Injured Employee checklist and Forms


Employee should notify supervisor as soon as practical

Supervisors contact Occupational Medicine and have injured employee report to occupational medicine clinic 703-784-1673 or urgent care / emergency room after hours. In the event of an exposure supervisors should request if source also would come for screening to Occupational medicine clinic.

Supervisors should fill out a medical referral form and send to clinic with injured worker.

Additional claim information and other forms (CA-1, CA-2, etc.) can be found at Human Resources and Organizational Management Headquarters Marine Corps.

Report the injury to safety / complete mishap report as soon as practical

Employees must follow-up with Occupational Health for any occupational related injury/illness

Employees may elect to be treated by a physician of their choice (usually located within 25 miles of residence/work) after they are assessed by Occupational Health or injury occurs after hours.

If seen at a personal provider, please follow up with Occupational health for any limited duties or restrictions received prior to return to work.