the commission will not take any action to modify the award. Proof of the remarriage of the dependent surviving spouse shall be made by filing a copy of the marriage license of the remarried dependent surviving spouse or affidavit of the surviving spouse admitting remarriage. Proof of the death of the employee or any dependent shall be made by filing a copy of the death certificate of the employee or dependent. Evidence of the remarriage of the dependent surviving spouse or the death of the employee or dependents may be made by deposition or other evidence as the commission may specify.
(5) Lump Sum Payment of Compensation (Motion for Commutation).
of the county in which the dependent resides and proof of the appointment of a guardian and a certificate of the probate court certifying that the guardian has qualified shall be filed with the commission.
(I) Where a motion for commutation is jointly agreed by the parties, the commission will consider the motion provided it includes the following:
total disability or death benefits:
of birth and presumed life expectancy, including, in the event the parties are requesting that the commission presume a life expectancy that substantially differs from that indicated in the most recent edition of the National Vital Statistics Reports published by the U.S. Department of Health & Human Services, a written opinion from a medical professional explaining why the life expectancy so differs;
assumptions utilized by the parties in calculating the present-day or commutable value of the future installments that may be expected under the award or settlement;
stances that would support a determination by the commission that commutation will be in the best interests of the employee or dependents; or will avoid undue expense or undue hardship to either party; or that the employee or dependent has removed or is about to remove from the United States; or that the employer has sold or otherwise disposed of the greater part of its business or assets; and
commutation on the basis that such will be in the best interests of the employee or dependents, or will avoid undue expense or undue hardship to either party, the specific facts and circumstances that would support a determination by the commission that unusual circumstances exist in the case that warrant a departure from the normal method of payment; and
medical benefits where the underlying award or settlement does not expressly preserve to the employer/insurer the discretionary right to close future medical benefits by funding an annuity or Medicare Set-Aside trust account—
presumed life expectancy, including, in the event the parties are requesting that the commission presume a life expectancy that substantially differs from that indicated in the most recent edition of the National Vital Statistics Reports published by the U.S. Department of Health & Human Services, a written opinion from a medical professional explaining why the life expectancy so differs;
the employee in connection with the claim for at least the last five (5) years, if any, listed by date, provider, treatment, and amount;
assumptions utilized by the parties in calculating the commutable value of the future installments of medical expenses that may be expected under the award or settlement;
or reasonably anticipated to become, within the next thirty (30) months, a Medicare beneficiary, and if so, whether Medicare has made any conditional payments for medical treatment related to the work injury;
account is proposed to commute the future installments of medical care, whether all reasonably anticipated future medical expenses are of the type that will be covered by Medicare upon exhaustion of the commutation funds, or, in the alternative, an identification of what additional sums are being paid to cover expenses not covered by Medicare, including any evidence, attestation, or other information that would support a finding by the commission as to the sufficiency of such additional sums;
employee memorializing his or her understanding and agreement that the funds from the proposed commutation should be used exclusively for the purpose of paying for medical treatment related to the work injury, and that failure to expend the commutation funds for such purpose may jeopardize the employee’s later ability to obtain any financial assistance (via Medicare, private insurance, or otherwise) for future medical expenses related to the work injury; and
stances that would support a determination by the commission that commutation will be in the best interests of the employee or dependents; or will avoid undue expense or undue hardship to either party; or that the employee or dependent has removed or is about to remove from the United States; or that the employer has sold or otherwise disposed of the greater part of its business or assets.
(6) The commission retains jurisdiction over disputes pertaining to the parties’ respective rights and obligations with regard to future medical treatment whenever a final award or settlement in the case leaves the issue of future medical treatment “open” or otherwise indeterminate. See State ex rel. ISP Minerals, Inc. v. Labor & Indus. Rels. Comm’n, 465 S.W.3d 471 (Mo. 2015). The commission will only consider issues falling within its statutory authority, such as whether a disputed treatment is reasonably required to cure and relieve the effects of the work injury for purposes of section 287.140, RSMo, and will not entertain requests to “compel” or “enforce” any award or settlement, because such powers are reserved to the judiciary.
