http://www.utah.edu Human Resources Home

Employee's Responsibilities When a Work Related Injury or Illness Occurs

Employee’s Responsibilities When a Work Related Injury or Illness Occurs

File the Employer’s First Report of Injury Form within 24 hours of injury. This form can be found on the Human Resources website at http://www.hr.utah.edu.  Go to Forms and look for the Employer’s First Report of injury, which is Form 122.  Print it off and complete the required fields. The form requires supervisor’s name and contact number in the” Contact Name/Phone Number” field and supervisor’s or payroll reporter’s signature in the “Preparer’s Name & Title” field.

What To Do If You Sustain A Work Related Injury

  1. Notify your supervisor immediately.

  2. Seek medical treatment as directed by your supervisor but preferably from a University medical provider, if possible. 

  • The preferred provider is
    OccMed Clinic at Redwood Health Center
    1525 West 2100 South
    Salt Lake City, Utah  84119
    (801) 213-9777
    Monday through Friday  8:00 a.m. to 5:00 p.m.
    Call the clinic to notify them that you need to be seen

  • After hours:  : Urgent Care at the Redwood Health Center (801) 213-9700 or University of Utah Emergency (801) 581-2292

  • If your injury-illness is life threatening, go to the nearest emergency medical provider.

  1. The University of Utah worker’s compensation carrier is Worker’s Compensation Fund. (WCF)

  2. Complete and have your supervisor sign the “Employer’s First Report of Injury or Illness Form.”  The form must be submitted to the Absence Management Team within 24 hours.  The Absence Management Team is located in the Human Resources department at
    420 Wakara Way Suite 105 SLC, UT, 84108
    Phone (801) 581-2169 or Fax (801) 581-5571.
    Tell your physician the information you gave your employer regarding the accident.

  3. Write your name and social security number on all medical forms the same way it appears on all of your employer’s payroll information.

  4. Ask your physician to immediately send all relevant information to Worker’s Compensation Fund and the Industrial Commission.

  5. Inform your supervisor of the outcome of your treatment(s).  Any note releasing you from work and returning you back to work must be provided to your supervisor and to the Absence Management Team.

  6. It is important that you inform your WCF claims representative or the Absence Management Team and supervisor of any changes or updates with your current mailing address, whereabouts, and treatment(s).

  7. Be aware that additional medical services may need pre-authorization (check with your WCF claims representative or the University Benefits Department).  Be sure to tell the professionals providing these services that you are insured by WCF.

 

WCF works to protect injured workers and their employers against fraud.  It is a felony to collect workers’ compensation benefits through fraudulent pretenses, misrepresentations or omissions.