Worker’s Compensation Resources for HR Representatives

Reporting injury and worker’s compensation claim submission process

1. Immediately obtain the completed Employee’s Work Injury and Illness Report and Supervisor’s Incident Analysis and Prevention Report.
2. Submit the completed forms to UW-Madison’s Worker’s Compensation, in one of the following three (3) manners:
   1. 1. Via email at workcompprog@bussvc.wisc.edu (preferred);
      2. Via fax at (608) 265-3624 (less desired); and/or
      3. By entering the claim into the Enterprise STARS Worker’s Compensation claims system

After claim is submitted

1. Assist the Office of Risk Management Worker’s Compensation Coordinator in investigating circumstances of the injury and obtaining information pertinent to the claim.
2. Maintain contact with the injured employee, whether the employee is at work or home, to stay apprised of changes in the employee’s work status.
3. Serve as a liaison between the employee and the Worker’s Compensation Coordinator, referring the injured employee to the Worker’s Compensation Coordinator if any questions arise concerning the Worker’s Compensation claims administration process.
4. Keep the Worker’s Compensation Coordinator apprised of any problems or issues with the claim.
5. Through the Divisional Disability Representative (DDR), work with the injured employee and/or their treating specialist to obtain timely, up-to-date documentation regarding the employee’s work status and/or Return to Work (RTW) restrictions. Send the Worker’s Compensation Coordinator all medical off-work/RTW medical notes for the employee and any other medical documentation that is received.
6. Provide timely work status updates and Leave documentation to the Worker’s Compensation Coordinator, including:
   1. Updates on changes in employee work status and Return to Work information;
   2. WC Lost Timesheets for the injured employee (submitted bi-weekly or monthly, as applicable);
   3. Leave updates (including leave taken without pay); and
   4. Other claim-related documentation as received, including any medical bills or reports for the injured employee.
7. Coordinated with the Divisional Payroll & Benefits Specialist to ensure Leave and Benefits WC Restorations are completed in a timely manner for employees who have taken Medical Leave from work due to a compensable work-related injury.
8. Assist the DDR in any employee’s campus RTW activities. To facilitate the employee’s RTW, the DDR will:
   1. Obtain RTW and/or Work Restriction medical documentation from the injured employee’s treating specialist;
   2. Correspond with the treating specialist to clarify employer-related concerns;
   3. Contact the employee’s supervisor to assure understanding of any necessary temporary work adjustments and identify suitable temporary work tasks for the injured employee;
   4. Assist with the development of temporary duty assignments, as appropriate, to return the employee to work.

Additional claims details