Worker's Compensation Insurance Letters

December 29, 1997

INS 384

To: All Worker’s Compensation Carriers and Self-Insured Employers

From: Gregory Krohm, Administrator

Subject: Introduction of Revised Forms, WKC-12, WKC-13 and WKC-13a

In order to facilitate the new Worker’s Compensation law changes that will become effective January 1, 1998, some key forms have been revised. Copies of the final revised versions of the WKC-12, WKC-13 and WKC-13a are enclosed.

Begin using these revised forms immediately. You may reproduce these forms. If you re-create these forms within your own automated systems, ensure they duplicate these formats and contain the form number. If you are making minor revisions, obtain authorization from the Worker’s Compensation Division before using them. The word processing file to create these forms can be downloaded easily from our website:

http://www.dwd.state.wi.us/notespub/wcwebfo/17e.htm

The WKC-13a contains several changes. It includes instructions on the reverse side and is designed to help your staff compute TTD rates accurately. One new aid is direct access to a wage analyst through the Division’s e-mail using the address:

WCWage@mail.state.wi.us

Please ensure that your staff or your claim administrators receive, understand, and submit these forms when due. Use of inappropriate forms may result in the form being returned with a request that the new versions be used.