Report An Injury
Report an On-The-Job Injury or Illness
Need to File a Workers’ Compensation Claim?
There are now three ways to report a Worker’s Compensation injury or illness claim. The County’s Web Report tool is the fastest and most secure way to report a claim.
Web Report presents several advantages to the injured worker and to a supervisor including:
- Increased protection of private information – no more paper copies of your injuries floating around the County.
- Web Report transmits data directly to Risk Management in real time. Once submitted, you instantly receive a receipt with a claim number right on it.
- The Web Report receipt can be given to a supervisor as proof of the injury.
- Once your injury is assigned to an adjuster, you will instantly receive via your supplied email, their name and contact information, your completed First Report of Injury Form, and a document that answers many of the common questions asked by injured workers.
- Mouse between data fields or use the Tab button to move forward.
- Dates can be entered as mm/dd/yyyy or mmddyyyy.
- Time can be entered as 09:30 a.m. or 0930a and Web Report will add the rest.
- Occupation is a drop down list. If your position is temporary it will begin with a “(T)”. All UPD positions begin with “UPD” for example “UPD Officer”.
- After entering the security code at the bottom a pop-up window appears with your claim number and asks about sending a receipt report. Be sure to write down the claim number if you are not printing the receipt.
Don’t want to use the Web Report?
If you don’t want to use the Web Report, the old paper forms will still be available until they are gone. You can also complete Form 122 (304 KB PDF).
Notice: OSHA must be called within 8 hours of any disabling, serious or significant injury or disease or fatality.
1. If an employee dies or incurs a disabling, serious, or significant injury or disease:
a. The administrator, supervisor or designee must immediately contact the Risk Manager.
b. The Risk Manager must contact the Occupational Safety and Health Division (UOSH) of the Utah Labor Commission within eight hours of the occurrence. The Risk Manager will document the name of the person contacted at UOSH, the date, and time of the contact.
c. If the administrator, supervisor or designee is unable to actually communicate with the Risk Manager, they must report the injury to UOSH within 8 hours of the occurrence and document the contact as noted in b. above.
d. Both the Risk Manager and the administrator, supervisor or designee must notify the District Attorney of the date and time the death or disabling, serious or significant injury or disease was reported and provide the name of the person contacted.
2. The Accident Scene must remain untouched where possible. Do not remove or alter any tools, equipment, materials or other evidence that might pertain to the cause of the accident until authorized by the Labor Commission or one of its Compliance Officers. If the scene can’t be preserved, note the reason and take many photos of the scene from different angles and distances and provide the photos to Risk Management.