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Wisconsin Workers Compensation Forms

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Wisconsin Workers Comp Coverage
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Workers Compensation Shop.com is your source for workers compensation quotes, information, and forms for Wisconsin coverage.  We have compiled a list of downloadable forms, brochures, and guides for WI employers and employees.  Contact us if you need help locating a form or have questions about your policy or coverage in general.  One of our Workers Comp Specialists are ready to assist you.

Find out if your business qualifies for lowers rates with premium discounts and policy dividends.  To start a Wisconsin workers compensation quote click the state on the right or call  888.611.7467

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Questions? Call 888.611.7467 for a Workers Compensation Shop Specialist

 

 WI Comp Forms

 

Wisconsin Workers Compensation Forms

Wisconsin Acord 130 Workers Compensation Application

The standard Acord 130 application form for workers comp coverage in Wisconsin.

Wisconsin First Report of Injury Form

First Report of Injury Form.  Employers should complete this form and send to their insurance company each time an injury occurs.

Wisconsin Application for Exclusion of Officers

Owners and Officers of corporations should complete this form to exclude themselves from a work comp policy.

Wisconsin Application for Exclusion of Stockholders

Stockholders should complete this form to exclude themselves from a work comp policy.

Wisconsin Application for Exemption for Workers' Compensation Insurance

Complete this form if you are a sole-proprietor, partnership with no employees or an sole officer of a corporation and would like to be exempt from coverage.

Workers' Compensation Insurance for Employers

Information about workers' compensation in Wisconsin for employers.

Farming and Workers' Compensation In Wisconsin

Information about workers' compensation in Wisconsin for farmers

Wisconsin Workers' Compensation and Employers Liability Insurance Manual

A comprehensive manual covering Wisconsin Workers' Compensation Laws.


State Resources for Wisconsin

State of Wisconsin

www.wisconsin.gov/state/home

Wisconsin Compensation Rating Bureau

www.wcrb.org/WCRB/wcrbhome.htm
20700 Swenson Drive, Suite 100
Waukesha, Wisconsin 53186
(262) 796-4540

Wisconsin Department of Workforce Development

www.dwd.state.wi.us/

Wisconsin Workers’ Compensation Division

www.dwd.state.wi.us/wc/default.htm
Room C100
201 East Washington Avenue
Madison, Wisconsin 53703
(608) 266-1340

Workers’ Compensation Advisory Council

www.dwd.state.wi.us/wc/councils/

wcac/default.htm

(608) 266-6841

WI Office of Commissioner of Insurance

www.state.wi.us/agencies/oci/

oci_home.htm
P.O. Box 7873
Madison, WI 53707-7873
608-266-0102
800-236-8517
www.state.wi.us/agencies/oci/ oci_home.htm

Wisconsin Labor and Industry Review Commission

www.dwd.state.wi.us/lirc/
Wisconsin Public Broadcasting Building
3319 West Beltline Highway
Madison, Wisconsin
(608) 266-9850

 

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WI Work Comp Penalties

Wisconsin aggressively monitors compliance with state workers compensation laws.  Penalties for employers who fail to purchase coverage include 1. penalties up to twice the premium, 2. business closure, and 3. liability for claims and injuries including medical and lost wages.

 

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