Worker's Compensation Process

If an employee is injured on the job/at the worksite, he/she should notify their supervisor as soon as possible.  This is true even in circumstances where the injury may appear minor and does not require medical treatment.

Any time an accident occurs, the following must occur:

• An Employee's Work Injury and Illness Report (form 1)
  (http://www.bussvc.wisc.edu/ecbs/OSLP-1EmpForm.pdf) must be completed.  
• The supervisor must complete the Supervisor's Report of Injury (form 2)
• (http://www.bussvc.wisc.edu/ecbs/wkc-sup.pdf).
• The employing department must complete the Employer's Report of Injury (form 3)
• (http://www.bussvc.wisc.edu/ecbs/WKC-12-E.pdf).
• These three forms must be submitted to Kallee Radtke in CALS Human Resources within 3 days of the incident.  Kallee submits these forms to the UW-Madison Worker's Compensation Office at 21 N. Park. 
• If the injury report cannot be sent to CALS HR within 3 days, contact Kallee Radtke at 608-890-2202 to inform her of the incident and the reason for the delay.  CALS HR must contact Worker's Compensation if there will be a significant delay -- departments risks being fined by the WI DWD if the report is not filed within 3 days.
• If an employee wants to file a claim for an injury/illness they believe happened at work previously, they should complete the same process as above, and simply list the date of injury as that on which they believe their injury/illness started.

After the campus Worker's Compensation Office receives all forms, the employee will be contacted by a worker's compensation examiner.  The employee will receive an acknowledgement of their claim, which lists their claim number and date of injury.  In addition, the type of claim will be listed.  CALS HR will be copied on this letter. 

Not all accidents lead to Worker's Compensation claims, but if they do, employees will receive status updates from the Worker's Compensation Office and may also be asked to provide additional information.  In addition, the department may be asked to complete and provide a "Worker's Compensation Employee Record of Lost Time" along with updated timesheets.

If you have questions regarding the Worker's Compensation process or a specific incident, please contact the CALS HR Manager working with your department. The campus Worker's Compensation website can be accessed at  http://www.bussvc.wisc.edu/ecbs/emp-wkc-menu.html.