Workers Compensation Information

Any time you are injured in the course of your employment, an “Employee Report of Injury and Illness” form must be completed and faxed to (608) 442-2169 or emailed to mediately.

We also recommend that an employee contact the Alaris 24/7 Nurse Care Line at 855-650-6580. An employee can receive assistance from a Registered Nurse, free of charge, to help with the following:

  • Providing general guidance after you sustain an injury
  • Finding a medical facility near your jobsite and/or home for convenient care
  • Coordinating modified work program (restrictions) with a physician
  • Obtaining necessary return to work documents for your supervisor/employer
  • Assisting in finding the appropriate medical care
  • Assisting with scheduling follow up appointments
  • Help finding specialist care when a referral is warranted

If you seek medical treatment, you should take a “Work Status Report” to the doctor with you and have the doctor complete the form. A doctor’s report/note from the visit will also be accepted. Completed “Work Status Report” or doctor’s notes need to also be faxed to (608) 442-2169 or emailed to soon as possible.

Both referenced forms can be found on the Staff Only section of the District Website under HR Forms.

A few other reminders:

  • The district works to accommodate light duty restrictions. Restrictions are accommodated even when they are outside your regular scope of work, whenever possible.
  • You should notify your treating physician at the time of being seen that the injury occurred at work.
  • All time away from work, including any related appointments, and/or notice of restrictions must be documented in writingby a licensed physician/medical doctor. Notes from a nurse practitioner (APNP) or physician’s assistant (PA-C) addressing time off or restrictions will not be accepted. All notes must be signed by a licensed physician/medical doctor.
  • Postdated notes for lost time will not be accepted and absences may not be paid.
  • Employees should work to schedule doctor appointments outside of their scheduled work time when feasible.
  • Anytime that is missed in relation to a workers compensation claim will be paid through your own available personal time until an approval (compensability) ruling has been given by the workers compensation insurance carrier. If the claim is accepted by the carrier, all time used that has proper documentation will be credited back to you.

Any questions regarding workers compensation and employee injuries can be directed to Jill Radzinski at (608) 663-5930 or