In This Section      



  1. Report any work-related injury or illness to your supervisor immediately.

  2. Obtain a Report of Incident form from your supervisor and proceed to the Occupational Injury Clinic (or Emergency Department when the clinic is closed) for evaluation.

  3. Follow instructions of health care providers in the Occupational Injury Clinic or ED, particularly those regarding follow-up contact and/or visits.  If evaluated in the Adult or Wilmer Emergency Rooms or via a 5-STIX bloodborne pathogen exposure evaluation, contact the Occupational Injury Clinic on the next available business day for further disposition.

  4. After exiting the Clinic, deliver the appropriate employee referral form to your supervisor immediately.

    a.  Review any restrictions with your supervisor.

    b.  Read "PART IV" on the JHWC Medical Restriction  Form, date it and sign your name.

  5. Report on time for any appointments scheduled or coordinated by the Occupational Injury Clinic.  If you are unable to keep an appointment, notify the appropriate facility and reschedule another appointment.  [NOTE:  Many departments also have policies on absences and/or lateness for appointments. Arriving late for an appointment may necessitate rescheduling. Continued absences may result in disciplinary action for noncompliance].

  6. Return to Occupational Injury Clinic after all appointments with specialty physicians.

  7. Contact your department as well as Occupational Injury Clinic if  you are unable to work as scheduled.  You may be requested to report to the Clinic for further evaluation on the day of absence.

  8.  Discuss the issue of Family Medical Leave with your supervisor.  If applicable, complete a "Request for Family Medical Leave (FML)" form and have the Certification by a Health Care Provider form completed.  Return both forms to the Benefits Office.

  9. Return to Occupational Injury Clinic if your symptoms persist, worsen, or recur.

  10. If directed by the Occupational Injury Clinic, contact Occupational Health Services regarding possible job accommodation/transfer.


  1. Determine if the employee's illness or injury on the job needs immediate medical attention.  Refer to definitions/guidelines in this document (page 1).

  2. Complete an Employee Report of Incident.  Retain the last copy; the first two copies should accompany the employee to the treatment location.  If unable to complete an incident report at the time of the injury,

a.  A call to the Occupational Injury Clinic or Emergency Room is required to properly identify the employee and department, and to provide a brief explanation of the incident. 

  b. Complete the Employee Report of Incident Form before the end of the shift.  Deliver the form to Occupational Injury Clinic, Blalock 139 before the end of the next business day.

  c. If the employee reports an injury but refuses to proceed to the Occupational Injury Clinic, complete the Employee Report of Incident Form.  Document that "employee refused treatment at this time" and forward the Form to the Occupational Injury Clinic.

  1. Review the employee referral form given to your employee upon exiting evaluation in the Occupational Injury Clinic.  These forms will note any restricted duty, referrals, follow-up appointments, etc.

a.  Determine if you can accommodate restrictions and check the appropriate slot.

b.  If you cannot accommodate the injured employee's restriction, or if you need assistance in determining an accommodation, contact the Environmental Health Officer (EHO) at 5-5918.

c.  Review the restrictions with the employee.   Sign the supervisor section Part III.  The employee is to sign Part IV.

d.  Have the employee return to the Occupational Injury Clinic with the completed form.

e.  If the employee has a permanent restriction which precludes them from performing an essential function of their job, he/she will be referred to the Occupational Health Services for evaluation of potential job accommodation.  If a reasonable accommodation is not possible, the employee may be terminated.

f.   The Employee Benefits Office will discuss the employee's options regarding the availability of disability and/or other benefits.

  1. Advise the employee to complete the Request for Family Medical Leave (FML) form and to have the Certification by a Health Care Provider completed.  The Occupational Injury Clinic can complete the certification portion of the form.  Both forms should be returned to the Benefits Office.

  2. Discuss injury/illness with employee to prevent recurrence, understand factors involved, and arrange for engineering controls or other hazard abatement methods.

Occupational Injury Clinic

  1. Provide prompt, efficient, quality care to employees who have sustained work-related injury/illness.

  2. Evaluate return to duty status with or without restrictions.

  3. Arrange necessary follow-up.

  4. Refer cases to designated specialty physicians in accordance with medical management guidelines.

  5. Review restrictions, follow-up appointments, referrals, and other information on Employee Referral/JHWC Medical Restriction Form as well as instructions outlined on the injury care sheet.

  6. Communicate to supervisor all time away from work (appointments, "LOD", etc.), disposition, changes in work status via Employee Referral/JHWC Medical Restriction Form, telephone contact, or fax.

  7. Coordinate job analysis with Environmental Health Officer.

  8. Contact Occupational Health Services to ascertain whether employee can perform essential functions of the job, as determined by the employee's supervisor with assistance from the Environmental Health Officer.

  9. Assist management in determining whether a reasonable accommodation may be made.

Workers Compensation Claims Office

  1. Process all incident reports.

  2. Prepare a First Report of Injury to be sent to the State of Maryland Workers' Compensation Commission and the Maryland Department of Labor and Industry.

  3. Determine the compensability of an alleged injury and approve all lost time resulting from a work-related injury.

  4. Prepare a claim form for employees who have lost more than three days from work due to an accepted on-the-job injury.

  5. Prepare a Workers' Compensation Benefit check for an employee who was placed off work due to an accepted on-the-job injury.

  6. Process all related medical care bills incurred by employees for an accepted on-the-job injury.

  7. Notify employees, via mail, when a reported incident is not accepted as a compensable injury.

Occupational Health Services

  1. Evaluate employees who cannot perform their former job duties for a reasonable accommodation.

Health, Safety and Environment

  1. Conduct job analysis as requested by Occupational Injury Clinic.

  2. Evaluate job duties of those employees with medical restrictions and provide direction to supervisors regarding the accommodation of employees.

  3. Convey results of job analysis and associated recommendations to supervisor.

  4. Report results of job analysis and associated recommendations to Occupational Injury Clinic.

  5. Conduct on-site evaluation of all incidents involving significant injury, ergonomics and indoor air quality.

  6. Report results of evaluation to Occupational Injury Clinic.

Human Resources

Employee Relations Specialist will review letter prepared by the supervisor/manager, advising the employee of the medical layoff.

For bargaining unit employees, the Employee Relations Specialist will notify the Union pursuant to the letter being forwarded to the employee. A copy of the letter will be sent to the Benefits Office for consideration regarding benefits.

Upon receipt of the letter regarding the termination of employment, the Benefits Office will determine what benefits may be continued and will advise the employee accordingly.

>Back to Top