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We provide free access to most of the forms needed for Workers' Compensation Insurance in the state of Wisconsin. We strive to keep these forms up to date and accurate. It is important you confirm with the state website to make sure you are using the most up to date form.
If you have questions about any of these forms please pick up the phone and call one of our Workers' Comp Experts. 888-611-7467 They will be more than happy to speak with you about all of your Workers' Compensation Coverage needs.
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WI 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.
Each state has its own laws and requirements regarding when and how employers are allowed to opt-out of coverage under their workers' compensation policy. Some states make it easier than others because they don't require anything to be filed. Other states require special inclusion or exclusion affidavit documentation. Failure to comply often causes employers to have to pay premium on themselves even when they wanted to be excluded form coverage.
A waiver of subrogation means that a business and their insurance company is foregoing all rights to file suit, or seek damages, from another business. This is common in the construction industry as builders attempt to protect their company from negligence. A workers' comp waiver of subrogation does not prevent an injured employee from filing a lawsuit for damages. This coverage typically add about $100 to the cost of a work comp policy.
A Certificate of Insurance is a document that serves as evidence of insurance or proof of coverage. Certificates indicate your current coverages and policy limits. Insurance Agencies issue on an insured's behalf and they often list a third party as a certificate holder. This means they should be notified if a policy cancels prior to expiration. Requests for any special wording should be carefully checked against the policy language before being added to a certificate as they can create legal issues with coverage.
Improve your business cash flow with our Agency Pay As You Go Workers' Comp plans. Available through most of our insurance companies.
State Resources for Wisconsin
Wisconsin Department of Workforce Development
Workers' Compensation DivisionP.O. Box 7901Madison, WI 53707-7946608-266-1340 https://dwd.wisconsin.gov/
Wisconsin Compensation Rating Bureau
PO Box 3080Milwaukee, Wisconsin 53201-3080262-796-4540 https://www.wcrb.org/WCRB/wcrbhome.htm
Workers' compensation insurance is required by law for Wisconsin employers.
Wisconsin forms and applications such as owners inclusion or exclusion forms are sometimes updated by the state. Contact us if you need help or can't find the workers' compensation form your need for Wisconsin.
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