Baldwin Wallace University
PA-15: Workplace Health and Safety

Injury Reporting Procedures for Work Related Injuries at Baldwin Wallace University
Updated February 2018

If you should have a workplace injury first rule of thumb is to:

• Seek Medical Attention, and then
• Complete First Report of Injury Form (these can be obtained in your department or you may download them off the web.

Have a witness sign off on the First Report of Injury report. If no one witnessed the accident, then the first person who you are able to report your injury to, will serve as your witness.

Your witness will write down their accounting of what took place. Next, have your supervisor or department head sign the form which is forwarded immediately to Janet Leonard in HR.

Please make sure that the form is filled out correctly and completely, especially the section that asks if your injury will cause any lost time.

Make sure you indicate the date of the injury and the date that you returned to work, if you will miss work due to the injury, please make a note of it on the injury report.

If there is no medical attention sought, then the report will be kept on file in the department of HR. If medical attention is necessary and it is a minor injury you may go directly to BW's health center for minor treatment if it is during their normal working hours.

If the injury occurred outside of work hours, go to the nearest health care provider for treatment. Tell the health care provider that BW is self-insured, and instruct them to bill Baldwin Wallace University for your initial treatment.

If the injury is not life threatening, consider using an urgent care facility instead of a hospital. You will receive care more quickly and BW will save money. Southwest Urgent Care has a facility on Snow Road in Brookpark and also on Pearl Road in Strongsville. North Olmsted Urgent Care is located on Lorain Road in North Olmsted. And Metro Urgent Care is on Pearl

If your injury is more serious than just a one-time treatment you will need further paperwork and documentation. If you will need further treatment or tests you will have to have your doctor fill out an Authorization for treatment called a "C9". Most medical providers carry this form in their office. If a non-emergency, no further treatment should be done until you have signed authorization in order to insure that it is approved and payment will be made.

When your doctor submits the “C9” to Baldwin Wallace they should make sure to also forward all proper documentation and office notes in order to have the “C9” reviewed for approved. After approval you can make further appointments for tests or treatments.

If you will have to miss any time for a workplace injury, you are required to provide a doctor’s excuse specifying what days you are to be off work with an estimated or actual return to work date. The doctor’s excuse must be forwarded immediately to HR with a copy to your department. If there are restrictions to be made to return they must be spelled out clearly. BW will make every effort to accommodate the restrictions if they are reasonable and can be accommodated to get you back to work.

For the first 7 days you are not paid for any time off due to a workplace injury. That is your waiting period.

If you should need to be out more than 7 days you will need to also file a "C-84/Medco-14" which is a request for temporary total compensation. This form also needs to be filled out by your physician as well. ** Just because you are out 14 days it has to be deemed medically necessary for you to be out that time, it does not automatically put you into lost time status if you are out that long or take it upon yourself to not come back to work when released by doc.

Once you have been off 14 days due to a workplace injury then the Bureau of Workers Comp will go back and pay the first 7 waiting days.

Here at BW if it is a serious financial hardship we will allow you to take sick time or vacation time to help pay for the first seven waiting days, only if you are not going to be out a lost time claim. We do not go back and reimburse your sick pay or vacation if you should be out beyond the 14 day period.

You will be expected to communicate with your department as well as the Dept. of HR when you are out for a workplace injury on a weekly basis to keep us informed of your progress. Once you have been off work for an injury, you will need to have a statement from the doctor releasing you to return to work with no restrictions before you can return to your job.

During the course of treatment of your injury if you wish to change physician of record, you may do so but you will need to fill out a Change of Physician form and have it approved and on record before making the change.

Facts you should know:

BW is self-insured through a third party administrator Sedgwick out of Columbus. We are not restricted to an MCO - which means you may choose your own doctor or emergency facility.

When visiting the facility please inform them that you are employed by Baldwin Wallace who is self-insured and instruct them to submit the bills directly to the attention of Janet Leonard, Director of Benefits, Baldwin Wallace University 275 Eastland Road, Berea, OH 44017
Phone 440 826-2219 Fax 440 826-3564. Our TPA is Sedgwick and our rep for Med Only Claims is Felicia Plybon phone 614 658-0740 and fax is 855-223-9836.

Baldwin-Wallace Safety Council Charter Updated Jan 2019
Mission

To Help Make Safety a Fundamental Priority for the BW Campus Community

Motto and Logo

Majoring in Safety

Objectives
The committee will achieve its mission by:

1) Conducting and promoting Safety Education and awareness
2) Conducting and identifying need for hazard assessments
3) Recommending controls / solutions to prevent injuries
4) Facilitate safety communications among the college constituency

Goals

1) CPR, first-aid, and fire extinguisher training for Safety Council.
2) Develop in-house training for initial responders (Safety and Security, Academic Building Security, Parking Officers, Custodial Staff) in hazard recognition and reporting
3) Ongoing safety training for Safety Council
4) Implement accident investigations and follow through to correction
5) Identify safety training needs for all departments
6) Monitor and investigate calls on safety issues

Meeting Schedule
The council meets at 2:30 p.m. on the second Wednesday of each month in the Dean’s Conference Room in Bonds. Meetings will be limited to one hour in duration, unless special activities or training events are being held. Safety Council will break June-Aug.

