CSN Incident Reporting

Effective July 1, 2024, the NSHE Risk Management Office will manage all workers’ compensation injury reports and the reports should be submitted to risk@nshe.nevada.edu.
Employees with existing workers’ compensation injuries will be contacted directly by the NSHE Workers’ Compensation Office to discuss claim details and provide support.
The C-1 Notice of Injury and the Supervisors Incident Report form along with up-to-date information on the incident report and claims process can be found at https://nshe.nevada.edu/workers-comp.

The primary contact for workers’ compensation claims is Lauren Preston at LPreston@nshe.nevada.edu.

Incident Reporting At-A-Glance

Criminal Activity

To report criminal activity, contact University Police Services.

• To report a crime in progress:
  • Call dispatch at 702-895-3669 from your cellphone or x7911 from any campus phone.
  • Press University Police (9-1-1) button in the CSN Mobile Safety App.
  • Call 702-895-3668 from your cellphone or x7311 from any campus phone.
  • Use Non-Emergency (3-1-1) button or the “Report a Tip” feature in the CSN Mobile Safety App.
  • Fill out the University Police Services Crime Report Form online.

  Facility Issues

  To report unsafe building conditions, problems with the building infrastructure, or property damage:

  • Call Facilities Management during regular business hours (8 am-5 pm) at 702-651-4888 (x4888) or
  • Visit Facilities Management website to submit a facilities work request through the iServiceDesk or
  • Use the CSN Mobile Safety Application to submit facilities work request by selecting the “Maintenance Request” feature.
  • If facility issues occur after business hours (5 pm-8 am and weekends) – call University Police Services at 702-895-3669 or x7911.

  Near Miss or Safety Concern

  To report a near miss and other safety or compliance concerns:

  • Complete "Report a Safety Concern or Near Miss" form online
  • Email ehs@csn.edu
  • Call Environmental Health & Safety at 702-651-7445

  Reportable Chemical Spills & Releases

  • Reporting of a Chemical Spill or Release is required for:
    • Chemical Spill/Release over one gallon of liquid or one pound of solid
    • All mercury spills (regardless of size)
    • All uncontrolled compressed gas releases
    • All unintentional release of a chemical to bare ground, sewer, or surface water
    • Unintentional release of oil to bare ground or water

    Student Injury, Illness or Exposure (On-Campus or Off-Campus at Clinical or Field Site)

    • If the injury or illness is life-threatening, contact University Police Services if on campus (702-895-3669 or x7911) or go to the nearest emergency room.
    • Students with less serious injuries should refer to their medical provider for further evaluation and treatment.
    • If the injury is minor and only requires first aid treatment, seek assistance from faculty or staff to obtain supplies from the nearest first aid kit.
    • Faculty or Staff aware of a student injury or exposure should fill out an Incident Report Form and forward it to ehs@csn.edu.
    • Student exposure to another person’s blood or body fluids as part of their clinical activities should be reported by the site supervisor or instructor. In addition to the Incident Report, a Report of Exposure to Bloodborne Pathogens should be filled out and forwarded to ehs@csn.edu. For more information, please refer to the EH&S Bloodborne Pathogens Exposure Control Plan.
    • A student’s faculty member or department is responsible for notifying EH&S, 702-651-7445 immediately if there is a student hospitalization or fatality so the appropriate actions can be taken.
    • Student employees injured while working should follow the employee workplace injury process.

    Employee Workplace Injury, Illness, or Exposure

    • All employee injuries, even minor ones, should be reported as soon as possible.
    • Injuries that result in emergency care are to be reported to the employee’s supervisor or appropriate departmental contact ASAP.
    • If the employee is admitted as an inpatient to a hospital, the employee’s supervisor or departmental contact is responsible for notifying CSN Environmental Health & Safety (702-651-7445 or ehs@csn.edu) and NSHE Risk Management (775-784-3406 or risk@nshe.nevada.edu), so the appropriate actions can be taken within the 24 hours of hospitalization or fatality.
    • The CSN Workers’ Compensation Program is administered by the NSHE Risk Management Office, and the reports should be submitted to risk@nshe.nevada.edu.
    • Visit the NSHE Workers’ Compensation Program webpage for up-to-date information on the incident report and claims process and to download the C-1 Notice of Injury, Supervisor Accident Investigative Report, and additional forms related to the process.
    • For workers’ compensation claim questions, contact Lauren Preston at LPreston@nshe.nevada.edu.

    Workers’ Compensation Claim Filing Instructions

    1. Seek Medical Treatment
       If the injury/illness is life-threatening or severe, call University Police Services (702-895-3669 or x7911) or go to the nearest emergency room.
       If the injury/illness is less severe, an injured employee should visit one of the Approved Medical Providers.
       During the visit, the employee must:
       1. Inform the treating physician that the injury/illness is work-related.
       2. Ensure that a C-4 form is completed by the attending physician. The medical provider will submit a completed C-4 to the employer to initiate the workers’ compensation process.
       3. Request a doctor’s note (required) to support an absence from work under a workers’ compensation claim. Note: Employees have 90 days from the date of the incident to file a claim with Workers’ Compensation and seek medical treatment.
       1. After each appointment with the treating physician, all medical certifications of work status (restrictions, full-duty release, etc.) must be submitted to the supervisor and the Risk Management department.
       2. Once notified of the availability of a modified-duty assignment, the employee must return to work on the date established by the department and/or Risk Management office.

       Supervisor Responsibility
       Employees must be informed of their rights and responsibilities in the event of a work-related injury. Employees have the right to file a workers’ compensation claim and to seek medical treatment from a worker’s compensation provider. As a supervisor, your role is to:
       

       1. Assist the employee in obtaining the appropriate medical treatment.
          1. For emergencies, call University Police Services (702-895-3669 or x7911) or go to the nearest emergency room.
          2. For non-emergency care, refer the employee to one of the approved workers’ compensation providers. Most up-to-date list of approved medical providers can be found at NSHE Workers’ Compensation Office webpage: https://nshe.nevada.edu/workers-comp.
          3. If the injury is minor and only requires first aid treatment, provide first aid.

          1. Employee injuries involving exposure to another person’s blood or body fluids require an additional Report of Exposure to Bloodborne Pathogens form. Forward this report to ehs@csn.edu. For more information, please refer to the EH&S Bloodborne Pathogens Exposure Control Plan.