Resources for Current Employees

Workers Compensation

CONTACT: Jodi Anthony, (920) 424-2070, anthonyj@uwosh.edu

The Worker's Compensation Act of Wisconsin provides coverage when, the employee is performing service growing out of and incidental to his or her employment, and sustains an injury as a result of that service.

The following steps should be taken when a faculty/staff member or student worker is injured while performing job responsibilities:

1. The Employee injured should complete the "Injury and Illness Report" and submit it to their chair/supervisor. http://www.uwsa.edu/oslp/wc/forms/OSLP-1EmpForm.doc
   
   
2. The Chair/Supervisor must complete the "Supervisor's Accident Analysis and Prevention Report" and the "Employer's First Report of Injury or Disease" form.

Supervisor's Analysis Report: http://www.uwsa.edu/oslp/wc/forms/slp2su.doc

Employer's First Report: http://www.uwsa.edu/oslp/wc/forms/wkc-12.doc

3. Send all 3 signed and dated forms to Human Resources, Dempsey Hall 328, within 3 days of the injury.

UW System policy requires all forms to be submitted to the Office of Safety and Loss Prevention within 7 days of the injury date, thus, UW Oshkosh Human Resources requests forms to be submitted within 3 days of the injury to allow for questions and data entry.

If it is a work related death please contact Human Resources immediately. It must be reported to the Department of Workforce Development within 24 hours.

NOTE: Please complete the forms as thoroughly as possible to avoid delays in processing.

4. All Physician Return to Work forms and reports should be forwarded to Human Resources upon receipt. These forms will indicate the date a faculty/staff member may return to work with or without restrictions and must be filed with UW System Worker's Compensation. For each physician visit, a return to work form should be submitted including if the diagnosis is to return to work with no restrictions.

5. Timecard/Leave Reporting should indicate any lost time due to a work related injury. If lost time occurs, it is important that the timecard/leave report indicate those days off of work. Jodi will assist with how time should be recorded on the timecard/leave report on a case-by-case basis.

If, due to the injury, the chair/supervisor or employee are unable to complete the forms within the 3 days immediately contact Jodi to inform her of the details of the injury.

This is especially important for injuries causing lost time or requiring medical treatment beyond first aid. If reports of injury are reported late to the Office of Safety and Loss Prevention, the department may be responsible for paying for fines related to worker's compensation requirements.

Upon receipt of the injury reports, Human Resources will review for completeness and submit to the Office of Safety and Loss Prevention. The UW Oshkosh Safety Coordinator will review all injury reports for evaluation of safety practices on campus.

The UW System Worker's Compensation Coordinator will contact the employee injured with details of the claim. Jodi will be the liaison between the Office of Safety and Loss Prevention and the employee. If you should have any questions or concerns regarding claims, please contact Jodi.

For further information regarding Worker's Compensation, please visit the Office of Safety and Loss Prevention website at: http://www.uwsa.edu/oslp/wc/

Worker's Compensation Forms:

Think Safety First!

CONTACT:
Jodi Anthony
WC Coordinator
UW Oshkosh
(920) 424-2070
anthonyj@uwosh.edu

Questions about the website? Contact Becky Beahm at beahm@uwosh.edu

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