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Required Reports (Event Table)

In Wisconsin, the Worker's Compensation system has timely reporting requirements associated with certain claim events or changes in the claim status. Claim events that trigger reporting requirements, the required forms to be reported, and the timeframes for reporting are found in the table below. For complete text of provisions, please see Wisconsin Administrative Code DWD 80.02

For complete text of provisions, see Wisconsin Administrative Code DWD 80

Required Reports (Event Table)
Due Form Code Requirement
1 day WKC-12, First Report of Injury DWD 80.02(1) An employer shall within one day after the death of an employee due to a compensable injury, report the death to the department and the employer’s insurance carrier.
14 days WKC-12, First Report of Injury DWD 80.02(2)(a) A first report of injury… on or before the 14th day after an accident or the beginning of a disability from occupational disease.
30 days WKC-13, Supplemental Report DWD 80.02(2)(b) A supplementary report, with information required by form WKC-13 on or before the 30th day following the day on which the injury occurred. (First payment & Wage Info)
30 days WKC13A, Wage Info DWD 80.02(2)(c) The wage information required by form WKC-13A if the wage is less than the maximum wage
30 days Part-time employee’s restriction statement if applicable DWD 80.02(2)(d) A signed statement from the employee to verify that the employee restricts his/her availability on the labor market to part-time employment, and is not actively employed elsewhere.
30 days from event WKC-13, Supplemental Report. (Accompanied by WKC-16, Final Medical, at end of healing when more than 3 weeks of temporary disability, any PPD or surgery as a result of injury). DWD 80.02(2)(e) A WKC13 report within 30 days after each of the following events, with a copy to the employee

Payment type is changed from TTD or salary continuation in lieu of compensation to PPD

TTD benefits or salary continuation in lieu of compensation are reinstated

TPD is paid including information 30 days from event required by form WKC-7359-1-E

Final payment of compensation is made or salary continuation in lieu of compensation ended
At time of event WKC13, supplemental report DWD 80.02(2)(f) Due when: Submitting stipulation or compromise at time of hearing