Supervisor's Report of On-the-Job Injury/Illness

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To be completed by the immediate supervisor or manager only.

Reporting an injury:

1. When an employee reports a work-related injury or illness, direct him/her to complete the on-line Employee Report for On-the-Job Injury/Illness.

If the employee is seriously injured or ill contact 911 immediately.

2. Contact Risk Management at (918)495-7236 to report the injury. The purpose for immediate notification is so that the Risk Management can verify occurrences of a work-related injury/illness and direct the employee to the Preferred Occupational Health Facilities. If Risk Management has no knowledge of the injury or illness, then the injured employee may be kept waiting for medical attention until the supervisor can be located and the injury is verified.

3. Complete and submit the Supervisor Report for On-The-Job Injury/Illness within the first 24 hours of notification.

Responsibility of the Employee:
All employees are required to report every work-related on-the-job injury or illness to his or her supervisor immediately. Failure to promptly report a job-related injury is considered grounds for termination. Should an employee seek medical attention, he or she is required to immediately provide documentation to the supervisor and Risk Management regarding his or her ability to work. If the employee is unable to personally deliver the treating physician’s status report, it can be emailed to riskmanagement@oru.edu or mailed to Attn: Risk Management, Oral Roberts University 7777 South Lewis Avenue, Tulsa, OK 74171.

Employees placed on “no work” status must keep the immediate supervisor and Risk Management informed of absences, doctor’s appointments and medical progress. If the supervisor and/or Risk Management have not received periodic updates from the employee accompanied by treating physician documentation, it is the supervisor’s responsibility to contact the employee. If the employee cannot be reached and has not returned to work, please contact Risk Management at (918)495-7236. Employee’s returning to work from a “no work” status must provide documentation from the treating physician regarding his or her ability to return to work.

Any hours missed from work must be reported in the Kronos Timekeeping System using pay code WCC, unless otherwise advised by Risk Management. If you have any questions, please call Risk Management at (918)495-7236.

All documentation should be forwarded to Risk Management.

REPORTING NEEDLESTICK & SHARPS INJURIES:
Because of federal and state regulations with regard to blood borne pathogens, additional information must be provided whenever an employee receives an injury arising from the use or accidental exposure to medical or laboratory devices, such as hypodermic needles, scalpels, etc. Supervisors and managers of any employees injured by such devices are responsible for obtaining and reporting the information on this form.

Employees who have been exposed to potentially infectious and/or hazardous materials should seek treatment within two (2) hours of the exposure. Post -exposure evaluation and follow-up protocols for HIV, HBV, and other
infectious diseases will be determined at the time of treatment .