Accidents that occur during work-related activities, in the classroom, or during a University event must be reported immediately following the accident.

 For University of Nebraska-Lincoln Employees:

  1. If the individual needs medical attention, call 911 or make appropriate arrangements.
  2. Fill out First Report of Alleged Occupational Injury or Illness, Workers' Compensation Incident Report, along with the Employee's Choice or Change of Doctors Form. All forms need to be turned in to Deb DeWald (Room C201) immediately. If the injury occurs on a weekend or after hours, the Department Head needs to be notified as soon as possible.

For student workers (undergraduate or graduate):

  1. If the individual needs medical attention, call 911 or make appropriate arrangements.
  2. Fill out the First Report of Alleged Occupational Injury or Illness, Workers' Compensation Incident Report, along with the Employee's Choice or Change of Doctors Form and turned in to Deb DeWald (Room C201) immediately. 
  3. Contact the Department Head.

For students in the classroom (undergraduate or graduate):

  1. If the individual needs medical attention, call 911 or make appropriate arrangements.
  2. Fill out the form at the following link: https://ehs.unl.edu/. This form will be received by EHS
  3. Contact the Department Head as soon as possible

For members of the community attending an event:

  1. If the individual needs medical attention, call 911 or make appropriate arrangements.
  2. Fill out the Injury/Property Damage Report and immediately email to Office of Benefits and Risk Management (benefits@unl.edu) immediately.
  3. Contact the Department Head as soon as possible.

Automobile Accident:

  1. If the individual needs medical attention, call 911 or make appropriate arrangements.
  2. Fill out the Vehicle Accident report and turn in to Deb DeWald (Room C201) immediately.  If the accident occurs after hours, notify the Department Head as soon as possible.

All forms can be obtained from the list below or from Deb DeWald in C201 or in the Administrative Office, C203.

Workers' Compensation Forms

Please note that all four documents below are to be filled out for each claim.

First Report of Alleged Occupational Injury or Illness  PDF (104 kb)

Workers' Compensation Incident Report  PDF (80 kb)

Employee's Choice or Change of Doctor Form  PDF (106 kb)

Release to Return to Work  PDF (91 kb)

Vehicular Damage Forms

Vehicle Accident Report  PDF (102 kb)

Private Injury/Property Damage Forms

Injury/Property Damage Report  PDF (75 kb)