Accident Reporting & Workers' Compensation

Please report all accident and injuries, even if the injury seems minor at the time the event occurs. Small injuries can grow into more severe injuries if left untreated. It is necessary to complete and submit accident reports to the UW Colleges Human Resources Office in Madison within 24 hours, or, as soon as possible after an incident. This is important to ensure that the employee’s worker compensation claims are processed accurately and timely. See your supervisor to discuss repairs to facilities or changes to work processes that may be implemented to prevent future accidents.

There are 4 required reports that need to be completed and sent as follows:

  • Employee Injury and Illness Report [UWS/OSLP-1Emp (03/02)]**
    To be completed by the employee within 24 hours after incident and sent as e-mail attachments to hrstaff@uwc.edu
  • Employer's First Report of Injury or Disease (WKC-12)**
    To be completed by the Assistant Campus Dean for Administration and Finance and sent within 24 hours after the incident as e-mail attachments to hrstaff@uwc.edu.  
  • Supervisor Accident & Analysis Form [UWS/OSLP-2 (2/98)]
    To be completed by the Supervisor immediately after Employee Injury and Illness Report received. 
  • Safety Coordinators Review [UWS/OSLP Safe-1 (03/02)]
    To be completed by Safety Coordinator (Assistant Dean) after above two forms have been completed

The above forms can be found here: https://www.wisconsin.edu/workers-compensation/forms/

NOTE: The original, signed, hard copies of each of the forms above need to be sent to the Central HR Office via campus mail as soon as all forms have been completed.  DO NOT EMAIL ANY DOCUMENTS THAT CONTAIN SOCIAL SECURITY NUMBERS, PLEASE REDACT BEFORE SENDING VIA EMAIL.

** The first two reports should be sent to Madison within 24 hours of the incident.

Information on Worker's Compensation can be found at:

https://www.wisconsin.edu/workers-compensation/

http://dwd.wisconsin.gov/wc/default.htm