Injury Reporting
Emergency Services Department
All injuries, regardless of severity, will be reported according to the guidelines of this document.
For all employee accidents:
This includes adjunct instructors and Certification testers.
A. Call 911 or go to an emergency room. EMS will be called on any life threatening situations: airway, breathing, circulation, consciousness. NO EXCEPTIONS!
B. If minor medical attention:
Intermountain WorkMed
830 North 980 West, Orem UT
C. Call the appropriate contacts
1. Report major injuries directly to UVU’s Risk Management, Department of
Health and Safety (######) or Campus Police (801-863-5555).
Then call ESD’s Risk Assessment employee (Jennifer 801-863-
7708 or 801-404-0139)
a. Where substantial injury or loss incidents occur, call UVU Risk
Management first.
b. When an accident is in progress of any severity, i.e. EMS has been
summoned, call campus police.
c. If there is potential liability, call Campus Police ASAP.
2. Report minor injuries to ESD’s Risk Assessment employee
(Jennifer 801-863-7708 or 801-404-0139) Minor = bumps, bruises, a band-aid or a
couple of stitches.
D. Fill out all necessary documentation
1. UVU Claim Form
Located at: http://www.uvsc.edu/safety/pdfs/Injury.pdf
S:\EVERYONE\IESHS UFRA SOG SOP\Safety\Injury
Copies in the On Call Program Managers Handbook
On top of the first aid kit, south-most bay door of Support
Services
2. Workers Compensation Form
Located at: S:\ACAD\TC\UFRA\SOG SOP Handbook\Safety\Accident Injury
Copies in the On Call Program Managers Handbook
E. Hand deliver, fax or mail all documentation to ESD’s Risk Assessment employee no less than
24 hours after the accident. Benefits can be lost if forms are not filled out and returned in a
short period of time. Jennifer K. Brown, 3131 Mike Jense Parkway, Provo UT 84601,
fax 801-863-7738
All documentation will be routed to the correct persons via ESD Risk Assessment employee
For all (non-intern) student accidents:
This includes Academic, on site Training courses and off site Training courses
A. Call 911 or go to an emergency room. EMS will be called on any life threatening situations:
airway, breathing, circulation, consciousness. NO EXCEPTIONS!
B. UVU does not carry insurance on students so each student has the ability to seek medical attention where desired.
C. If there is a possibility of human negligence or faulty equipment, seek medical attention at:
Intermountain WorkMed
830 North 980 West, Orem UT
D. Call the appropriate contacts
1. Report major injuries directly to UVU’s Risk Management, Department of
Health and Safety (######) or Campus Police (801-863-5555).
Then call ESD’s Risk Assessment employee (Jennifer 801-863-
7708 or 801-404-0139)
a. Where substantial injury or loss incidents occur, call UVU Risk
Management first.
b. When an accident is in progress of any severity, i.e. EMS has been
summoned, call campus police.
c. If there is potential liability, call Campus Police ASAP.
2. Report minor injuries to ESD’s Risk Assessment employee
(Jennifer 801-863-7708 or 801-404-0139) Minor = bumps, bruises, a band-aid or a
couple of stitches
E. Fill out all necessary documentation
1. UVU Claim Form
Located at: http://www.uvsc.edu/safety/pdfs/Injury.pdf
S:\ACAD\TC\UFRA\SOG SOP Handbook\Safety\Accident Injury Copies in the On Call Program Managers Handbook
On top of the first aid kit, south-most bay door of Support
Services
F. Hand deliver, fax or mail all documentation to ESD’s Risk Assessment employee no less than
24 hours after the accident. Benefits can be lost if forms are not filled out and returned in a
short period of time. Jennifer K. Brown, 3131 Mike Jense Parkway, Provo UT 84601,
fax 801-863-7738
All documentation will be routed to the correct persons via ESD Risk Assessment employee
For all Non-paid internship student accidents:
This includes interns who serve without pay
~ This includes students receiving no compensation during an internship with UVU/ESD, Paramedics and Recruit Internships.
If an intern steps outside of the parameters of the internship program to perform any other duties, they may forfeit the insurance that is carried on them.
A. Call 911 or go to an emergency room. EMS will be called on any life threatening situations:
airway, breathing, circulation, consciousness. NO EXCEPTIONS!
