University of Wisconsin - Green Bay

Safety & Environmental Management

Worker's Compensation

Marie Lemerond, Workers Compensation Coordinator
Business & Finance, CL 830
2420 Nicolet Drive
Green Bay, WI 54311-7001

Phone: (920) 465-2210
Fax: (920) 465-5110
Email: stephenm@uwgb.edu

Fact Pages

Facts regarding worker's compensation, lost time and links to outside resources

• Medical Only
• Lost Time

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Instructions for Required Forms

1. For the Employee:
   • Employee's work injury and illness report
   • Information on how to write injury descriptions


2. For the Supervisor:
   • Supervisor accident analysis and prevention report
3. For the Employee and Supervisor:
   • Employer's first report of injury or disease

For additional information: or if you need additional forms please visit the State of Wisconsin Department of Workforce Development page entitled Workers Compensation forms List and Order Form or visit the Worker's Compensation Forms Library.

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On-Campus Care

On-campus rehabilitation and injury care program

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Filing Requirements

More information regarding the requirements for filing a claim

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Related Sites

• UW Green Bay Human Resources
  
• The University of Wisconsin System Administration OSLP
• Wisconsin Worker's Compensation Division