Worker’s Compensation 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 the Department of Military Affairs, Worker’s Compensation claims are coordinated through the Worker’s Compensation Coordinator/Medical Coordinator within State Human Resources. 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
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Reporting Claims
All work-related incidents that resulted in injury/illness, or that have the potential to result in injury/illness must be reported immediately. You will find the required forms below.
Employees
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.
Supervisors
Supervisor 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.
Reporting Process
Upon learning of an employee’s work-related injury or illness, report of the incident, including all forms must be submitted to the DMA Medical Coordinator within 24 hours of the incident. Forms may be submitted:
1. Via email at DMAMedicalCoordinator@widma.gov (preferred)
2. Via fax at (608) 242-3168
Questions and/or concerns can be directed to the DMA Medical Coordinator at:
Email: DMAmedicalcoordinator@widma.gov
Phone: 608-977-2423