B. If minor medical attention:
1. Intern student go to:
Intermountain WorkMed
830 North 980 West, Orem UT
C. Call the appropriate contacts
1. Report major injuries directly to UVU’s Risk Management, Department of
Health and Safety (######) or Campus Police (801-863-5555).
Then call ESD’s Risk Assessment employee (Jennifer 801-863-
7708 or 801-404-0139)
a. Where substantial injury or loss incidents occur, call UVU Risk
Management first.
b. When an accident is in progress of any severity, i.e. EMS has been
summoned, call campus police.
c. If there is potential liability, call Campus Police ASAP.
2. Report minor injuries to ESD’s Risk Assessment employee
(Jennifer 801-863-7708 or 801-404-0139) Minor = bumps, bruises, a band-aid or a
couple of stitches
D. Fill out all necessary documentation
1. UVU Claim Form
Located at: S:\ACAD\TC\UFRA\SOG SOP Handbook\Safety\Accident Injury Copies in the On Call Program Managers Handbook
On top of the first aid kit, south most bay door of Support
Services
2. Workers Compensation Form
Located at: S:\ACAD\TC\UFRA\SOG SOP Handbook\Safety\Accident Injury
Copies in the On Call Program Managers Handbook
a. Non-paid internship students submit to UVU/ ESD personnel
F. Hand deliver, fax or mail all documentation to ESD’s Risk Assessment employee no less than
24 hours after the accident. Benefits can be lost if forms are not filled out and returned in a
short period of time. Jennifer K. Brown, 3131 Mike Jense Parkway, Provo UT 84601,
fax 801-863-7738
All documentation will be routed to the correct persons via ESD Risk Assessment employee
For all paid intern student accidents
If an intern steps outside of the parameters of the internship program to perform any other duties, they may forfeit the insurance that is carried on them.
Since paid interns are insured by their department or the interning department , UVU does not carry the interns insurance. If that intern steps outside of the internship to perform any other duties, the responsibility for insurance coverage will be covered by the employing department. A memorandum of understanding (MOU) is strongly suggested for all paid interns.
A. If medical attention is needed by a paid internship student, use the employer’s
recommended medical provider, as the employer pays the workman’s compensation
insurance. Follow the employers SOG’s/ SOP’s and fill out their Workers Compensation
information.
B. Since Non-paid Interns are students of UVU (Intern for college credit) they are still required to
fill out the necessary documentation for UVU.
1. UVU Claim Form
Located at: http://www.uvsc.edu/safety/pdfs/Injury.pdf
S:\ACAD\TC\UFRA\SOG SOP Handbook\Safety\Accident Injury
Copies in the On Call Program Managers Handbook
on top of the first aid kit, south-most bay door of Support
Services
2. Hand deliver, fax or mail all documentation to ESD’s Risk Assessment employee
no less than 24 hours after the accident. Jennifer K. Brown, 3131 Mike Jense
Parkway, Provo UT 84601, fax 801-863-7738
All documentation will be routed to the correct persons via DES Risk Assessment employee
Revised 02/08/07, 06/12/09, 02/24/12
Additional information:
? What are the time lines for reporting to the above?
Minor injuries, call ASAP
Immediately on workers comp or potential liability cases
? The UVU Accident Document stipulates, if Health and Safety is contacted, is it still necessary to contact campus police OR vice versa?
Answer: Campus Police creates a report with dates, names, and times of occurrence and a synopsis of events. Risk Management will conduct a complete investigation of the incident to protect the victim and the department from litigation.
? Does a campus officer have to be sent out, or can ESD get a case number over the phone?
In order to create a report, the officers must come to the scene and conduct an investigation. Report numbers can be created but have no relevance without an investigating officer assigned.
Any possibility of liability, Risk Management shall be notified.
? How does this department policy affect off campus classes or non-academic courses? i.e. ESD Training courses?
Every accident will be reported (academic, training or personnel) regardless of extent of injury.
All incidents are reported with the same guidelines as above.
An incident in Logan or St. George may need to be investigated the same as one that happens at ESD campus.
? Do not contact Student Accident Insurance as this insurance does not exist anymore?
Correct, there is no longer Student Accident Insurance provided by Student Services.
Student Accident Insurance is different than Workers Compensation Insurance!