Medical
Consultation and Examination
- Employees
Who Work With
Hazardous
Substances
- Medical
Examinations and
Consultations
- Workers'
Compensation
Procedures and Forms
- Information
Provided
to Physician
- Information
Provided to
the University of
Minnesota
1. Employees Who Work With Hazardous
Substances
All employees who work with hazardous substances will have an
opportunity to receive medical attention, including any follow-up
visits that the examining physician determines to be necessary, under
the following circumstances:
Signs or symptoms of
exposure
Whenever an employee develops signs or symptoms associated with a
hazardous substance or organism to which the employee may have been
exposed in the laboratory, the employee will be provided an opportunity
to receive an appropriate medical examination.
Exposure monitoring
Where exposure monitoring reveals an exposure level routinely above the
action level (or in the absence of an action level, the PEL) for an
OSHA regulated substance for which there are exposure monitoring and
medical surveillance requirements, medical surveillance will be
established for the affected employee as prescribed by the particular
standard.
Exposure incident
Whenever an event takes place in the work area such as a spill, leak,
explosion or other occurrence resulting in the likelihood of a
hazardous exposure, the affected employee will be provided an
opportunity for a medical consultation. Such consultation will be
for the purpose of determining the need for a medical examination.
Physical Injury
Whenever an employee is physically hurt or injured on the job, the
affected employee will be provided an opportunity for a medical
consultation and/or examination. Physical injuries include but are not
limited to cuts, burns, punctures and sprains.
Contact the Chemical Hygiene Officer whenever the need for medical
consultation or examination occurs, or when there is uncertainty as to
whether any of the above criteria have been met.
2. Medical Examinations and
Consultations
In the event of a life-threatening illness or injury, dial 911 and
request an ambulance. Employees with urgent, but non-life-threatening,
illnesses or injuries should go to the St. Mary’s-Duluth Clinic (SMDC)
Occupational Medicine or to the nearest medical clinic. If
off-hours medical attention is required, the employee should be taken
to the SMDC emergency room at 407 East Third St., Duluth MN. All
medical examinations and consultations will be performed by or under
the direct supervision of a licensed physician. The initial examination
or consultation will be provided without cost to the employee, without
loss of pay and at a reasonable time and place.
3. Workers' Compensation Procedures and Forms
It is very important that even minor job-related injuries or illness
are reported. These statistics help the Department of Environmental
Health and Safety track trends that may indicate occupational hazards
that need evaluation. To report an illness or injury, go to the UMD - Workers’ Compensation
(http://www.d.umn.edu/umdhr/WorkComp/) website. This site provides
links to the forms listed below. University of Minnesota's Policy
for Reporting Workers' Compensation Related Injuries is also
available on the web.
This policy explains the procedures and provides the necessary
reporting forms. As long as the illness or injury is not life
threatening, the supervisor should provide the employee with:
- a brochure describing Workers' Compensation
Information for the University of Minnesota;
- a Work Status Report for the physician to
complete and return to Cathy Rackliffe, UMD Workers Compensation
Coordinator.
Within 24 hours of receipt of the Employee Incident Report, the
following must be completed:
- a State of Minnesota First Report of Injury
form to be completed by Cathy Rackliffe;
- an Employee Incident Report form to be
completed within 24 hrs. by the employee; and
- a Supervisor Incident Investigation Report to
be completed within 24 hrs. by the supervisor.
Within 24 hours, supervisors must submit or fax both Employee, and
Supervisor’s Incident Report forms to:
Cathy Rackliffe,
UMD Workers' Compensation Coordinator
269 Darland Administration Building,
Phone: (218)-726-6827,
Fax (218)-726-7505.
4. Information
Provided
to Physician
The employee's supervisor or department will collect and transmit the
following information to the examining physician:
- The identity of the hazardous substance(s) to
which the employee may have been exposed;
- A description of the conditions under which the
exposure occurred including quantitative exposure data, if available;
and
- A description of the signs and symptoms of
exposure that the employee is experiencing, if any.
5. Information Provided to the University of
Minnesota
The UMD Workers Compensation Coordinator should request that the
examining physician must provide the University with a written report
including the following:
- Any recommendation for further medical
follow-up;
- The results of the medical examination and any
associated tests;
- Any medical condition which may be revealed in
the course of the examination which may place the employee at increased
risk as a result of exposure to a hazardous chemical found in the
workplace; and
- A statement that the employee has been informed
by the physician of the results of the consultation or medical
examination and any medical condition that may require further
examination or treatment.
The written opinion will not reveal specific findings of diagnoses
unrelated to occupational exposure. |
