Report an Injury

Supervisors: First Report of Injury (FROI) and Return to Work Steps

Process Workflow Chart

Step 1) Medical Treatment

  • Send injured employee to approved medical facility as soon as possible. If necessary, assign transportation to the appropriate approved medical facility.
  • Eliminate any obvious hazards and secure the area as necessary.
  • In case of a fatality, hospitalization, amputation, or loss of an eye notify Kristi Evans immediately at 765-494-1431 or Cindy Guy 765-494-7388.

Step 2) Submit the report

  • Complete and submit a FROI within 24 hours
    • To find the department number, from “Employee Launchpad” go to the “Org Chart” tile and type in the employee’s name.  Click on the employee’s tile and a window will appear. Click on the employee’s name in that window, and the department number will be next to the department name.  

Step 3) Investigate

  • Complete investigation attached to FROI
    • In some situations, EHS, Worker's Compensation Administrator and JWF Specialty claims adjuster may request a more detailed investigation, this investigation may include members from EHS, and your department.
    • If requested, complete Witness Report Form.
    • Medical release (when requested).

Step 4) Work Status

Research [1][2][3] has shown that early return to work enhances both psychological and physical recovery while minimizing the negative impact on an employee’s life. 

  • Suggested light duty task
    • You may add to these suggested tasks by creating a departmental list of predetermined tasks employees can complete while on restrictions.
  • Review restrictions with: Worker’s Compensation Administrator, EHS, and JWF Specialty claims adjuster to determine modified duty.
  • If modified essential tasks is not possible, use list of suggested of light duty tasks.

Example List of Light Duty Tasks

If return to work is not possible:

  • Call the employee to check in
    • Ask how the employee is doing.
    • Keep employee engaged and informed of the status of projects and worksite changes.
    • Do not ask when the employee is coming back to work.
  • Review restrictions after every medical appointment to determine if able to return to work.
  • Continue to evaluate task to return employee to work as soon as possible.
  • If required by department complete a Departmental Return to Work Letter and give to employee after every medical appointment.

Step 5) Return to work

After every medical appointment, the employee or the JWF Specialty claims adjuster will provide a note for the supervisor to review.  The supervisor must determine if there is work within these restrictions and communicate this to the employee, JWF Specialty claims adjuster, Worker’s Compensation Administrator and EHS.  This process is followed until the employee is released from care by the medical provider.

  • If required by department, complete Departmental Return to Work Letter and give to employee.
  • Do not assign any tasks outside of restrictions. If you question whether a task is within the employee’s restrictions, please contact EHS and/or the Worker’s Compensation Administrator.
  • Direct any clarifications to the Worker’s Compensation Administrator or JWF Specialty claims adjuster.
  • Contact Worker’s Compensation Administrator and/or EHS for task evaluations when needed.


  1. Shaw, W., Nelson, C., Woiszwillo, M., Gaines, B., and Peters, S. (October 2018). “Early Return to Work Has Benefits for Relief of Back Pain and Functional Recovery After Controlling for Multiple Confounds”. Journal of Occupational and Environmental Medicine. doi: 1. 10.1097/JOM.0000000000001380.
  2. Calley, D. and Buus, R. (2015). “Psychosocial Factors in Low Back Pain” (PDF). Minnesota Physical Therapy Association. Retrieved 14 April 2022.
  3. Stay at Work/Return to Work Research & Publications. S Department of Labor. Retrieved 14 April 2022.

For questions regarding this process:

Campus Safety Contacts

call 911

If you see something, say something.

Purdue Police
Phone: (765) 494-8221

Purdue Fire
Phone: (765) 494-6919


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