Workers' Compensation


The Pennsylvania’s Workers’ Compensation Act provides for disability and medical benefits for an employee (including student employees) that suffers a work-related injury or occupational illness. It is important for university employees and student employees to know the procedure for reporting such injury or illness.


In the event that an employee should suffer a work-related injury or occupational illness, the employee should:

  1. Immediately report all work-related injuries or occupational to their supervisor, no matter how minor the injury.
  2. In the event of a life-threatening emergency, call University Police (814-732-2911) for emergency medical services (EMS). The employee may seek treatment from any emergency medical facility.  However, after discharge the employee must follow up with one of the medical providers on the Panel of Medical Providers List.
  3. If the injury or illness is not a medical emergency, the employee must seek non-emergency medical treatment from the Panel of Medical Providers. Failure to do so will result in the employee being responsible for the medical bills incurred.
  4. The employee is to complete the Incident Report form. The employee’s supervisor is to complete the Supervisor’s Incident Report form, with the employees input, if possible.
  5. These forms are to be submitted to the Office of Safety and Risk Management within 24 hours of the incident.
    1. Only a completed Incident Report signed by the employee is accepted as the official notification of injury or illness. In the event of an emergency, these forms can be submitted after the incident is stabilized.
    2. Failure to complete and submit the forms to the Office of Safety and Risk Management may result in the claim being denied and/or the employee benefits being delayed or adversely affected.

If you any questions or need assistance, please contact the Office of Safety and Risk Management at 814-732-2709.


Incident Report

Supervisor's Incident Report

Witness Statement

Panel of Medical Providers

Physical Capacities Checklist
(to be completed by physician)

Contact Us

Office of Safety and Risk Management
1st Floor Lawrence Towers
150 Perry Lane
Edinboro, PA 16444
Phone: 814-732-2709
Fax: 814-732-2228

Jim Dahle
Director of Safety and Risk Management
Phone: 814-732-2709