Injury Reporting and Incident Reporting

UW Safety Office

UNIVERSITY OF WYOMING 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
• Stitches Acute Care Center, 3810 Grand Ave (307) 721-1794

Emergency Department in Laramie:

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

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 Kira Poulson in Human Resources (kpoulson@uwyo.edu).

Note that in some situations multiple forms are required.

A. For Employee Work-Related Injuries and Illnesses (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 Kira Poulson, 307-766-4220.

If the work related injury meets criteria “B” below the "UW First Report of Accident/Incident" must also be completed.

B. For injuries/incidents (including employee injuries) involving:

• a motor vehicle being used for university business,
• damage to university property, or
• injury to a third party,

the "UW First Report of Accident/Incident" form must be completed. Once completed, forward this form to the UW Risk Management Office.

Student injuries and incidents (not UW employee) are reported on the “UW First Report of Accident/Incident” form.

C. 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.

D. Additional Information for reporting injuries and incidents

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

E. Links to Incident Response Procedures

• Accidental Spill Prevention and Control Plan
• Animal Research
• Biological Agent Exposure, Spill, and Disposal Instructions
• Biosafety Incident Reporting Form
• Emergency Preparedness Information
• 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

F. 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