Supplementary Report On Accidents And Industrial Diseases {WKC 13}

WKC-13 - SUPPLEMENTARY REPORT ON ACCIDENTS AND INDUSTRIAL DISEASES. This form is used by self-insured employers and insurance companies in Wisconsin to provide detailed updates on workers’ compensation claims after the initial report of injury has been submitted. It collects comprehensive information regarding the injured employee, including personal details, injury dates, employer and insurer information, claim numbers, and the nature of the injury or illness. The form tracks the dates, types, and amounts of compensation payments made, including temporary total disability (TTD), temporary partial disability (TPD), permanent partial disability (PPD), salary continuation, and other payments. It also records return-to-work dates, end-of-healing dates, and any employer-paid holidays. The form ensures compliance with Wisconsin statutes by reporting suspensions, denials, or delays in compensation, and it requires submission of final medical reports when applicable. www.FormsWorkflow.com