Missed Time Weekly Report Instructions

ONLY COMPLETE IF EMPLOYEE HAS MISSED WORK HOURS OR ON RESTRICTED HOURS

Please complete the Weekly Time Report regarding your employee’s attendance as it relates to his/her recognized health condition (i.e. worker compensation claim, leave of absence, etc). This information must be submitted to UI Benefits by 5 PM each Monday.

The Benefits Office will adjust time (via corrected ETRs) as workers compensation missed time benefits are paid. Contact the Benefits Office if an employee has less than 50 hours of accrued sick and vacation leave available.

The Missed Time Report should be completed on the HR Self Service site under HR Applications/Systems/Worker's Compensation.  If you do not have security access to use this function, please contact your HR Unit Representative.  If you have questions regarding completion of the form, please contact a Worker's Compensation Specialist in the Benefits Office.

Missed Time Weekly Report

Workers' Compensation

Campus address
120 USB
U.S. mailing address
The University of Iowa
120 University Services Bldg.
Iowa City, IA 52242
Phone
319-335-2676
877-830-4001
FAX
319-335-2776