At any time you are injured in the course of your employment, you must report the injury as soon as possible.  This packet of information includes directions on how to report the injury, the necessary forms for you to complete and some additional information about Workers Compensation. 

Filing an Injury/Illness Report

Step 1

Submit a claim by calling Travelers at 800-832-7839. Have your B number ready.

   OR

You can complete the Employee First Report of Injury or Illness as soon as possible and return it to the Benefits Division.  The form should be returned within 3 days after the injury/illness or as soon as you complete it.

Step 2

Contact Nurse on Call (24x7 Nurse Line for all healthcare needs).  Contacting a Nurse on Call is not required but strongly suggested.  Please contact the nurse through your healthcare plan:

   Dean Nurse 800-576-8773

   GHC Nurse 855-661-7350

Step 3

If you seek medical care, ensure your doctor(s) complete the Work Status Report/Medical Services Form at each visit.  Return the form to the Benefits Division (FAX: 608-204-0346).  Additionally, complete the Medical Authorization Release Form and return it to Travelers (FAX: 877-786-5567) to ensure your medical bills are paid.

What’s Next?

Watch for an email from the Benefits Division and from Travelers with additional information about your injury/illness.

Seeking Medical Treatment

  • Generally, you can choose to see any doctor authorized by Workers Compensation. 
  • Advise your doctor that you have a work-related injury, and tell them you work for the Madison Metropolitan School District.  Do not pay for your care yourself or use other health insurance. Be sure to return the Medical Authorization Release Form to Travelers to ensure payment of insurance claims.
  • Medical reports are necessary for your injury.  Provide your doctor(s) with the Work Status Report/Medical Services Form and have it completed at each doctor appointment and returned to the Benefits Division.
  • Nurse on Call services are available to help you if you are injured at work. This confidential and free program allows you to speak to a registered nurse to help you through your injury.

Lost Wages

  • You may be entitled to a portion of your lost wages under Workers Compensation law.
  • Any work time that is missed in relation to a worker’s 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.
  • All time away from work, including any related appointments, and/or notice of restrictions must be documented in writing by 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.
  • Please schedule doctor appointments outside of your scheduled work time when feasible.

Returning to Work

  • When you are able to return to work, please provide the doctor completed Work Status Report/Medical Services Form to the Benefits Division.
  • MMSD will make a reasonable effort for you to return to work as soon as possible, even with light duty/work restrictions.  Restrictions are accommodated even when they are outside your regular scope of work, whenever possible.
  • If your doctor releases you back to work and MMSD is able to accommodate any restrictions and you do not return, any salary/benefits continuation may end. 

Contact Information

  • MMSD: Phone: 608-663-1692 / Fax: 608-204-0346
  • Travelers: (Workers Compensation Carrier): 800-842-6172 / Fax: 877-786-5567

Have Questions? Contact the Benefits Helpdesk at benefits@madison.k12.wi.us or at (608) 663-1692