If it is an emergency, please call 911 immediately for assistance.
How to File a Report
Please review the Incident Investigation and Reporting Program. The employee completes the Employee’s Incident Report Form and submits it to his/her supervisor or to the Department of Environment, Health and Safety.
The supervisor completes the Employer’s Report of Injury to Employee and forwards it to the Department of Environment, Health and Safety within 24 work hours of knowledge of the incident.
Note: Industrial Commission regulations require that the notification form be filed with the Industrial Commission within five days after the occurrence and knowledge of an injury; however, OSHA regulations require that injuries requiring medical treatment be recorded by the Department of Environment, Health and Safety within 48 hours. Therefore, it is imperative that injuries be reported to the Department of Environment, Health and Safety as soon as possible.
The supervisor must also complete the Supervisor’s Incident Investigation Form, to be submitted to the Department of Environment, Health and Safety along with Form
Incident Reporting, Injuries and Near Misses
Incidents resulting in personal injuries to students, staff, faculty, and visitors while on University property, or in the course of University employment or activity, are to be reported to the University Department of Environment, Health and Safety. EHS will investigate for potentially unsafe conditions and initiate corrective action as appropriate. Campus Police are to notify the Department of Environment, Health and Safety of incidents to which they respond.
Lost Work Time
Incidents resulting in lost work-time are to be reported to the Department of Environment, Health and Safety (252-335-3877)) as soon as practicable, during regular work hours (8:00 a.m. – 5:00 p.m.).
Death or Hospitalization
Any incident on the ECSU Campus resulting in death or hospitalization is to be reported immediately to the Environment, Health and Safety during normal business hours 252-335-3877) and Public Safety after business hours (252-335-3266)
Potentially Hazardous Condition
Any potentially hazardous condition is to be reported immediately to the DepartmentEnvironment,
Health and Safety for investigation, regardless of whether it has resulted in injury.
This includes “near misses”, i.e., incidents in which injury was narrowly avoided
and for which action is needed to prevent and correct unsafe conditions or actions.
Notifications of Personal Injuries: Employees
Injuries which result in hospitalization, lost work-time, or which require medical treatment beyond first aid, will be investigated by the Department of Environment, Health and Safety for the purpose of analyzing the circumstances surrounding the injury, the possible need for corrective action, and whether it is compensable under the North Carolina Workers’ Compensation Act.
The employee is responsible for notifying his or her supervisor immediately of any job-related injury or illness. If the employee is not able to do so, a fellow employee should notify the supervisor as soon as practicable.
The supervisor is responsible for ensuring that the employee receives prompt treatment of the injury by obtaining first aid or medical treatment. If the treatment requires more than first aid, the supervisor or another person must accompany the injured to the appropriate medical facility for treatment. Injured employees are not to be sent unescorted to seek medical attention. The supervisor is also to notify the Environment, Health and Safety Office by telephone for follow-up.