PRP 6527 - Work Related Injury Reports

Issued by: Boyd F. Buckingham, V. P. for Administration
Effective Date: March 2, 1981

Employee Responsibilities

In the case of a work related injury, the injured employee, if able, should:

Report the injury to his/her supervisor immediately.

The supervisor will be responsible to see that the employee obtains medical attention and files the report of the accident with the Personnel Office.

The employee should obtain a medical statement from the attending physician on the form provided.

Supervisor Responsibilities

See that the employee obtains medical attention as needed and that the employee files and accident report in the Personnel Office.

Provide forms to the employee or physician, as appropriate, for "certificate of physician."

Investigate the accident and file a written report on the SWIF form; obtain witnesses statements on SWIF forms (if available); complete Accident Analysis Report on the form provided; send copies of all forms to the Personnel Office and follow-up to be certain the employee provides all necessary forms to the Personnel Office.

Contact the Personnel Office, extension 4415, with any questions.