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Wisconsin Department of Workforce Development – Worker’s Compensation Division fax number

(608) 267-0394

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Department of Workforce Development, Worker’s Compensation Division (DWD WC)

Used for: Submitting workers’ compensation-related documents (e.g., Employer’s First Report of Injury, medical reports, wage and injury information) to the Wisconsin WC Division; also used for imaging/document submission.

Fax destination details

Department
Department of Workforce Development, Worker’s Compensation Division (DWD WC)
Purpose
Submitting workers’ compensation-related documents (e.g., Employer’s First Report of Injury, medical reports, wage and injury information) to the Wisconsin WC Division; also used for imaging/document submission.
Form
WKC-12-E — Employer’s First Report of Injury or Disease – Form WKC-12-E
Address
201 E Washington Ave, Madison, WI 53707-7901
Voice phone
608-266-1340

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Follow the official WKC-12-E instructions: employers must submit the form to the WC Division within seven days of an injury with occupational disability, using electronic or mail submission as specified; see official WKC-12-E page for details.

Review official form instructions

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