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WORK-RELATED INJURY PROCEDURESThe following procedures should be followed when a faculty, staff or student employee incurs a work-related injury or a student or visitor is injured on campus. Faculty, Staff or Paid Student Employee Directions to Concentra Medical Center Directions to Friends Medical Center Contact the Office of Environmental Safety & Health Faculty, Staff or Paid Student Employees Procedures1. When a faculty, staff or paid student employee has incurred a work-related injury, the injured person may be referred directly to: University Health Services
(UHS) Hours: Monday-Thursday, Authorization for Treatment forms may be obtained from the Environmental Safety and Health Office at the Physical Plant Building, Room 105. When University Health Services is not open, employees should be referred to: Concentra Medical Center Hours:
Monday, 7:00 a.m.- or Friends Medical Center, Inc.
Hours: Sunday, 10 p.m.- These clinics specialize in work-related illnesses and injuries in addition to offering physicals, special testing and vaccinations. They are a reasonably short drive from the campus. When the above agencies are closed, injured employees should be referred to: St. Agnes Hospital TO ENSURE PROPER COVERAGE BY THE STATE HEALTH CARE PROVIDER, THE INJURED EMPLOYEE SHOULD NOT BE REFERRED INITIALLY TO A FAMILY PHYSICIAN OR A PRIVATE CLINIC. 2. In cases of severe work-related injuries which necessitate the use of an ambulance to transport the injured person, emergency room facilities at St. Agnes Hospital are to be utilized. 3. All work-related injuries must be reported to the Office of Environmental Safety and Health using the following forms available from this office: a. The injured employee must complete an Employee's First Report of Injury form and submit it to the Office of Environmental Safety and Health within 24 hours of the time of the injury. b. The employee's supervisor or designee must complete a Supervisor's First Report of Injury form and submit it to the Office of Environmental Safety and Health within 24 hours following the injury. c. Witnesses should complete an Accident Witness Statement and submit it to the Office of Environmental Safety and Health. d. Once the forms have been completed, they are reviewed by the Office of Environmental Safety and Health. A campus Safety and Health Manager will investigate, if necessary, and notify the Injured Workers' Insurance Fund and the Office of Human Resources of the circumstances of the injury.
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