24 hours after fatal incident

All employers must report all work-related fatalities to the Worker’s Compensation Division, Madison Office, within 24 hours of the incident.

7 days after injury

Insured employers must report any claim of an injury to their insurance carrier within 7 days.

4 or more days lost time from work?

Self-insured employers and insurance carriers must report injuries which result in four days or more lost time from work to the:

Worker’s Compensation Division

201 East Washington Avenue

P.O. Box 7901

Madison, WI 53707-7901

The report must be on a form WKC-12 – Employer’s First Report of Injury or Disease, or electronically filed, and must be filed within 14 days after the injury.

Form WKC-13 – Supplementary Report on Accidents and Industrial Diseases or its electronic equivalent must be filed by the 30th day after the injury.

Various medical forms as well as final payment reports may be required as well.

Failure to Report

If an employer intentionally fails to file a report of injury, the employer may be assessed a penalty for bad faith up to $15,000 or 200 percent of compensation due.

An employer may be assessed a 10 percent penalty for delay in reporting an injury with the delay causing an untimely payment to the employee. If the penalty amount is not paid by the designated date, a default order may be issued.

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