WKC-12 - First Report of Injury: EDI Format

The electronic first reports of injury for the Wisconsin Worker’s Compensation contains data fields that are mandatory, optional and conditional depending on different maintenance type codes.  The format for this information is provided for your convenience.  For your reference, we have provided supplemental information in a frequently asked question mode.

 

 Updated June 21, 2010
 Division of Worker's Compensation
 Content Contact: Bureau of Claims Management, EDI Coordinator