Wkc 12 2026

1. Click ‘Get Form’ to open the wkc 12 in the editor.
2. Begin by filling out the Employee section. Enter the employee's full name, address, birthdate, and date of hire. Ensure all details are accurate to avoid processing delays.
3. Next, complete the Employer section. Provide your company name, mailing address, and Federal Employer Identification Number (FEIN). Indicate whether you are self-insured.
4. In the Wage Information section, input the employee's wage at the time of injury. Specify if they receive overtime pay and detail any additional compensation such as meals or tips.
5. Proceed to the Injury Information section. Document the date and time of injury, a description of what occurred, and any medical treatment received. This information is crucial for accurate claims processing.
6. Finally, ensure that all mandatory fields are completed before submitting your report to your insurance carrier or third-party administrator within the required timeframe.

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