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Accident/Incident Reporting


Legislative requirements demand documenting accidents in the workplace for legal and insurance purposes.

Reporting incidents which don't involve injury assists the Safety Office in monitoring trends and working with supervisors to make improvements to working conditions and the safety program.

An accident is an undesired event which causes harm to people or damage to property. An incident is an event which under slightly different circumstances could cause injury or damage to property.

Click here to download an Incident Report Form(DOC) (Opens in new window)

Click here to download an electronic fillable Incident Report Form (PDF) [Use Adobe Acrobat to utilize fillable portion] (Opens in new window)


Serious Incidents:

A serious incident must be reported to the province. A Serious Incident is defined in the Safety and Health Act (W210 10/02) means an incident:

  1. in which a worker is killed;
  2. in which a worker suffers
    1. an injury resulting from electrical contact,
    2. unconsciousness as the result of a concussion,
    3. a fracture of his or her skull, spine, pelvis,arm, leg, hand or foot,
    4. amputation of an arm, leg, hand, foot, finger or toe,
    5. Third degree (full thickness) burns,
    6. permanent or temporary loss of sight
    7. a cut or laceration that requires medical treatment at a hospital as defined in the Health Services Insurance Act, or
    8. asphyxiation or poisoning, or
  3. that involves
    1. the collapse or structural failure of a building, structure, crane, hoist, lift, temporary support system or excavation,
    2. an explosion, fire or flood,
    3. an uncontrolled spill or escape of a hazardous substance, or
    4. the failure of an atmosphere supplying respirator

Serious incident occurs, care for the person first and report the incident to the Manager, Safety and Health (204 782 2588) by the fastest means available.

Other Incidents:

The UWinnipeg’s Incident Report form must be completed for incidents even if there were no injuries sustained, regardless if the injured person is a student or visitor.

Injured employees must also complete a Workers’ Compensation Board (WCB) form, if appropriate. If you are not certain if you have WCB coverage, contact Bryan Ward  (Director, HR Services).

Information for Workers (including students working in laboratories)

If you suffer an injury while at work:

  1. Seek medical attention or call 911 for emergencies.
  2. Report your injury to your supervisor as soon as possible and start an incident report form by entering your particulars and a description of the incident.

Information for Supervisors

  1. Report the incident to the Manager, Safety and Health (204.786.9894) or Campus Security (204.786.9272).
  2. Accept incident report and meet with employee to discuss the incident direct and indirect causes. Complete all sections of the incident report.
  3. Submit completed incident report to departmental manager for signature.

Information for Managers

  1. Accept incident report and meet with supervisor & employee to implement corrective action with a focus on prevention of recurrence.
  2. Sign off on incident report and support to Workplace Safety and Health Specialist

Where supervisors are unable to fully complete the form within 24 hours, notify the Manager, Safety and Health

Workplace Health and Safety Committee Involvement

  1. Participate in the investigation of all serious incidents and dangerous occurrences.
  2. Review and analyze incident reports and make recommendations.
  3. Participate in Incident Investigation training.