CCS DISTRICT PROCEDURES

DISTRICT
1.1E15.1
Revised: April 24, 2002
Environmental Health and Safety Department
533-8623

REPORTING EMPLOYEE MEDICAL EMERGENCIES AND WORK-RELATED INJURIES AND ILLNESSES

Overview: Whenever there is a medical emergency or a work-related injury/illness involving an employee or student work-study, a Medical Emergency Report Form (CCS 1220) must be completed by the affected person, a witness to the incident, a supervisor, or a faculty/staff member.

Procedure:
  1. EMPLOYEE (INCLUDING PART-TIME OR STUDENT WORK-STUDY):
    2.
    1. The Medical Emergency Report must be completed within 24 hours of the incident.
    2. The completed report must be routed through that person’s immediate supervisor for signature.
    3. The supervisor must sign the form, retain one copy, route one copy to the affected person, and send the original to the Environmental Health and Safety Department at MS 1016.
    4. An employee seeking professional medical treatment for the incident must inform the physician’s office, hospital, emergency center, etc. that the injury or illness was work-related.
    5. A work-related injury or illness must be reported on the Washington State Department of Labor and Industries form by the employee and medical staff, initiating the employee’s claim to state workers compensation benefits.
    6. The employee who sustains the work-related injury or illness must contact the CCS Human Resources office to make arrangements for any required time off work. All paperwork involving a work-related injury and illness will be kept on file in the Human Resources office.
    7. The Washington State Department of Labor and Industries makes all claim determinations.
  2. Injuries and illnesses that occur at off-campus sites, but during approved college activities and functions, should also be reported on the form.

The Medical Emergency Report is available on the CCS intranet at http://ccsi.spokane.cc.wa.us/forms/distform.htm.