Accident And Injury Reporting Guidelines

Forms, procedures, and contact information to report an injury, a near miss, or an accident.

Life-Threatening Emergencies:
In the event of a life-threatening emergency, please dial 911 to contact the University Emergency Medical Services (EMS) system.

Reporting a non-life threatening Injury or Accident for an Employee:
Accidents or injuries should be reported each time someone is hurt, no matter how minor the injury may seem, regardless of whether the accident involves a full or part-time employee, student, or visitor. An injured worker may not complete their own injury report.

• If the accident involves an employee who is injured on University Park Campus, the report should be submitted to one of the contacts below, who is to report the accident to the Human Resources/Workers’ Compensation office, within 48 hours of the accident. The Worker’s Compensation benefits coverage could be delayed or denied if the employee does not notify the Safety representative listed below immediately.
• If the employee is injured elsewhere while performing his/her duties, the report should be submitted to Human Resources/Workers’ Compensation as soon as possible.
• If the accident results in possible injury to others including students (new or not employed by Penn State), visitors, and guests, the Risk Management Office requires the completion of an Incident Form.

Reporting a Non-employee injury:
Please report the accident to one of the following contacts below who can submit an accident report with the appropriate University office (see attached Accident form):

Primary Contacts:

Secondary Contact:

Brittany Grimes
201 Huck Life Sciences
University Park, PA 16802
E-mail: bng10@psu.edu
Phone: 814-865-2625

Human Resources/Workers Compensation
All employee injuries or accidents are required to be reported within 48 hours through the Human Resource/Workers Compensation division. The employee will receive an e-mail containing the claim number and the “Worker’s Compensation Signature Packet” containing forms that the employee is required to complete and return to the Penn State Human Resources Absence Management Team located at The 331 Building, Suite 234, University Park.

In order to ensure that the medical treatment will be paid for by the University, the injured worker must be treated by one of the designated physicians or health care providers.

If the injury results in an immediate medical emergency, initial medical assistance may be obtained from the nearest hospital. However, follow-up care must be from Occupational Medicine.

Penn State Occupational Medicine
Centre Medical Science Building
1850 East Park Avenue Suite 310
State College, PA 16803
814-863-8492

Risk Management Reporting:

Vehicle Accident Report
A Vehicle Accident Report must be submitted to the Risk Management Office for any accident involving a University vehicle, rental car, or if a personal vehicle is used on University business. A report must be submitted to the Risk Management Office no matter how minor the accident or even if there was no damage at all. The Driver is responsible for completing the form. In case of serious injuries or undrivable vehicle, please call the Risk Management Office at 814-865-6307. If the accident is alleged to be the result of a "Hit and Run", the police must be contacted. Driver must complete both sections of the Vehicle Accident Report, answering all questions, sign, and submit to Risk Management Office within 24 hours of the accident.

Incident Report
An Incident Report should be submitted to the Risk Management Office in the event of an incident or accident possibly resulting in damage to property or injury to students, visitors, and guests. This form is for incidents not falling under Workers’ Comp or Vehicle Accidents.

Property Loss Report
A Property Loss Report should be submitted in the event University Property is damaged due to fire, water, storm, electrical surge, or robbery/theft. This form notifies the Risk Management Office that the University’s Property Insurer may need to be involved. All losses are subject to a $25,000 deductible.

Risk Management Office Contact Information
Please visit the Risk Management Office website to find their contact information, including personnel phone numbers, email addresses, and office mailing address. Submit all questions and completed forms directly to them.

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