Reporting an Injury

• Ensure that the employee gets first aid or professional medical care as needed.
• Contact the appropriate administrative office as described below.
  • Preferably within 24 hours, report the injury using one of the following methods:
  1. Online Report: Preferred Reporting Method. Injuries may be reported using the Injury and Illness Report (IIR) on Risk & Safety Solutions. The employee or other staff members may access it at: https://app.riskandsafety.com/incident/.
     Note: to login use your University of California, Davis email, ___@ucdavis.edu (NOT @ucanr). A UC Davis Kerberos Login is required to access the form, UC ANR participates in UC Davis' injury reporting/workers compensation system. Once the report is submitted, an email will be sent to the supervisor, who will be prompted to complete additional information. Notification of the report will also go to EH&S and/or the UC ANR Staff Personnel Unit. 
  2. Paper form: Injuries may be reported to the Staff Personnel Unit (including Academic personnel). Use the UC Davis Employers Report of Occupational Injury or Illness  form and e-mail it to: anrstaffpersonnel@ucanr.edu or fax it to (530) 756-1180. For additional help with the form, consult the Employers Report Instructions  or Employers Report Example .
  • ANR Employees based at UCOP in Oakland – Most Oakland-based ANR staff have been converted to ANR payroll and would report as described above. If you knowingly are UCOP paid/payroll, then injuries are reported to UCOP Human Resources. For detailed instructions: Click Here
• Billing Information: If the clinic or hospital requires insurance billing information before they will provide treatment, use the information provided here. 
• After normal business hours, if the treating clinic needs insurance or claims information, call 1-877-682-7778 to report the injury and get the claims process started.
• If directed by the Workers' Compensation office, provide the employee with an Employee’s Claim Form (DWC 1 Rev. 1/94).  Follow Workers' Compensation office instructions for completing and returning the Employee Claim Form.
• Submit all required forms to the Staff Personnel Unit, UC Davis Workers’ Compensation (or UCOP Workers’ Compensation office), and maintain a copy for the employee file.

Safety Note 184 Workers Comp Claims describes the workers' compensation process and what units/representatives are involved. Those reporting an injury can benefit from this guidance.

Safety Note 123 Reporting An Employee Injury or Illness summarizes the employee injury reporting process.

To report SERIOUS work-related injuries or illnesses – see Safety Note # 76.

To report Incidents (and non-employee injuries) - such as theft, property damage, injuries to non-employees, or auto accidents of any nature, see the ANR Risk Services Incident Report form at:http://ucanr.org/incidentreport

If you have any questions about reporting an injury, please send a message to ask EH&S or call Brian Oatman at (530) 750-1264.

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