WKC-16-BPractitioner's Report (WKC-16-B)
Issued by Wisconsin Department of Workforce Development – Worker’s Compensation Division
Practitioner's Report (WKC-16-B) (WKC-16-B) — state-prescribed clinician report used by the state workers’ comp agency.
Key facts
Clinicians fill out · Submitted to regulator · Employers file
- When it’s used
- Initial treatment (WKC-16-B filed with insurer); ongoing treatment when treatment plan changes; return-to-work determinations; when employee reaches healing plateau / end of healing period (Wis. Stat. §102.13).
- Who fills it out
- Treating physician of record. Wisconsin allows "practitioner" broadly defined. NPs and PAs may treat workers' compensation patients and submit practitioner reports within their scope of practice (Wis. Stat. §102.42).
- Who signs
- Wisconsin allows "practitioner" broadly defined. NPs and PAs may treat workers' compensation patients and submit practitioner reports within their scope of practice (Wis. Stat. §102.42).
- Where it goes
- WKC-16-B: filed with insurer upon initial treatment and as treatment progresses. Additional reports upon insurer request or when work status changes. No fixed periodic interval, but reports required at key clinical milestones.
- Electronic submission
- Supported — Wisconsin DWD provides electronic filing options. Insurers accept electronic medical reports. EDI for FROI/SROI.
- Narrative substitution
- WKC-16-B is the prescribed practitioner's report form. Detailed medical narratives may supplement the form. Wis. Stat. §102.13 authorizes Division to prescribe form of reports.
Sources & citations
Every form we publish traces to an authoritative government source. We cite the issuing agency, the underlying statute, and the operative regulation so you can verify scope and signing authority for your own records.
Issuing agency
Wisconsin DWD – Workers' Comp
Statute
Wis. Stat. §102 (WC)
Form library
WKC-16-B Form Info
Attribution. Researched and maintained in collaboration with the wc-hub workers’ compensation reporting project (WI). BlueHive does not modify the underlying government PDF; the file you download is the agency original.
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The regulatory information presented on BlueHive Compliance Watch is provided for general informational purposes only and should not be construed as legal advice. While we strive to maintain accurate and up-to-date information, regulations can change rapidly and may be subject to interpretation.
You should always:
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