Report a Work-related Incident or Illness

Research, Environmental Health and Safety   |   Approved June 2, 2020

Purpose

Report a work-related injury or illness and complete appropriate documentation.

Applicability

Employees and volunteers on campus requiring medical care for a work-related injury or illness.  If the employee or volunteer covered under Maryland's workers compensation system chooses not to use the on campus services, they may also seek treatment from a health care provider of their choice. However, they must still file an Employee’s First Report of Injury.

If you are a student requiring medical care, please seek assistance with the Student Health Center.

Instructions

Report work-related injuries and illnesses, regardless of whether medical treatment is required, to Environmental Health and Safety (EHS) within three (3) days of the incident. Prompt reporting ensures that the injured person receives the medical treatment and benefits entitled to them.

1. Notify your supervisor of the injury or exposure.
2. Complete the appropriate first report of injury form,
   1. Faculty or staff should complete the following form: Employee First Report of Injury (PDF) or (Online Form).
   2. Faculty or staff working outside of Maryland should complete the following form: Out of State Employee First Report of Injury (PDF).
   3. Volunteers should complete the following form: Volunteer First Report of Injury (Online Form).
3. If seeking medical treatment, print a copy of the injury report and take it with you to document notification to EHS.
4. Your supervisor must complete an investigation report. (PDF) or (Online Form)
5. Any witnesses should complete Accident Witness Statement. (PDF) or (Online Form)
6. If any PDF forms are used, you must fax completed copies to the attention of EHS Risk Management at 410-706-8212.