Skip main navigation

Outdated or Unsupported Browser Detected
DWD's website uses the latest technology. This makes our site faster and easier to use across all devices. Unfortunatley, your browser is out of date and is not supported. An update is not required, but it is strongly recommended to improve your browsing experience. To update Internet Explorer to Microsoft Edge visit their website.

Temporary Partial Disability Worksheet

Document Number: WKC-7359-E

Description: TPD earnings are to be submitted through the internet. The WKC-13 and this worksheet will assist you in calculating temporary partial disability when you need to submit physical TPD information only. Instructions for using this form are included on the same page as the form itself and appear between the upper area of claim information and the lower worksheet area.

Comments: This form is an electronic Microsoft Excel template that can be filled out on your computer (if you have Microsoft Excel). The Microsoft Excel template functions best when you download and save a copy to your computer. We are also providing a PDF (WKC-7539) which you can print and complete by hand.

Content Contact: Lynn Weinberger

Document Attachments:

WKC-7359-E (Electronic Version - Excel/109 KB)

WKC-7359 (Print Version - pdf/109 KB)

Note: If you need this form in an alternate format, please send a message to the Content Contact listed above.