University of Wisconsin–Milwaukee

Worker's Compensation Program for Staff
Worker's Compensation Lost Time Fact SheetThis provides information for when a work related injury or illness results in absence an employee's absence from work.

Safety & Loss Prevention Medical Only Fact SheetThis Fact Sheet briefly explains options available under the Wisconsin Worker's Compensation Act.

Employee's Work Injury and Illness ReportIf you have been injured on the job, you must complete and submit this form within 24 hours of an injury to your supervisor.

Authorization for Release of Medical InformationFor employee injuries resulting in loss of work time, this form should be completed, signed and dated by the employee.

Early Return to Work Policy and ProcedureUWM will make every effort to help employees to maximize their healing and facilitate their early return to work.

For Limited Term Employees (LTEs) and student employees who have filed a work related injury:
Labor Market Availability Restriction StatementComplete this form and submit it to the Workers' Compensation Coordinator in the Human Resources Office

UWM Worker's Compensation Coordinator:Barb Willkomm
Phone: 414/229-5652
Human Resources
Engelmann Hall, Room 125