Accident Reporting and Workers Compensation

Accident Reporting and Workers' Compensation

Any employee, student, or visitor that sustains an injury or illness while on campus should fill out a university Accident Report Form and submit it to EHS. Directions for submission can be found on the top of the Accident Report Form.

91�� employees, including student employees, are covered under the University's Workers' compensation Insurance Program. Employee accidents/injuries, however, may or may not result in a workers' compensation claim. If a claim is indicated, EHS will process a claim on the respective employee's behalf to our third party administrator for claims. Employees are advised that a valid social security number is required in order to process a workers' compensation claim.

University Accident Report Form

Supervisors Accident Investigation Form

91�� Incident Report Form (Non-injury)

Accident Reporting Program & Procedures

Information on Accident Reporting Program and Procedures is provided in the document linked below. 91�� employees should obtain the signature of their supervisor prior to submitting the accident report form to EHS. Supervisors of injured employees are to perform accident investigations and submit documentation on the Supervisor's Accident Investigation Form.

EHS tracks of accidents on campus and reports data derived at University Safety Committee Meetings.

Accident Reporting Program & Procedures

Workers' Compensation Programs & Procedures

During the first 90 days following a workplace injury, 91�� employees are required to make and attend a follow-up appointment with a medical provider on the University's Panel of approved medical providers for workers compensation. Employees should not seek a follow-up with their own personal medical providers/physician. Following 90 days, employees may request to seek medical attention elsewhere.

While EHS facilitates workers' compensation claims on our employees behalf, it is the responsibility of each employee to submit appropriate paperwork from the medical provider (Physician, specialist Physician and/or group, laboratory, MRI providers, etc...) to EHS. Of particular importance is a medical status report that clearly indicates the employees work status. There are three options for returning to work:

Return to work-no restriction
Return Work-with restriction (identify specific restrictions)
Unable to return work

With the exception of the returning to work without restriction, it is also the employee's responsibility to keep EHS informed of all the follow-up appointments with medical providers, and subsequent updates to work status.

Volunteers to campus are covered under the workers' compensation insurance program.

Workers' Compensation Program & Procedure

Designated Health Care Providers

Workers' Compensation Employee Notification

Workers' Compensation Notification Form

Workers' Compensation Payroll Information

Administrator for Claims Processing

91�� utilizes Inservco Insurance Services as our third party administrator for workers' compensation claims processing.

Inservco Contact Information

91��

Environmental Health and Safety

Environmental Health and Safety

Contact Information