24/7/365 Claims Reporting Number: (844) 522-6082

IPRF Employers Injury/Accident Guidelines

A simple accident investigation procedure should be followed after every incident, regardless of whether or not the incident becomes a workers’ compensation claim. If the member agency has no established procedures, IPRF has created the “Injury/Accident Investigation Tool Kit” which will guide the member agency through the four action steps of an investigation along with the forms and reports needed to process the work related injury claim.

IPRF Injury/Accident Action Steps

Care for the injured employee

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Help all injured workers get medical treatment!

  • Seek medical attention in accordance with IPRF Member policy and procedures.
  • If no policy or procedure is in place, go to the nearest emergency room.

What to do when an employee is seriously injured:

  • In an emergency call 911 immediately.
  • Call your IPRF Claims Specialist immediately if the injury is serious or life threatening.

Note that it is extremely important that the IPRF Claims Specialist be notified as soon as possible as they may be able to arrange any special medical care that might be necessary.

 

All public sector employers under Illinois OSHA’s jurisdiction must report:

  • All work-related fatalities within 8 hours.
  • All work-related inpatient hospitalizations, all amputations and all losses of an eye within 24 hours.

Secure the injury/accident scene

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The Immediate Supervisor will make the determination if Step #2 is warranted or not. If not, proceed to Step #3.

 

If a fatality or catastrophe event occurs, then the area must be secured until the Illinois Department of Labor or OSHA releases the area.

 

Prevent disturbance of the incident scene/area is very important.

  • Inform all applicable inter-agency supervisors and safety committee.

The injury/accident area may encompass as little as one piece of equipment and the immediate area, or could include an entire room, depending on what was affected during the incident. It should be secured until a higher authority releases the area.

 

Begin injury/accident investigation

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Supervisor Injury Investigation Reports

Care must be taken to assure the investigation is fact finding, not fault finding. Obtaining signed statements as soon as possible following an accident insures that you, the employer, have an accurate account of how the injury occurred. If possible, photograph the injury/accident site or area for causative factors.  

 

Once medical treatment is rendered, the immediate supervisor of the injured employee must begin the investigation process which will include completing the following reports:

 

Reports/Forms

    Submittal time
First Report of Injury Form 45 Within 24 Hours
Injury Description Report (Form 45-A) Within 24 Hours
Supervisor Investigation Report (From 45-B) Within 24 Hours
Witness Report (Form 45-D) Within 24 Hours (if applicable)
Questionable Claim Form (Form 45-E) Anytime during the claims process

 

Employer’s First Report of Injury Filing
Illinois
Workers’ Compensation Act requires that all injuries be reported on the form, “Employer’s First Report of Injury” which is known as the Form 45.  However, IPRF members can complete Form 45 by one of the two following methods which are both accessible on the IPRF Website:

  • On-line using iCE.  
  • By completing the downloadable fillable Form which can be faxed or emailed to IPRF. Injuries that do not require medical attention should still be reported to IPRF but noted as an “Record of incident Only”.

Send reports and forms are to be faxed or emailed to:
IPRF Claims Fax: 888-223-1638
IPRF Claims Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Meet with the injured employee

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When scheduling allows, the member agency representative shall meet with the injured employee to ensure their well-being as well as obtaining their report to what had occurred that caused the injury/accident.  

 

The injured employee is to complete the employee accident/injury report and medical authorization form as exhibited in the table below.

 

Reports/Forms

    Submittal time
Employee Accident/Injury Report (Form 45-C) Within 24 Hours
Medical Authorization Form (Form 45-F) Within 24 Hours

 

Send reports and forms are to be faxed or emailed to:
IPRF Claims Fax: 888-223-1638
IPRF Claims Email: This email address is being protected from spambots. You need JavaScript enabled to view it.

Notify IPRF when the employee is granted a “Return to Work” release

Contact Information

IPRF Executive Director
Robert M. Buhs
Office (630) 649-6039
Cell: (708) 935-9979

IPRF Accounting
Office: (800) 289-4773
Fax: (708) 429-6488

IPRF Marketing
Office: (800) 289-4773
Fax: (708) 429-6488

IPRF Grant Program
Office: (800) 289-4773
Fax: (708) 429-6488

For Loss Control
Office: (630) 649-6082
Fax: (630) 223-1638