Accidents (Employee)
What to do in case of an injury at work:

  • Report incident to the immediate supervisor and call Human Resources at 423-439-4787(If after hours, call the next morning).
  • Incident must be reported within 30 days.
  • When seeking medical attention, the employee must go to an entity listed on the Physician Panel Form. If an approved facility or physician is not seen, the employee could be held responsible for payment.
  • Do not use personal health insurance card.
  • Complete an OSHA Form # 301, a TN Accident Report Form, a Physician Panel Form and a Workers' Compensation 
    Medical Waiver as soon as possible, and send or bring forms to Human Resources. The forms are available on the
    Human Resources web site on the forms web page, under Workers' Compensation Forms.

Workers' Compensation Claims  


Accidents (Student or Visitor)
Visitors and students other than RSWP that receive an injury/illness while on the ETSU campus must submit their claim to the Division of Claims Administration of the State Treasury Department. This form can be obtained directly from the Office of Financial Services, Box 70732, Burgin Dossett Administration Bldg., 2nd floor, Room 202, phone: 423-439-4414. 
It's also accessible via the Office of Financial Services website.

Reporting Accidents and Injuries
In order to assist with accurate and timely reporting of incidents/accidents, ETSU has a reporting mechanism in place to insure proper documentation and follow-up of the event. All accidents and injuries occurring on ETSU owned or leased property must be documented. Emergencies should be reported to Public Safety (423-439-4480 or 911 from campus landlines) immediately for proper medical treatment. Public Safety will arrive to assist with the injured and dispatch other emergency personnel if needed. Public Safety will complete the Injury/Illness Report Form. ETSU colleges and departments are required to complete this form for incidents (i.e. minor injuries involving first aid, near miss events, etc.) involving students and guests when Public Safety is not called. The report must then be faxed to Public Safety (423-439-5805) within 24 hours of the event.

Illness/Injury Report Form

If the injury occurs to Faculty and Staff employees, additional paperwork must be completed and sent to ETSU Human Resources.