Workers Compensation
The Worker's Compensation Act provides benefits when at the time of injury the employee is performing service growing out of and incidental to his or her employment. Injuries should be immediately reported to a supervisor. The required forms and injury reporting procedures can be found under the links below.
Please do not include social security numbers on any forms and do not submit via email as they contain confidential information.
Injury/Illness Reporting Procedure
- In the event of a medical emergency call 911 or contact University Police at 4660.
- Report the injury or illness to your supervisor immediately. Failure to report the injury/illness on the day of injury may compromise your claim.
- Complete the Employee's Work Injury and Illness Report (see sample) within 24 hours of injury/illness. Return it to your supervisor.
- Seek medical attention if necessary. If medical treatment is required, review the Medical Fact Sheet. When you seek medical treatment, advise the provider you have a worker's compensation claim and to submit medical bills to your campus worker's compensation coordinator. Should you receive medical bills, including prescription receipts, submit them to the worker's compensation coordinator on your campus.
Worker's Compensation Coordinator
UW-Whitewater Risk Management & Safety
800 W. Main Street, Hyer Hall Room 333
Whitewater, WI 53190
Phone: 262-472-1856
Fax: 262-472-5668 - When a work related injury results in work restrictions, or an absence from work, a work slip showing the reason and effective dates is required. Provide work slip to supervisor or Risk Management as soon as possible. The University of Wisconsin System has an Early Return to Work Policy. Your supervisor will contact Risk Management & Safety to discuss whether temporary modified duty is available within given work restrictions. The employee may be placed in another department temporarily if the employing department cannot accommodate restrictions. The employing department continues to pay wages.
- If lost time from work is more than 3 days after the date of injury, review the Lost Time Fact Sheet and contact your Worker's Compensation Coordinator. Medical documentation is required to substantiate disability payments under Worker's Compensation.
- Provide regular updates on health condition, treatment and medical status to your supervisor at least weekly until end of healing has been reached.
If you have any questions about reporting or procedures contact Risk Management & Safety at 262-472-1856
Supervisor Injury/Illness Reporting Procedure
- Initiate immediate medical attention if necessary. In the event of a medical emergency call 911 or contact University Police at 4660.
- Conduct investigation and correct hazards
- Report the injury
Supervisors are responsible for reporting the injury or illness to the Risk Management and Safety office by telephone as soon as possible, 262-472-1856. If after hours, or if Risk Management & Safety is not available, leave a voicemail message with:- Name of employee
- Date of injury/illness
- Nature of injury/illness
- If medical attention was sought
- Complete the following forms within 24 hours of notification of the injury/illness:
Employer's First Report of Injury or Disease (see sample)
Supervisor's Accident Analysis and Prevention Report
Retrieve the Employee's Work Injury and Illness Report (see sample) from the Employee if not already received.
Hand deliver the Employee's Work Injury and Illness Report, Employer's First Report of Injury or Disease and the Supervisor's Accident Analysis and Prevention Report to Risk Management & Safety Hyer Hall Room 333, for processing as soon as possible, but within 24 hours of the injury/illness notification. - When a work related injury results in work restrictions, or an absence from work, a work slip showing the reason and effective dates is required. Provide the information to Risk Management and Safety as soon as possible. The University of Wisconsin System has an Early Return to Work Policy. Contact Risk Management and Safety to discuss whether temporary modified duty is available within given work restrictions. When appropriate, find or develop modified duty assignment to the employee within restrictions. The employee may be placed in another department temporarily if the employing department cannot accommodate restrictions. The employing department continues to pay wages.
- If the employee's lost time from work is more than 3 days after the date of injury, contact the Worker's Compensation Coordinator. Medical documentation is required to substantiate disability payments under Worker's Compensation.
- Maintain contact with the injured worker and Risk Management & Safety regarding health condition, treatment and medical status at least weekly until end of healing has been reached.
If you have any questions about reporting or procedures contact Risk Management & Safety at 262-472-1856
Policy
The health and well being of all employees is of great importance and concern to the University of Wisconsin-Whitewater. It is well documented that injuries affect the whole body and that effective rehabilitation and treatment must address the whole body. A part of that treatment includes the concept of keeping physically and mentally active within the restrictions of the particular injury. The University of Wisconsin-Whitewater will make every effort to provide its employees the opportunity to maximize their rehabilitation and physical therapy and enable their early return to work.
Responsibility
The Office of Risk Management and Safety in the Administrative Affairs division in coordination with UW-System staff are charged with the responsibility of providing medical and disability benefits through the Worker's Compensation program, to employees who are injured on the job. The administration of a return-to-work program, including light duty or alternate duty assignments, is a responsibility of the Office of Risk Management and Safety in close cooperation with the Office of Human Resources and Diversity and the effected employee's department.
Authority
Executive Order 194 states "promote effective investigation and management of worker's compensation claims and the early return to work of injured employees using transitional work assignments and other rehabilitation strategies." In addition to a positive return to work program, the University will make every effort to continue the employment of the employee within any permanent restrictions and within the spirit of the law.
Supervisor
If it is determined at the time of any injury, that the disability will exceed five working days, the supervisor shall advise the Office of Risk Management and Safety of the employee's job duties and of potential alternate duty work available within the employee's department.
Risk Management and Safety
Upon receipt of the injury report and supervisor's comments, the Office of Risk Management and Safety will consult with the treating physician regarding alternate duty assignments. With the concurrence of the treating physician, the University will be advised of the employee's release to return to an alternate duty assignment within the restrictions established by the physician.
Supervisor/Employee
The employee will be advised by the supervisor of the alternate duty chosen and will be assigned such duty for a period not to exceed 90 days or until such time as the restrictions are changed or withdrawn by the physician. The 90 day period may be extended upon recommendation of the attending physician so long as medical progress toward end of healing is being made.
Department/Unit
If, at the end of the healing period, the employee's permanent restrictions preclude a return to their former position, it is the responsibility of UW-Whitewater to place the employee on the campus and within the restrictions whenever possible. Reasonable accommodations consistent with EEO and ADA guidelines will be made. The employing department/unit Administrator is encouraged to consult with other departments/units in an attempt to secure a job placement for the employee if none can be found in the employing department. The salary of the injured/ill employee will be the responsibility of the original employing unit until appropriate transfers have been made.
Human Resources and Diversity
If placement is not established within 30 days of the disability determination, after end of healing, the matter will be decided by the Director of the Personnel and Payroll Services. If suitable vacancies do not exist at UW-Whitewater, Human Resources and Diversity will seek other employment options within state service for the employee.