Employees who are performing work for the University within the scope of employment and are on the University payroll are covered under Worker’s Compensation for work-related injuries.

UW SYSTEMS RESPONSIBILITIES POLICY

EMPLOYEES                                   SUPERVISORS

When an Injury Occurs

1. The employee shall inform a supervisor of the injury immediately. In the event of a medical emergency call 911 or Protective Services (x3456). Make sure the injured employee seeks or obtains medical help as needed. This is the first priority. Follow Medical Emergencies as necessary.
   
   

2. The employee shall submit a report via the E-Form Process
   

To begin the process, click the following link below or scan the QR code with your smart device to open the Employee Work Injury and Illness Form. 

Employee's Work Injury and Illness Report

Steps in the Automated Process

Employee Injury-Illness Reporting Workflow

1. Employee submits the Employee Work Injury/Illness eForm
2. Supervisor gets notified of submission through email
3. Supervisor reviews submission in the eForm system
   
4. Once reviewed Supervisor completes the Supervisor's Report in the eForm system Supervisor Incident Analysis and Prevention eForm
5. Both submitted reports are sent to internal UWSP contacts, such as the EHS Specialist and sent to the UW System Workers Compensation Coordinator
   

Note for Supervisors: If your employee is unable to immediately submit the report due to the nature of the injury you do have the option to create the Supervisor's Report first by clicking the link below to initiate the claim filing process.  Supervisors must have their report submitted within 24 hours of the incident.

Supervisor's Incident Analysis and Prevention Report

Additional Employee Information

1. If medical treatment is necessary, the employee has the choice of any physician, chiropractor, psychologist, or podiatrist licensed in the State of Wisconsin. Ascension Saint Michael’s, Marshfield Clinic, and Aspirus are examples of the closest treatment facilities to the main campus. If seeking treatment, the employee needs to ensure they receive a return to work note/status from the provider.



2. Inform the place of treatment that the injury is work-related and to submit all medical bills to:

   UWSA Office of Risk Management 

   780 Regent Street 

   Madison, WI  53715 

   Billing Fax:  608.263.7330
   



3. When a work-related injury results in work restrictions or absence from work, a return to work note/status from your medical provider showing the reason and effective dates are required. Human Resources must be contacted for any lost time or restrictions involving work-related injuries. Contact the HR Compliance Specialist for questions on this topic.
   


4. UWSP and the University of Wisconsin System have an Early Return to Work Program. The supervisor of the injured employee must contact the HR Compliance Specialist in Human Resources to discuss whether temporary modified duty is available within given work restrictions. The employee will be placed in another department or State agency temporarily if the employing department cannot accommodate restrictions. The employing department continues to pay these wages.



5. Once all forms are submitted a follow-up safety review will be conducted by the EHS Specialist. Employees and Supervisors shall participate in this review fully and provide all requested information. This may include a walkthrough of the accident, follow-up questioning, confirmation of statements, reconciliation of information, pictures, and other necessary analysis.

Forms

Witness Statement Form

UW Mileage Reimbursement