Get the free WKC-12-E, Employer's First Report of Injury or Disease. This form is for the employe...

Name: Fillable Online WKC-12-E, Employer's First Report of Injury or Disease. This form is for the employer to report every work-related injury to its insurance company.If an employee is out more than 3 days due to a work-related injury, or there is PPD, a copy Fax Email Print - pdfFiller
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EMPLOYERS FIRST REPORT OF INJURY OR DISEASE Department of Workforce Development Fatal Injuries: Employers subject to ch.102, Wis. Stats., must report injuries resulting in death to the Workers Compensation

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How to fill out wkc-12-e employers first report

01

Step 1: Gather all necessary information about the employer and the employee involved in the incident.

02

Step 2: Download the WKC-12-E Employers First Report form from the appropriate government website or obtain a physical copy from the relevant authorities.

03

Step 3: Fill in the required information on the form, including the date and time of the incident, a detailed description of what happened, and any relevant medical treatment provided.

04

Step 4: Attach any supporting documents, such as witness statements or medical records, to the form if necessary.

05

Step 5: Review the completed form to ensure all the information is accurate and complete.

06

Step 6: Submit the form to the designated authority or department, either electronically or by mail, within the specified timeframe.

07

Step 7: Keep a copy of the completed form for your records.

Who needs wkc-12-e employers first report?

01

Employers who have experienced a workplace incident involving an employee need to fill out the WKC-12-E Employers First Report. This report helps the authorities track and investigate workplace incidents and ensure appropriate actions are taken to prevent future occurrences.

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