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Missouri State Employees Retirement System (MOSES) STAYATWORK FORM Reset Contract #: 604201 Group #: 10008243 Employer/Dept: Employer Contact Name/Job Title: Email: Phone: Fax: Address: Employees
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How to fill out stay-at-work form - mosers:

01
Start by accessing the stay-at-work form - mosers from the official Mosers website.
02
Read the instructions carefully to understand the purpose and requirements of the form.
03
Begin by entering your personal information, such as your name, employee ID, and contact details.
04
Provide the necessary details regarding the accident or injury that occurred at work. This may include the date, time, and location of the incident.
05
Specify the nature of your injury or the reason for needing to stay at work. Include any medical diagnosis or recommendations from healthcare professionals.
06
If applicable, indicate any witnesses to the incident and their contact information.
07
Next, outline your work restrictions and limitations resulting from the injury. Be specific about the tasks or activities you cannot perform or require accommodation for.
08
If you have been receiving treatment, provide details about your healthcare provider, any medication or treatments prescribed, and the expected duration of your recovery.
09
If necessary, attach any supporting medical documentation, such as doctor's notes, test results, or invoices related to the injury.
10
Review the form to ensure all information is accurate and complete. Make any necessary corrections before submitting it to the appropriate department within Mosers.

Who needs stay-at-work form - mosers?

01
Employees who have suffered an injury or accident at work and require accommodations to continue working.
02
Individuals who have work restrictions or limitations due to a work-related injury or medical condition.
03
Mosers members who want to utilize the stay-at-work program and receive support in returning to work safely and effectively.
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Stay-at-work form - MOSERS is a form that allows members of the Missouri State Employees' Retirement System (MOSERS) to report their work status while receiving disability benefits.
Members of MOSERS who are receiving disability benefits and return to work or have changes in their work status are required to file the stay-at-work form.
The stay-at-work form can be filled out online through the MOSERS website or requested to be sent by mail. Members need to provide details about their work status, earnings, and any changes in their employment.
The purpose of the stay-at-work form is to ensure that MOSERS has updated and accurate information regarding a member's work status while receiving disability benefits.
Information such as work status, earnings, changes in employment, and any other relevant details must be reported on the stay-at-work form.
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