There are several forms for Accident Reporting. Please select the appropriate form below:
Used for accidents / incidents involving employees that result in injury or illness.
This form can be completed online and has a “Submit Button” at bottom of page two; it can also be saved, completed, and emailed.
Used for accidents / incidents involving employees that result in no injury (near miss, property damages,etc.)
Used for all accidents / incidents involving students or visitors
All forms should be completed and submitted to Environmental Health & Safety. If the form does not allow for a submission through Microsoft Forms, please attached completed form and email it to email@example.com
All injuries must be reported immediately to the employee’s supervisor.
Accidents Resulting in Injuries
Minor first aid should be administered on the job as available. Injuries requiring more than first aid will be referred to the Emergency Department at either Cabell Huntington Hospital or St. Mary’s Hospital in Huntington, or the nearest hospital for injuries occurring off of main campus. Call the Marshall University Police Department at 696-HELP (4357) if an ambulance is necessary.
Once the supervisor has been notified and any necessary first aid or medical treatment has been rendered, all injuries or illnesses must be reported to the Environmental Health and Safety Department within 24 hours of the injury or illness via the on-line reporting form. The employee form is in Adobe® pdf with fields that can be completed and submitted online. The form will transmit electronically to the appropriate parties for processing. The student and visitor form is in Microsoft Word and must be completed, saved, and emailed to firstname.lastname@example.org.
Marshall University has partnered with University Occupational, Environmental and Disability Medicine to provide injury care and follow up for Huntington campus employees. This group of physicians specializes in the diagnosis and treatment of occupational related injuries and illnesses and management of worker’s compensation claims as well as preventive care and occupational health surveillance. Marshall University employees will receive prompt, efficient quality medical care for acute non-urgent work related injuries as well as any follow up care that is necessary. The clinic is located on the 1st Floor of the Joan C. Edwards School of Medicine on the campus of Cabell Huntington Hospital. (Note: This service is offered as an optional courtesy. MU employees are not required to receive care from the University Occupational, Environmental and Disability Medicine group in the treatment of work-related injuries. All services offered through the group will be billed through regular insurance processes. Medical records of employees shall remain confidential as per HIPPA requirements).
Records for injuries as required by OSHA will be maintained by Human Resources.
Insurance Claim Reporting
The West Virginia Board of Risk & Insurance Management BRIM) provides casualty insurance coverage for Marshall University. This includes protection from lawsuits and other liability claims resulting from incidents due to automobile accidents, employment practices, property, flood, general liability, and medical professional liability at the respective teaching institution.
Any employee of Marshall University who either witnesses or is made aware of the occurrence of any insurable incident should gather all available information on the incident and report it to the Environmental Health and Safety Department within 24 hours of the incident via the reporting forms listed above. Environmental Health & Safety will file any necessary forms with the WV BRIM.
Report all auto accidents immediately to the Marshall University Police Department 304-696-6357 (HELP). All claims should be reported following the above procedures.