Worker’s Compensation (WC) is a State of Wisconsin statutory benefit program that provides medical treatment, wage replacement and other benefits to employees who sustain work-related injury or illness.

At DMA, Worker’s Compensation claims are coordinated through the Risk and Health Manager. Claims examination, administration and the payment of benefits performed by the Bureau of State Risk Management.

Major Benefits Provided by Worker’s Compensation Include:

  • Medical treatment resulting from work-related injury or illness
  • Lost wages
  • Compensation for permanent disabilities
  • Vocational rehabilitation

Reporting Claims

All work-related injuries and illnesses must be reported immediately.

Below are the necessary steps to follow in reporting a Worker’s Compensation claim:

Employee must complete and submit the  Employee’s Work Injury and Illness Report (DOA 6058)  to their supervisor within 24 hours of the occurrence of injury or illness.

 must complete the  Supervisor Incident Analysis and Prevention Report (DOA 6437) * and email the form with the completed Employee’s Work Injury and Illness Report, to The Risk and Health Manager. * This is a word doc that will automatically download when clicked.

All forms
upon learning of an employee’s work-related injury or illness,  must immediately obtain the completed  Employee’s Work Injury and Illness Report  and  Supervisor Incident Analysis and Prevention Report  and submit to The Risk and Health Manager, in one of the following two (2) possible ways:

a.   Via email at (preferred)

b.   Via fax at 608-242-3168 (less desired)



Or 608-242-3157