Employee's Work Injury and Illness Report
Please complete the report before your shift ends or within 24 hours of the incident.
Worker’s Compensation is a benefit program that pays for medical treatment and wages lost due to work-related injuries or illnesses.
What do you do if you have a work-related injury or illness?
The most important things to do as soon as possible are to:
- report the injury or illness to your supervisor (employer) as soon as possible,
- get the medical attention you need, and
- Complete and submit Employee’s Work Injury and Illness Report. (Link takes you to a BP Logix form online)
These and other important steps are outlined for you on our page, What if you’re injured at work?
What does worker’s compensation cover?
The major areas that worker’s compensation covers are:
- Medical treatment resulting from your work-related injury or illness.
- Lost wages.
- Compensation for permanent disabilities.
- Vocational rehabilitation.
For more detail, see our page, What does worker’s compensation cover?
What will happen when you file a claim?
Your injury report will start the worker’s compensation claims process. Your claim will be promptly reviewed to determine that your injury is work related.
- If the claim is determined to be work related, your employer will begin coverage and payment for the costs discussed in What does worker’s compensation cover?
- If your claim is denied, you will be notified. If you disagree with the decision about a denial and cannot resolve a claim dispute with your employer, you have certain appeal rights. For more information, see Limitations and denials.
Fraudulent claims
Collecting worker’s compensation benefits by intentionally misrepresenting, misstating, or failure to disclose any material fact is fraud. Fraudulent claims are subject to prosecution. All suspected violations will be investigated.
Who assists with worker’s compensation claims on your campus?
You can find the name and phone number for your campus worker’s compensation coordinator on the Campus WC Coordinators page. That page also provides a link to your campus worker’s compensation website.
If you are injured while traveling internationally on University business:
Outside Agency Links
The Wisconsin Department of Workforce Development (DWD) administers the worker’s compensation statute.
“Facts for Injured Workers about Worker’s Compensation in Wisconsin” (DWD publication)