University of Michigan
Office of Business Affairs
1110 Administration Building
Dearborn, MI 48128-2406
Phone: 313-593-5110
FAX: 313-593-5111
Contact:
Tina Jordan (313-593-5110)
Please contact for assistance to report incidents involving workplace illness and injuries/accidents and receive authorization for treatment.
FOR INCIDENTS INVOLVING EMPLOYEES: |
How to Report Incidents Involving Workplace Illness and Injuries/Accidents and Receive Authorization for Treatment for Employees: |
The basic steps for employees to report incidents and receive treatment authorization are: |
- Notify your supervisor immediately after a work-related illness/injury occurs.
- Let your supervisor know that you would like medical treatment if treatment is needed between 8 am - 5 pm, Monday-Friday. Contact Public Safety (at x.3-5333 or x.911) if medical treatment is needed after hours or in the event of a life-threatening injury.
- Your supervisor will report the incident and receive authorization to send you to Midwest Health Center, P.C./Metropolitan Airport Office Center-Romulus (map/information), the University's designated treatment facility for work-related injuries for medical treatment. (After hours and weekend treatment is provided by the Midwest Health Center, P.C. facility located in Dearborn, Michigan.)
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The basic steps for supervisors to report employee incidents and receive treatment authorization are: |
- The employee's supervisor must immediately contact either Business Affairs (at x.3-5110) or Public Safety (at x.3-5333 or x.911) to report the incident. Business Affairs or Public Safety will send an authorization form to Midwest Health Center, P.C./Metropolitan Airport Office Center-Romulus (map/information), the University's designated treatment facility for work-related injuries for medical treatment. (After hours and weekend treatment is provided by the Midwest Health Center, P.C. facility located in Dearborn, Michigan.)
- The supervisor must complete the Work~Connections Illness or Injury Report Form and mail or fax it to Business Affairs (at 1110 AB, Fax: x.3-5111). Do not send the form directly to Ann Arbor Work~Connections.
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FOR INCIDENTS INVOLVING NON-EMPLOYEES: |
How to Report Incidents Involving Workplace Illness and Injuries/Accidents and Receive Authorization for Treatment for Non-Employees: |
Contact the Public Safety office from any University telephone (at x.3-5333 or x.911) or from any non-University telephone (at 313-593-5333). An Injury Report for Non-Employees form should be completed. (These forms are available in the offices of Public Safety, Business Affairs, and Human Resources.) The original should be sent to Tina Jordan, Business Afairs (1110 Administration Building). |
The Counseling and Support Services department has a service agreement
available with the Henry Ford Medical Center-Fairlane for students, faculty, and staff.
Detailed information is available at the Counseling and Support Services/ Health Services website.