WI Form LS-119 2021 free printable template

Labor Standards Complaint Instructions What is a wage complaint? A wage complaint is a written complaint filed with the Department of Workforce Development against your current or former employer

How to fill out WI Form LS-119

How to fill out WI Form LS-119

1. Obtain a copy of WI Form LS-119 from the appropriate state department website or office.
2. Read the instructions provided with the form carefully.
3. Enter your personal information, including your name, address, and contact details, in the designated fields.
4. Provide information about your employer, including their name and address.
5. Fill in the details related to your injury or illness, including the date and description.
6. Attach any necessary documentation, such as medical records or evidence of your injury.
7. Review the form for completeness and accuracy.
8. Sign and date the form to certify that the information is true.
9. Submit the completed form to the appropriate authority as indicated in the instructions.

Who needs WI Form LS-119?

1. Individuals who have been injured at work and are seeking workers' compensation benefits.
2. Employees who need to report a work-related injury or illness.
3. Employers who need to document an employee's injury for workers' compensation claims.

People Also Ask about

What are the rights of an employee in Wisconsin?

The Wisconsin Fair Employment Law prohibits discrimination in all areas of employment against any qualified person because of sex, race, disability, age (40 and over), creed, color, national origin, ancestry, sexual orientation, marital status, arrest and conviction record, military status, use of lawful products and

How do I file a complaint in Wisconsin?

If you have questions about a case or believe you may have information or a complaint related to a case handled by DOJ, please contact the Consumer Protection Hotline at 1-800-998-0700 or (608) 266-1852.

How do I file a complaint with the EEOC in Wisconsin?

There are strict deadlines for filing a charge of discrimination, please review the information in the timeliness tab or call 1-800-669-4000. For individuals who are Deaf or Hard of Hearing, you can reach EEOC by videophone at 1-844-234-5122.

How do I report an employer in Wisconsin?

phone: 608-243-2424 fax: 608-243-2433 e-mail: werc@werc.state.wi.us. Chapter 111, Wis. Stats. The rules of the Commission provide that complaints alleging unfair labor practices or prohibited practices may be filed by any party in interest and require that they must be in writing.

What to do if an employer doesn't pay you in Wisconsin?

If the employer refuses to pay wages earned on the regular established payday, the employee should request payment. If the employee doesn't receive the payment after 6 days, the employee may file a claim with the division. Once a claim is filed, the division will seek to resolve the matter with the employer.

How do I file a discrimination complaint in Wisconsin?

File an Equal Rights Division complaint Create your DWD ID. Enter your information, create a username and password, and click next. Confirm your email. Once you have created your DWD ID, you will receive a confirmation email from the DWD Wisconsin Logon Management System. File your complaint.

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What is WI Form LS-119?

WI Form LS-119 is a form used in Wisconsin to report certain employment information related to labor standards and wages.

Who is required to file WI Form LS-119?

Employers in Wisconsin who are subject to labor laws and regulations pertaining to wages, hours, and working conditions are required to file WI Form LS-119.

How to fill out WI Form LS-119?

To fill out WI Form LS-119, employers must provide accurate information regarding their business, employee wages, hours worked, and any other required details as specified in the form's instructions.

What is the purpose of WI Form LS-119?

The purpose of WI Form LS-119 is to ensure compliance with state labor laws and to provide a means for the Wisconsin Department of Workforce Development to monitor employer practices related to employee wages and working conditions.

What information must be reported on WI Form LS-119?

WI Form LS-119 requires reporting information such as employer details, employee wages, hours worked, and any deductions or other relevant employment data.