Worker's Compensation - Filing Requirements
The University of Wisconsin System Office of Safety and Loss
Post Office Box 8010
Madison, Wisconsin 53708-8010
(608) 263-7330 Environmental/Occupational Health & Safety
(608) 263-4381 Risk Management
(608) 263-4381 Workers' Compensation
(608) 262-8589 FAX
TO: UW System Supervisor
FROM: Office of Safety and Loss Prevention Workers Compensation Office
RE: Workers Compensation - Filing Requirements
The Wisconsin Administrative Code 80.02 was revised effective January 1, 1998. This section pertains to filing requirements of workers compensation forms and in part states:
Reports: The employer (the UW campus) must submit a first report of injury [WKC-12] on or before the 7th day after an accident or the beginning of a disability from occupational disease to UW System Administration. For self insureds, such as the State of Wisconsin, UW System Administration must in turn file the WKC-12 with the Workers Compensation Division, Department of Workforce Development (DWD) by the 14th day.
The Workers Compensation Division is now holding employers accountable for these filing requirements.
Please note that once the employee advises you of an injury, or you become aware of an injury, it is your responsibility to complete and file the WKC-12 form immediately with your campus workers compensation coordinator. Although by practice we require the employee to complete the Employees Work Injury and Illness Report, by Statute it is the employers responsibility to report and file the WKC-12, First Report of Injury. Do not wait for the employee to complete their report before you complete the WCK-12.
If employee does not lose time initially at the time of injury, and subsequently loses time from work due to the work injury, the claim has changed to a lost time claim, which requires a supplemental report. Please advise your campus Workers Compensation Coordinator immediately so we can advise UW System. Administrative Rules state the first payment must be made by the 14th day after the employee leaves work as a result of the accident or disease.
The Administrative Code further provides enforcement procedures to ensure compliance with filing deadlines. Failure to submit reports or information as required may result in a fine of $100. In addition, a 10% delayed payment penalty may be assessed.
In accordance with Wisconsin Statutes, the $100 fine and 10% delayed payment assessment are penalties, and are charged to the employer - not the insurer. This means, the employing department is responsible for the penalty payment; it is not paid from the workers compensation claim.
Letters will be issued by the Workers Compensation Division to UW System Administration at the time of delayed reporting, advising of an assessed fine. UW System will expect explanation for delayed reports. Invoices will be issued annually by the Workers Compensation Division.
- To Summary of Reporting Requirements in DWD 80.02
- To Revisions to DWD Admin. Code 80.02, effective 1/1/98
Code, Chapter DWD 80 Workers Compensation