AUTHORITY: section 286.060, RSMo 2016.* This version of rule filed Dec. 18, 1975, effective Dec. 28, 1975. Amended: Filed July 11, 1991, effective Dec. 9, 1991. Amended: Filed Sept. 30, 1992, effective April 8, 1993. Rule action notice invalidating subsection (2)(C) March 12, 1996. Rule action notice validating subsection (2)(C) Aug. 28, 1998. Amended: Filed April 11, 2019, effective Oct. 30, 2019. *Original authority: 286.060, RSMo 1945, amended 1947, 1980, 1995, 2011. Farm v. Barlow Truck Lines Inc., 979 SW2d 169 (Mo. banc 1998) State ex rel. Doe Run Company v. Brown, 918 SW 2d 303 (Mo App. 1996). An administrative law judge set aside a dismissal of a claim for workers’ compensation. The claim had been dismissed for the failure to prosecute. A regulation promulgated by the Labor and Industrial Relation Commission, 8 CSR 20-3.010(2)(C), implied that an administrative law judge had authority to change or modify any final award within twenty days. Twenty days is the period of time in which to file an application for review with the Labor and Industrial Relations Commission. The Doe Run Company (employer) filed a petition for writ of prohibition of mandamus in circuit court, challenging the administrative law judge’s authority to set aside the dismissal of the claim for compensation. A permanent order in prohibition was denied by the circuit court and the employer sought review in the appellate court. The Missouri Court of Appeals, Eastern District, said that section 287.610.2, RSMo (1994), provides an administrative law judge with no jurisdiction to review or authority to reopen any prior award. Another statute, section 287.655, RSMo (1994), provides that an order of dismissal for lack of prosecution is an award, subject to review the same as any other award. The appellate court held that the proper avenue for review of an order of dismissal for failure to prosecute is by filing an application for review with the Labor and Industrial Relations Commission within twenty days of the date of the dismissal. Section 287.480, RSMo (1994). The administrative law judge was without jurisdiction to reinstate the employee’s compensation claim against the employer. To the extent that 8 8 CSR 20-3 CSR 20-3.010(2)(C) is interpreted as granting an administrative law judge with authority to reinstate a dismissed workers’ compensation claim within twenty days of a dismissal order, the rule conflicts with section 287.610.2, RSMo (1994), and is invalid. Cowick v. Gibbs Beauty Supplies, 430 SW2d 626 (Mo. App. 1968). Court of Appeals limited in review of award of Industrial Commission concerning workers’ compensation claim to a determination of whether the award was supported by competent and substantial evidence and whether an award could have reasonably been made upon a consideration of all of the evidence. The commission is the sole judge of the credibility of witnesses and the weight to be given to their testimony. Collins v. Eicher Heating Company, 319 SW2d 666 (Mo. App. 1959). Application for review by the full Industrial Commission filed by insurer and employer on form prepared by and furnished by the Industrial Commission and setting forth specific findings of administrative law judge appealed from, a request for permission to argue the case orally before the full commission because of conflicting medical evaluation of record, requesting the commission to appoint a qualified impartial physician to examine the employer and report his/her findings, court held to be in substantial compliance with the rules of the commission concerning applications for review; and therefore commission had jurisdiction to review the findings and award of the administrative law judge. Hogue v. Wurdack, 298 SW2d 492 (Mo. App. 1957). Industrial Commission is a creature of the legislature, and its jurisdiction and the question of what persons are subject to it is to be determined from the act of legislature. Commission’s jurisdiction cannot be dependent on or enlarged by estoppel, waiver, conduct or agreement. E.B. Jones Motor Company v. Industrial Commission, Division of Employment Security, 298 SW2d 411 (1957). Industrial Commission of Missouri is an entity subject to being sued in its official name; however, it is not a “state officer” within the meaning of the constitutional provision, Art. V, Section 3, Constitution of Missouri; thus, Supreme Court did not have jurisdiction of an appeal from decision of the commission, because of the absence of a “state officer” as a party. Employment Security Law is not a revenue law. INDUSTRIAL RELATIONS