Worker's Compensation
Worker’s Compensation is a benefit program that pays for medical treatment and wages lost due to work-related injuries or illnesses. Employees must report the injury or illness to their supervisor (employer) as soon as possible, and get any medical attention needed.
Worker’s Compensation Covers
- Medical treatment resulting from your work-related injury or illness
- Lost wages
- Compensation for permanent disabilities
- Vocational rehabilitation
- Return to Work Program
Workers Compensation Coordinator
Cofrin Library 823B
2420 Nicolet Drive
Green Bay, WI 54311-7001
Phone: (920) 465-2781
Fax: (920) 465-5104
Email: maines@uwgb.edu
Filing a Workers Compensation Claim
Employees who are injured while on the job are required to report work related accidents or injuries within 24-hours of the time of the accident or
injury. The employee's supervisor is required to follow the UWGB Worker Compensation SOP and complete the Supervisor Report within the same timeframe.
Use the links below to complete the required forms. Employees have two options for reporting: using an online link or using a QR Code.
| Role | Complete Online Links | QR Code | Responsibilities |
|---|---|---|---|
| Employee | Employee Injury and Illness Report Voluntary Consent Disclosure Authorization for medical treatment |  | Employees who have medical restrictions will receive notification to 1) return to work, 2) remain off work, or 3) return to work in a Transitional Work Assignment as part of the Return to Work Program. Approved: If the claim is determined to be work related, your employer will begin coverage and payment for the costs. Review What Does Workers Compensation Cover. Denied: You will be notified if your claim is denied,. If you disagree with the decision about a denial and cannot resolve a claim dispute with your employer, you have certain appeal rights. See Limitations and Denials |
| Supervisor | Supervisor Incident Analysis and Prevention Report |  | In the event of medical restrictions, Supervisors will work with employee and the Worker's Compensation Coordinator to facilitate transitional work assignments. Supervisors have the continued responsibility to ensure a safe work environment, train and educate employees on how to work safely, continuously improve safety behavior with employees and advise employees when unsafe practices are observed. |
Understanding Your Responsibilities
Read through What if you are Injured at Work to understand your responsibilities. Depending on the nature of your injury or claim, you may want to have a better understanding of what you’ll expect relating to medical, lost time, and the On Campus Care program. Use the links below for additional information:
Medical Treatment
Lost Time
Return to Work Program
Rehabilitation & Injury Care Program