Work-related Injury or Illness

For Incidents Involving Employees:

If a worker gets injured while on the job they are encouraged to seek medical attention, if necessary. When the injury is of a serious nature, this can be done by calling the UM-Dearborn Department of Public Safety at 313-593-5333 from a mobile phone or 911 from a campus phone. UM-Dearborn Public Safety will administer first aid and request for an ambulance to send the employee to a local ER if the injury warrants such a response.

If the injury is not serious (mildly sprained ankle, etc.), the employee should contact their supervisor, and follow the injury reporting process, below. If the cause if the injury is a safety issue that others may injure themselves similarly (i.e., broken concrete, ice on the sidewalk, missing/ loose handrail in a stairwell), UM-Dearborn Public Safety should be notified to write up an incident report. The report will initiate corrective actions by generating a Facilities Operations work order. EHS will become involved when notified of the unsafe condition by the police.

For all non-emergency (non-life threatening) assessments and /or medical treatments, direct the employee (faculty or staff) to Concentra Medical Center, 17500 Federal Drive, Ste. 750, Allen Park, MI (313-982-1370). This is the assigned clinic for all work-related injuries for the University of Michigan-Dearborn and it provides medical services from 8:00 am to 5:00 pm, Monday thru Friday.

During after-hours and weekends, direct employee (faculty or staff) to Concentra Medical Center, 11700 Metro Airport Center Drive, Ste. 104, Romulus, MI (734-955-7000). this is a 24 hour, 7 days a week clinic.

Your supervisor will need to complete a Concentra Authorization for Examination or Treatment Form for you to be treated. Take this completed form with you. If you go to the clinic without a form, the clerk will need to call your supervisor for a verbal authorization and a form will need to be faxed or scanned/ emailed to the clinic for treatment to be approved.

If treatment for your injury cannot wait, please go to Henry Ford Medical Center - Fairlane Emergency Room if you require immediate care. UM-Dearborn Department of Public Safety will assist by contacting EMS to transport you to the ER. Paperwork can be completed after you are treated in this instance.

Occupational Injury Reporting Process:

Upon notification of workplace injury or illness, the immediate supervisor will complete a Risk Management Services (a.k.a., Work Connections) Claims Submission Form.

  1. The first question on the form says: "What type of incident are you reporting?"
  2. The drop menu will have an option for "Employee Injury or Illness", use this option.
  3. The Reporter (i.e., injured employee's immediate supervisor) will complete the Claims Submission form and attach any supporting documents, such as but not limited to; photographs, police report, or Work Connections Injury/Illness Report Form.
  4. Click on the "Summary" button on the bottom of the page. The Reporter will review the Event Details and any Attachments for the claim. Click on "Submit" to send the report.
  5. The completed report is sent directly to Risk Management Services in Ann Arbor. The supervisor will automatically receive a copy of the report via email.
  6. After the form and documents are submitted to Work Connections, the supervisor is required to forward a copy of the completed report to UM-Dearborn Human Resources (Kelly Schester - kcarron@umich.edu) and the EHS Department (umdehs-email@umich.edu) for local record-keeping purposes.

If there are any questions regarding this process, please contact the EHS Department at 313-583-6679 or send an email to David Fogle, EHS Direcdtor.

Laboratory Injury or Illness Reporting Process:

Laboratory personnel are required to report ALL occupational injuries, illnesses, and Near Miss/Near Hit incidents to the Principal Investigator (PI) as soon as practical.

A "Near Miss" or "Near Hit" incident is considered a precursor to actual incidents or events and must be reported whether or not an injury occurred. The Principal Investigator (PI) would be responsible for completing the Risk Management Services (a.k.a., Work Connections) Claims Submission Form. Follow the Occupational Injury Reporting Procedures as described above.

In addition, an EHS Laboratory Incident and Near Miss Report must be completed and submitted to EHS Department (umdehs-email@umich.edu). The EHS Department requires that the incident shall be investigated by the Principal Investigator (PI) and a team of appropriate individuals (e.g., Laboratory Supervisor, Laboratory Safety Coordinator) to determine the cause and identify any preventative measures that can be put in place to prevent reoccurrence of the incident.

Non-Employee Injury or Illness Reporting Process

Report all incidents that result in serious bodily injury immediately by telephone to the Dearborn campus Department of Public Safety (313-593-5333) and the Risk Management Services group in Ann Arbor (734-764-2200).

Non-Employees for the purposes of this process are identified as students or guests when they are on campus property or are involved in a university sponsored event off-site.

  1. Contact the University of Michigan-Dearborn Police & Public Safety at 911 (building phones) or 313-593-53333 (mobile devices).
  2. Obtain a Police report for the incident.
  3. The professor, instructor, or primary activity sponsor will complete an Injury Report for Non-Employees for the incident.
  4. Submit the completed form to Risk Management Services in Ann Arbor and a copy to the Dearborn campus Human Resources.

Environmental Health and Safety

108 - Auxiliary Program Center
4901 Evergreen Road
Dearborn, MI 48128
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Phone: 313-583-6679
Fax: 313-493-9161