Accident Incident Reporting and Investigation Program

Policy

All work-related injuries, illnesses, or incidents involving University employees, students, or visitors shall be reported in accordance with this policy.  All workers have a right to report work-related injuries and illnesses without being retaliated against.

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Authority and Responsibility

Risk Management is responsible for:

  • Responding to and investigating accidents and injuries;
  • Developing corrective action; and
  • Requesting assistance from Environmental Health and Safety to investigate accidents.

Environmental Health and Safety is responsible for:

  • Assisting Risk Management, as requested;
  • Developing corrective action, as necessary; and
  • Contacting the appropriate Project Manager for accidents/incidents occurring on construction sites.

Supervisors or HR Representatives are responsible for:

  • Reporting unsafe conditions to Environmental Health and Safety;
  • Reporting all incidents/accidents to Risk Management;
  • Completing the required forms detailed in this policy for all injuries; and
  • Implementing corrective actions.

Employees are responsible for:

  • Reporting unsafe conditions to supervisors;
  • Immediately reporting any accident/injury to their supervisor or HR Representatives; and
  • Completing the required forms detailed in this policy.

Human Resources - Leave Administration is responsible for:

  • Processing incident/accident reports; and
  • Receiving and processing medical bills and workers' compensation claims resulting from work related injuries.

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Notification

All University employees and students shall immediately inform their Supervisor or Human Resources representative that a work related injury or illness was sustained.

Supervisors or Human Resources representatives shall immediately notify Risk Management and Environmental Health and Safety of any incidents involving death or hospitalization.

Project Managers shall report any incident causing or creating an unsafe condition during construction/renovation in University buildings to Risk Management and Environmental Health and Safety.

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Procedure

Emergency Medical Attention

For incidents occurring:

  • On campus, contact University of Chicago Police at extension 123 or 773.702.8181 to arrange for on-scene medical assistance; or
  • Off campus, dial 911 to arrange for on-scene medical assistance.

General Medical Attention – University Employees

If you are a University of Chicago employee and you are injured on the job during your employment:

  1. Report the accident or injury to your Supervisor or Human Resources representative immediately;
  2. Your supervisor or Human Resources representative will complete a Request for Evaluation and Treatment – Work Related Illness or Injury WC Form 100 (Form 100);
  3. Take the original copy of the Form 100 and seek medical treatment at the nearest Emergency Room;
  4. Your Supervisor will complete the Supervisor’s First Report – Workers’ Compensation Claim of Injury/Illness;
  5. Your Supervisor or Human Resources will provide you with an Employee Statement of Injury or Illness -Workers’ Compensation, Accrual Use Option Form, Workers’ Compensation Rights and Responsibilities statement, and an Authorization to Release Protected Health Informaiton for your completion to complete;
  6. Scan and email the aforementioned forms to leaveadministration@uchicago.edu or fax to 773.834.4847;
  7. Always use the “buddy” system when obtaining medical attention by having someone escort the injured individual to receive medical treatment; and
  8. If you or another employee cannot escort yourself to the University of Chicago Occupational Medicine clinic or Adult Emergency Room due to the extent of your injury, dial 123 or 773.702.8181 (University of Chicago Police Department) and request an ambulance.

UNIVERSITY OF CHICAGO OCCUPATIONAL MEDICINE (UCOM)
Location: University of Chicago Medicine, 5841South Maryland Avenue, D136
Phone Number: 773.702.6757
Hours: 7:15 a.m. – 4:30 p.m. M-F

ADULT EMERGENCY ROOM
Location: Bernard Mitchell Hospital, 901 East 58th Street
Phone Number: 773.702.6250
Hours: Open 24 hours

Note: There are other forms you may be required to complete during or following your medical evaluation and treatment.

General Medical Attention – Off-Site University Employees

If you are a University of Chicago employee, but work at a satellite location and are injured on the job during your employment:

  1. Report the accident or injury to your Supervisor or Human Resources representative immediately;
  2. Supervisor or Human Resources representative will complete a Request for Evaluation and Treatment - Work Related Illness or Injury WC Form 100 and the Supervisor’s First Report – Workers’ Compensation Claim of Injury/Illness;
  3. Your Supervisor or Human Resources will provide you an Employee Statement of Injury or Illness - Workers’ Compensation, Accrual Use Option Form, Workers’ Compensation Rights and Responsibilities statement, and Authorization to Release Protected Health Information for your completion to complete;
  4. Scan and email the aforementioned forms to leaveadministration@uchicago.edu or fax to 773.834.4847;
  5. Always use the “buddy” system when obtaining medical attention by having someone escort the injured individual to receive medical treatment;
  6. If you or another employee cannot escort yourself to the nearest emergency room due to the extent of your injury, contact the local emergency care provider and request an ambulance;
  7. Inform the emergency room that it is a work related accident and you are an employee at the University of Chicago so the facility directly bills the University of Chicago; and
  8. If you are billed directly for any reason, forward these bills to Human Resources – Leave Administration.

General Medical Attention – Students

Student Injury/Illness Reporting Flow Chart shall be used to guide students/student workers to the right department for medical assistance. If you are a University of Chicago student and are injured while performing work, follow the procedures above for “Employees Injured on the Job”. If you are a student and are injured or become ill for any other reason:

  1. Seek first aid or medical treatment immediately at one of the following depending on the time or nature of the accident or injury;
  2. Always use the “buddy” system when obtaining medical attention by having someone escort the injured individual to receive medical treatment; and
  3. If you or another student cannot escort yourself to the Student Care Center (SCC) or Mitchell Emergency Room due to the extent of your injury, dial 123 or 773.02.8181 (University Police) and request an ambulance.

STUDENT HEALTH SERVICES (SHS)
Location: Albert Merritt Billings, 5841 South Maryland Avenue, Suite R100
Phone Number: 773.702.4156
Hours: 8 a.m. – 5 p.m. M-F

Note: The SHS is an appointment-based clinic: you must call and schedule an appointment to be seen.  No walk-ins will be accepted.

ADULT EMERGENCY ROOM
Location: Bernard Mitchell Hospital, 901 East 58th Street
Phone Number: 773.702.6250
Hours: Open 24 hours

Non-University Personnel

Report all accidents/incidents involving non-university personnel to the University of Chicago Police Department at 773.702.8181 and Risk Management at 773.702.3693.

Supervisor’s Follow-up

If there is any suspicion of injury or illness, make sure the employee follows the procedures for employees injured on the job. If medical treatment is not required, send the original copies of all the three forms to Human Resources – Leave Administration. All forms are available on the Human Resources website under Leaves of Absence and Workers’ Compensation.

Investigate the accident or incident to determine the cause and initiate any necessary corrective action to rectify the problem. Report your findings to Environmental Health and Safety. If you need assistance conducting this investigation, contact Environmental Health and Safety. HR Absence Management shall forward copies of all WC Form 100’s to Environmental Health and Safety for follow-up investigation, as deemed necessary by Risk Management. All corrective actions identified during the investigation shall be the responsibility of the supervisor and associated department.

If an injury or illness involving a student consists of a chemical exposure, needle stick, bloodborne pathogen exposure, or any other safety issue, the Student Care Center shall report the injury/illness to Environmental Health and Safety by completing the Student Injury/Illness Assessment Form. A safety representative shall evaluate if further investigation is necessary.

Reviewed: August 2016

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