Injured Employee checklist and Forms

CALL 911 FOR ALL MEDICAL EMERGENCIES

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. http://www.hqmc.marines.mil/hrom/Employee-Advisory/Employee-Relations/Injury-Compensation/

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.