Department of Personnel and Civil Service Commission
Workplace Injury Reporting Policies, Procedures and Forms
Injury Reporting Policy

All employees must understand the City of Pittsburgh Injury Reporting Policy as part of their employment with the City of Pittsburgh.  This policy is provided at the time of hire but is always available here.

Worker’s Compensation Forms

The City of Pittsburgh worker’s compensation program is managed by UPMC WorkPartners and it is important for all employees to understand their responsibilities when they are injured in the workplace. 

All injury claims, whether or not they require medical attention, must be called into UPMC WorkPartners at 1-800-633-1197. 

The forms below details the employee’s responsibilities as required by the PA Department of Labor and Industry.  These forms must be signed by injured employees at the time of injury and forwarded to the Department of Personnel & CSC Safety Office.

Work Injury Reporting Forms

It is imperative that all employees who are injured during work complete a Work Injury Form so that there is a clear understanding of the factors which contributed to the injury.  Please use the form below that is appropriate to your job position.

Infectious Disease Reporting Form

Many employees must interact closely with the public and are at risk of infectious disease transmission.  In these situations, the employee involved is to contact UPMC WorkPartners to relate to them the circumstances surrounding the exposure incident.  In addition, the City of Pittsburgh Infectious Disease Exposure Form must be completed and forwarded to the Safety Office so that a complete understanding of the situation and all City of Pittsburgh employees involved can be determined.  For more information on occupationally acquired infectious diseases and the precautions to avoid infection, please refer to the Infectious Disease Control Program Exposure Control Manual.  Safety Manager/ Infectious Disease Officer David C. Reed can also be contacted for immediate information for infectious disease information (cellular: 412-287-9920).

Injury Investigation Form

Every injury to City of Pittsburgh employees must be investigated.  By speaking to those involved and evaluating the scene of the incident, the root cause of the injury may be able to be determined and corrective actions may be necessary to assure that others are not similarly injured.  The investigation is to be done by the employee’s immediate supervisor who is most familiar with the injured employee’s job duties.  The Safety Office is always available to assist in these investigations or to answer any question about completion of the Injury Investigation Form.

Post-injury Drug and Alcohol Testing

All employees who need to seek medical treatment for an injury will be post-injury drug and alcohol tested to determine if drugs and/or alcohol contributed to the injury.  Please see the policies below regarding these procedures.

Injury Occurring in a Vehicle Accident

Should an employee of the City of Pittsburgh be injured in a vehicle accident while on duty, in addition to the forms mentioned above, they must also complete a Motor Vehicle Accident Form.  This important document details the particulars of the accident as well as identifying the other vehicles or properties involved in the accident.

 

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