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Easy Guide for Supervisors

Workers’ Compensation

Even in a workplace with relatively few hazards, there is always a possibility for an employee or student worker to become injured or ill at work. If an injury or illness occurs at work, please follow the steps below.

If a work-related death occurs, contact Risk Management (920.424.3215) and Human Resources (920.424.1166) immediately.

Step 1

  • The employee must complete the injury and illness report and submit to their supervisor. It is the employee’s responsibility to report the injury to their supervisor promptly after the injury has occurred.
    • Detailed information related to workers’ compensation can be found here.
  • The employee’s supervisor must complete the two-sided supervisor’s accident analysis and prevention reportIt is the supervisor’s responsibility to ensure that the employee’s first injury/illness report and the supervisor analysis and questions form are submitted to the University Police Dispatchers (424-1212) as soon as possible after an injury occurs.
    • For an overview of supervisor’s responsibilities in the workers’ compensation process, click here.

Step 2

  • Send signed and dated Employee Injury & Supervisor Analysis forms to the University Police Dispatchers. Both signed and dated forms should be e-mailed or hand-delivered to the University Police Department at Radford Hall, lower level within 24 hours of the injury.
    • To avoid delay, it is best to email the forms to both Nakeeta Giebel and Alli Van Toll before sending the originals through intercampus mail if unable to hand-deliver them.
    • If, due to the injury, the chair/supervisor or employee are unable to complete the forms within 24 hours, immediately contact Lori Welch in the Risk & Safety Office to inform her of the details of the injury.
  • Forward all physician return-to-work forms and reports to Human Resources upon receipt. These forms will indicate the date a faculty/staff member may return to work with or without restrictions and must be filed with Human Resources. An evaluation, in collaboration with the supervisor, will be conducted to determine if job duties may be modified to work within the restrictions. For each physician visit, a return-to-work form should be submitted, including if the diagnosis is to return to work with no restrictions.
    • Physician documentation and return to work forms should be submitted to:
      • Human Resources, UW Oshkosh
        800 Algoma Blvd, Oshkosh WI 54901
        Fax Number: (920) 424-2021

Step 3

  • Time card/leave reporting should indicate any lost time due to a work-related injury. If lost time occurs, it is important that the time card/leave report indicate those days off of work. Human Resources Payroll personnel may assist with how time should be recorded on the time card/leave report on a case-by-case basis.
  • The Environmental, Health & Safety (EHS) Coordinator will review all injury reports and interview relevant parties to assess our safety practices on campus and make recommendations for improvement.  The UW System Workers’ Compensation Coordinator will contact the employee injured with details of the claims process.  If you should have any questions or concerns regarding claims, please call the EHS Coordinator, 424-0985.

Additional Resources

Click here to access the Witness Statement form.

Click here to learn more about returning to work after an injury.

Supervisors: click here for tips on managing an employee who is returning to work.

For further information regarding Workers’ Compensation, please visit the UW System Workers’ Compensation website.