State Human Resources Office

How and When to File a Claim

If you've sustained an injury or contracted an illness at work, please notify your supervisor as soon as possible. This is true even in circumstances where your injuries or illness may be minor and do not require medical treatment.

To begin a Worker's Compensation claim, complete the Employee's Workplace Injury or Illness Report  under Safety Forms, and submit it to your supervisor or Risk Officer.

Your supervisor and employing department will then complete the Supervisor and Safety Coordinators Investigation Report for Injury or Illness and then Employer's First Report of Injury or Disease

Please take the Physicians Certification DOA-6125 with you when seeking medical treatment.

These forms will then be sent to the Risk Officer, Joint Force Headquarters, 2400 Wright Street, Madison, WI 53714.

Worker's Compensation Eligibility

Worker's Compensation law provides benefits to employees who are in the service of an employer. This includes classified employees, LTEs, faculty, academic staff, student assistants, and student hourlies.


The Worker's Compensation Act provides for payment of reasonable medical expenses and compensation for lost wages resulting from work-related injuries or disabilities.
These benefits are the responsibility of the self-insured employer or the employer's worker's compensation insurance carrier.
Important Note: If You Are Receiving BOTH Worker's Compensation Benefits and Social Security Disability Payments: An injured worker is required by law to notify the employer's worker's compensation insurance carrier (or self-insured employer) if receiving both worker's compensation benefits and Social Security Disability Payments.

When Does Coverage Begin?

  • Regardless of how long an employee has been working for an employer, or whether or not he/she is in a probationary or training status, coverage for Workers Compensation purposes begins on the first day of work.
  • However, in order to expedite the processing of your claim, you should immediately report your injury or ailment to your supervisor.
  • There is a three-day waiting period. The first 3 days of lost time after the injury are not compensable. Compensation is payable beginning on your 4th day of lost time. If your disability extends beyond 7 calendar days, the 1st 3 days of lost time would be picked up and paid retroactively.

What Happens If My Claim is denied?

If your claim is denied, in full or in part, and you believe that you should receive benefits (or further benefits), your dispute may be handled through a formal hearing or through an informal alternative dispute resolution process.
If you have not retained an attorney, your claim will initially follow the informal process. Your claim will be referred to a specialist in the Division’s Alternative Dispute Resolution (ADR) Unit. The ADR staff will review your claim to determine the issues in dispute and assure that the medical information submitted supports your claim for benefits. If the ADR staff believes that the issues can be resolved without a formal hearing, you and the insurer will be contacted in an attempt to resolve your dispute.
If the issues cannot be resolved through the informal alternative dispute process, you may request a formal hearing with an Administrative Law Judge (ALJ). To request a hearing, you will need to complete an application for hearing form and provide medical information to support your claim. While it is not a requirement, many people believe that it is beneficial to have an attorney involved in the hearing since it is a legal proceeding.
As a legally binding procedure, the ALJ is required to obtain information from all parties during the hearing. The ALJ reviews all pertinent information related to the hearing and issues a decision based on his/her findings. This decision by the ALJ becomes a formal "order" to which the parties of the hearing must adhere. The order specifies the conditions under which the dispute will be resolved.
You may appeal a decision by an ALJ if you believe the decision was incorrect. Your appeal would be made to the Labor and Industry Review Commission (LIRC). Your case would be reviewed by LIRC and they will provide you with a decision. If you disagree with the decision from LIRC, you may appeal to circuit court.

Statute of limitations

By law, the claim is usually held open for 12 years from the date of the injury or from the date of the last payment to you, whichever is later, should you continue to incur expenses. It is recommended that you save your record of the last WC payment for 12 years.

Claim denial – injured worker’s rights

If your claim is denied, either in part or in full, and you believe that you should receive further benefits, your dispute may be handled through a formal hearing or through an informal alternative dispute resolution process. For more information, go to the Department of Workforce Development page, What Happens If My Claim Is Denied?

Leave Options

Temporary disability compensation can be supplemented with your accumulated leave credits. This allows employees to supplement their worker’s compensation payment (approximately two-thirds of salary) with approximately one-third leave credits so they receive about their normal paycheck.
An employee may elect to be on leave-without-pay during the period of absence and receive only temporary disability compensation. If this option is chosen, or the employee does not have enough leave credits to cover the absence, the employee would not be paid any accrued leave credits.
Leave credits are not earned for hours of leave-without-pay, including hours restored as a result of an overpayment.
Worker’s compensation payments are not taxable for social security, federal tax or state tax.
Worker’s compensation is integrated with Income Continuation Insurance. Benefits paid under worker’s compensation will be deducted from any paid income continuation benefits.
If during the absence an employee is no longer on the payroll, you should contact your Benefits Office to make arrangements for premium payment of benefits and/or insurance, as well as appropriate leave of absence forms.

Worker's Compensation Benefits

Worker's Compensation law provides benefits to employees who are in the service of an employer. This includes classified employees, LTEs, faculty, academic staff, student assistants, and student hourlies.

    • Medical Benefits

You are entitled to medical, surgical, chiropractic, psychological, podiatric, dental, and hospital treatment "as may be reasonably required to cure and relieve the effects of the injury." The Department of Administration makes these determinations.

    • Wage Benefits

Benefits are equal to 2/3 of your average weekly wage up to a maximum of $1,441.50 and are not taxable. Benefits are payable until you reach a healing plateau.

    • Vocational Retraining Benefits

If your medical practitioner determines that you have permanent restrictions and are unable to return to your job, you may be eligible for vocational retraining. If enrolled and participating in a qualifying program of vocational retraining and/or on-the-job training, you may be eligible for additional Temporary Total Disability benefits for at least the first 80 weeks and payment for certain expenses such as travel, lodging, and meals.

Independent Medical Evaluation (IME)

You may be required to undergo an IME by a practitioner selected by your Worker's Compensation Claims Examiner. You will be notified in writing as to the date, time, place, and name of the practitioner. You are not required to travel more than 100 miles to this examination unless the Department of Workforce Development determines that circumstances warrant you traveling a greater distance, or the place where you have been receiving medical treatment is more than 100 miles from where you live. You will be reimbursed for travel and lost wages during the time of the examination.

You have the right to have your own physician present at the examination at your own expense. You also have the right to have a translator provided by yourself present at the exam if you have difficulty speaking or understanding the English language.

Following the examination, you will receive a copy of the report.


You are eligible to be reimbursed for mileage for travel to obtain medical treatment. The rate of reimbursement is set by the Department of Workforce Development at $0.51 per mile.

Mileage Reimbursement Form

Return to Work (RTW)

You may be eligible for continued temporary disability or partial disability benefits if you are released to return to work with temporary restrictions.

If The Department of Military Affairs cannot or does not make work available, you will be entitled to temporary disability benefits until the end of the healing period or until work is offered within your limitations. If you refuse to return to work once temporary restrictions can be accommodated, you will forfeit the right to continued disability benefits.

DOA Form 15336 Fitness For Duty Certification – Return To Work Release.

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DMA_Icon  State Human Resources

(608) 242-3153
2400 Wright Street
Madison, Wisconsin
Mailing Address
Department of Military Affairs
P.O. Box 14587
Madison, WI 53708-0587
Equity and Inclusion Officer
Director, State Human Resources,
Department of Military Affairs
WORK: (608)242-3163
FAX: (608) 242-3168