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The "FIRST REPORT OF INJURY QUESTIONS - umes" is a critical form used by the University of Maryland Eastern Shore’s Department of Human Resources to collect detailed information after a workplace injury occurs. This report is essential for documenting the incident, capturing vital information about the worker's injury, the situation surrounding the event, and any medical treatment received. The form ensures that the necessary documentation is in place to comply with workplace safety regulations and assists in processing any insurance claims or legal requirements that may follow. By providing a thorough record of the incident, it helps protect all parties involved by detailing exactly what occurred and what measures were taken subsequently.
This form is typically used following an injury at the workplace and involves several steps to ensure the information captured is comprehensive and accurate. The injured worker or their representative should begin by gathering all relevant information, including personal details and the nature of the injury. Each section of the form corresponds to specific information needed, starting with the injured worker’s personal and contact information, followed by details about the event. The form guides users to provide information on the time, date, and location of the incident, as well as descriptions of how the injury occurred. Precision and accuracy are paramount, as this information may be used for further legal or medical action.
Gather Personal Information: Collect and fill out the injured worker's full name, contact information, and identification or employee number.
Detail the Incident: Clearly document the date, time, and location of the injury. Provide a detailed description of how the incident occurred, including any equipment involved.
Describe the Injury: List the specifics of the injury sustained, such as area of the body affected, severity of the injury, and any initial symptoms.
Safety Equipment Usage: Note whether any safety equipment was in use at the time of the incident, such as gloves, goggles, or helmets. This can affect liability and prevention measures.
Medical Treatment Received: Record what immediate medical treatment was provided, including the name of the medical facility and the attending physician or medic. Also, include any ongoing medical requirements.
Past Work Injuries: If applicable, provide details of any previous work-related injuries to identify patterns or systemic issues.
Once completed, the form should be reviewed for accuracy and signed by the necessary parties before submission.
This form is primarily utilized by employees of the University of Maryland Eastern Shore who have experienced a workplace injury. It is also used by HR personnel who manage the documentation and processing of workplace injuries within the institution. Supervisors and team leaders might initiate the completion of this form when they are first informed of an incident, ensuring that comprehensive and accurate data is collected promptly.


The form serves as an official document and is vital for compliance with worker compensation laws and regulations in the United States. It ensures that the university and the employee adhere to all legal requirements in reporting workplace injuries, which can potentially protect against liability and ensure proper handling of insurance claims. Accurate completion is crucial, as inaccuracies or omissions might lead to legal complications or challenges in compensation claims.
While the form is specific to the University of Maryland Eastern Shore, it aligns with Maryland state regulations regarding workplace injuries. The state requires detailed reporting for accurate monitoring of workplace safety and compliance with worker compensation laws. The form must be filled out in accordance with state guidelines to ensure legal validity and proper processing through state channels.
To accompany the first report of injury questions, additional documents might be needed, such as:
These comprehensive documents ensure that the report is complete and can aid in any subsequent investigations or claims processing.
While the "FIRST REPORT OF INJURY QUESTIONS - UMES" is typically handled manually or through internal systems at the university, the information could be managed digitally using platforms compatible with document handling tools like DocHub. This can facilitate the electronic completion, signing, and submission of such documents, integrating seamlessly with cloud storage and collaboration tools for efficiency and accessibility.
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Apr 30, 2025 (410) 651-6400. FIRST REPORT OF INJURY PLEASE COMPLETE ALL QUESTIONS (Print or Type Legibly) Injured. Date of Injury: Tel: (410) 651-6400