Injury Reporting and Incident Reporting

INJURY REPORTING AND INCIDENT REPORTING PROCEDURE

The first priority is protecting people, followed immediately by securing hazardous materials and the scene for safety.

For an emergency, call 911 

Report injuries and incidents immediately to your Supervisor.

Seek medical attention if necessary.

Urgent Care facilities in Laramie:

• Grand Avenue Urgent Care, 3236 Grand Ave, (307) 760-8602
• BestMed Urgent Care, 3810 Grand Ave, (307) 721-1794

Emergency Department in Laramie:

• Ivinson Memorial Hospital, 255 North 30^th Street (307) 742-2141

Medical care outside of Laramie:

• See nearest medical care provider

Advise the health care provider that you are employed by UW and that you were injured on the job. If you are asked for a case or claim number, explain that it will be issued by the Wyoming Workers’ Comp office. Take the UW Work-Related Injury Follow-up Form with you to your appointment. Send this completed form to Christian Carter in Human Resources, ccarter8@uwyo.edu.

** Note that in some situations multiple forms are required. **

Forms for Reporting Injuries

Work-Related Injuries and Illnesses for Employees (includes student employees):

The "Workers Compensation Report of Injury" form must be completed.

Once completed, sign the Employee Certification section (the form may be completed electronically or on paper, but must be printed and signed). Submit the completed form to your Supervisor or other person authorized by your department to sign the Employer Certification. Do not wait to turn in the form. If your supervisor is not available, please submit the form to Human Resources. If you need assistance call David Heath, 307-766-5693.

If a work-related injury meets any of the following criteria, the "UW First Report of Accident/Incident" must also be completed. Once completed, send the form to the UW Risk Management Office.

UW First Report of Accident/Incident

For injuries/incidents (including employee injuries) involving:

• a motor vehicle being used for university business
• damage to university property
• injury to a third party
• Student Injuries and incidents (not UW employees)

Reporting to Other UW Committees:

You may need to report the injury or incident to other UW committees such as the UW Institutional Animal Care & Use Committee (IACUC), Institutional Biosafety Committee (IBC), or Radiation Safety Committee (RSC).

• You may be needed to provide expertise, assistance, or advice regarding the injury or incident.
• Further UW investigation and reporting may be required to be submitted to other State or Federal agencies.

Additional Injury Reporting Resources

Note: for some situations, multiple forms are required.

• Animal Research
• Biological Agent Exposure, Spill, and Disposal Instructions
• Biosafety Incident Reporting Form
• Chemical Hygiene Plan (Laboratory Safety, OSHA)
• Hazardous Materials Spill Emergency Response Plan
• Human Subjects Research
• Laser Safety Plan
• Radioactive Materials Safety Plan
• X-ray Safety Plan

Links to Incident Response Procedures

• Accidental Spill Prevention and Control Plan
• Animal Research
• Biological Agent Exposure, Spill, and Disposal Instructions
• Biosafety Incident Reporting Form
• Hazardous Materials Spill Emergency Response Plan
• Human Subjects Research
• Laser Safety Plan
• Radioactive Materials Safety Plan
• X-ray Safety Plan
• More Procedures on the A-Z index

Questions?

For questions regarding injury and incident reporting, contact:

• Human Resources, 766-4220
• UW Safety Office, 766-3277
• Research and Economic Development – 766-5353
• Risk Management – 766-6787