Outdated or Unsupported Browser Detected
DWD's website uses the latest technology. This makes our site faster and easier to use across all devices. Unfortunatley, your browser is out of date and is not supported. An update is not required, but it is strongly recommended to improve your browsing experience. To update Internet Explorer to Microsoft Edge visit their website.
Document Number: WKC-136-E
Description: This form is used when an injured worker needs to request an advancement on their permanent disability benefit or from a restricted account. The information provided is used by the division to determine if the advancement request can be approved as specified in the Worker's Compensation Act.
Comments: This form can be filled out on the computer as a fillable pdf.
Content Contact: Lynn Weinberger
Document Attachments:
WKC-136-E (English Electronic Version) - pdf/682 KB)
WKC-136-E-S (Spanish Electronic Version - pdf/700 KB)
Note: If you need this form in an alternate format, please send a message to the Content Contact listed above.
DWD Contact Information
201 E. Washington Ave
P.O. Box 7946
Madison, WI 53707
(608) 266-3131
Sign up for DWD news and updates
A proud partner of the 
network