All accidents/exposures are to be reported to supervisor as soon as possible.

Serious Injury/ Illness

For health-threatening injuries/ illnesses, call x9-911 or proceed immediately to the Stanford Hospital Emergency Department.  Supervisor is to immediately contact EH&S @ 725-9999 to report deaths, or serious injury or illness.

Cal/OSHA defines an injury or illness as “serious” and reportable if it involves:

  • inpatient hospitalization, regardless of length of time, for other than medical observation or diagnostic testing;
  • amputation;
  • loss of an eye; or
  • serious degree of permanent disfigurement.

All Other Injuries

For treatment of all other injuries, proceed to:

Standardized Forms for Accident/Exposures

  • Supervisors are to provide Employee’s Claim for Workers’ Compensation Benefits (Form DWC-1) to injured employee immediately. Supervisors andemployees are to complete within 24 hours.
  • The SU-17 Accident, Incident or Exposure Report (for all incidents/ injuries/ exposures) has two sections: one for the supervisor and one for the employee to complete. To be completed within 24 hours and sent to Risk Management.
  • Cal-OSHA 5020 to be completed (typed) within 24 hours by the supervisor (for cases when one or more workdays is lost by an employee or when treatment of the employee is required by a physician in a medical facility).
  • SU-16 Workers’ Compensation Lost Workdays Report is completed by the supervisor when an employee has one or more workdays is lost.
  • All forms are available from the Stanford University Office of Risk Management.