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Safety Committee Members and Responsibilities

Name Dept/ Ext Safety Council Responsibilities
Janet Leonard
Chair Safety Council HR / 2219
Prepare agenda
Lead meetings
Appoint members to conduct safety audits
Document follow-up actions

Karen Stenger Purchasing and Motor Pool/ 2726 Liability
Tom Bobek Parking/ 2759 Investigative Team Review safety concerns brought to attention of Safety Council
Tom Dietrich B and G Investigative Team Review safety concerns brought to attention of Safety Council
Matt Regula Food Service / 2412 Member

Christine Cancian Rec Ctr / 7473 / 2283 Member
Vic Snyder Safety & Security
2336 Member
Gary Black Safety & Security 2336 Mermber

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Safety Team Resources
Following are some of the internal and external resources that are available to assist with safety and health issues.

Topic Resources Contact Info
Baldwin-Wallace College – safety and health regulations and policy issues Sam Ramirez - HR
Janet Leonard – HR 826-2908 sramirez@bw.edu
826-2219 jleonard@bw.edu

First Aid/CPR - Policies, Techniques, Training Christine Cancian – Rec Ctr 826-2283 ccancian@bw.edu

Emergency Evacuation and Disaster Plan Management George Richard – Col Rel
Homeland Security
Brand Eisenhardt – Berea Fire Dept 826-2328 grichard@bw.edu

440-234-1214
BW Community Health Lauren Bara – Health Center 2015 lbara@bw.edu

Accident Investigation - Karen Husak
JC Turner
Steve Krone 826-2759 khusak@bw.edu
826 -2336 jcturner@bw.edu
826-2917 scrone@bw.edu

Building and Equipment Maintenance Don Dubena – B & G 2229 ddubena@bw.edu

Chemical Hazard Communication Program Dave Revta – Science Labs
Brand Eisenhardt – BFD
Hazmet
J.C. Turner – Safety & Sec 2497 drevta@bw.edu
440-234-1214

2336 jcturner@bw.edu

Asbestos/Black Mold Ted Gurnick – B & G 2917 tgurnick@bw.edu

Safety and Health Training Courses and videos Ohio Bureau of WC 1-800-OHIOBWC
www.ohiobwc.com
Policy # 20003948
Safety consulting/training – hazard assessments, accident analysis, written programs Al Emley - BWC Safety Consultant 216-308-7956
Allan.E.1@bwc.state.oh.us

Ergonomics consulting/training – Lifting/pushing/pulling task assessment, computer workstation assessments Mike Rienerth – BWC Ergonomics Consultant 216-538-9724
Mike.R.1@bwc.state.oh.us

Workers comp claims and cost management information
Janet Leonard - HR
Linda Nolan - Cambridge

2219 jleonard@bw.edu
877-202-4283
Industrial Hygiene – air quality monitoring and noise monitoring Natalie Reno – BWC Industrial Hygienist
216-538-9723
Natalie.R.1@bwc.state.oh.us

Fire Prevention and Emergency Evacuation Tim Washington / JC Turner
Karen Husak - Parking
Berea Fire Department 2336 jcturner@bw.edu
2759 khusak@bw.edu
440-234-1214
Workplace Violence
Safety Videos Doug Chatfield – Safety / Sec
JC Turner – Safety / Sec 2377 dchatfield@bw.edu

Vehicle Safety and Insurance (Vehicle & Property)
Karen Stenger – Purchasing 2726 kstenger@bw.edu

Attendance
Each council member is expected to attend at least 80% of all regularly scheduled meetings and participate in workplace inspections and other council activities. Members not able to attend should also provide the chairperson with an update on any assignments or information that they were expected to have prepared for the meeting.

Agenda
An agenda will be used to outline the order in which the committee will conduct its business. A sample is attached to this document.

Minutes
Minutes will be recorded at each council meeting by the scribe and will be distributed to top management and council members. The scribe will submit a copy of the minutes to the Department of HR; the HR Dept. will retain the copy for three years. All reports, evaluations, and recommendations of the council will be included in the minutes. The minutes will also identify representatives who attended monthly meeting, and representatives who were absent.

Council Member Training
New safety council members will receive training on how the safety council functions, member responsibilities, hazard identification, and accident-investigation procedures.

Employee involvement
Council members will encourage fellow employees to identify workplace-health-and-safety hazards. Concerns raised by employees will be presented to the council for discussion, prioritization, and action. The council will review non-urgent concerns at the next regularly-scheduled meeting.

Response to Employee Safety Concerns
The appropriate safety council member will respond to the employee who raised concern and, present the concern to the council for evaluation and to discuss the plan for resolving the concern.

Action Item Log
The council will maintain a log of all action items until they have been resolved. The action items will be generated at each meeting as a result of discussion of employee concerns/suggestions, and accident analysis.

The action items will be assigned to the appropriate person(s), along with a target date and will be reviewed at each meeting until the action item has been completed or the issue has been resolved, along with the disposition of the corrective actions taken.

Incident and accident investigation
The council will conduct and review new safety or health-related incidents and near misses at each regularly-scheduled meeting. The council will review the corrective actions developed by the department manager/supervisor and will determine if additional recommendations for eliminating or controlling hazards should be considered.

Communication of Council Activities
The following methods will be used by the safety council to communicate its activities and progress:

Meeting Minutes – will be distributed to the council members, department of HR and college officers within 1 week of each meeting
Action Item Log – Will be updated and distributed to all council members, and department of HR within 1 week of each meeting
Safety Council Concerns – Will be passed on to Staff Council and Mid Managers

Terms for Council Members
Council members will retain membership for their tenure at B-W.

We gratefully acknowledge the support of the Assistant VP for Human Resources, Sam Ramirez and the Director of Benefits, Janet Leonard, for their assistance in providing this information.