Medical Report On Industrial Injury {WKC-16} | Pdf Fpdf Docx | Wisconsin

 Wisconsin   Workers Comp 
Medical Report On Industrial Injury {WKC-16} | Pdf Fpdf Docx | Wisconsin

Last updated: 7/15/2025

Medical Report On Industrial Injury {WKC-16}

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Description

WKC-16 - MEDICAL REPORT ON INDUSTRIAL INJURY. The Department of Workforce Development (DWD) administers the Worker's Compensation Act, Chapter 102 Wis. Stats. The purpose of this form is to assist with the procurement of information related to or required by Chapter 102. Completion of this form is voluntary and failure to complete said form may result in a delay in the administration of Chapter 102. DWD may use the personally identifiable information (PII) it obtains from you on this form for purposes other than those for which it is being collected. www.FormsWorkflow.com

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