Employee accidents must be reported immediately!

Regardless of the location (on campus or off campus), University Police must be contacted (318-357-5431) to report the accident. Then contact the EHS Office at 318-663-0441 or 318-663-6080.



              REPORTS: (updated 7/18/208)

                   DA-2000-Employee Accident Report and Supplemental Report  and Instructions

                   Witness Statement

                   Slip, Trip and Fall Supplement

                   DA-3000 - Student or Visitor Incident/Accident Report and Instructions

                      DA-2041-Accident Reporting


Procedures to follow when you have an accident:


When an incident/accident takes place, the following 4 steps must be followed IMMEDIATELY:



1.  Contact NSU Campus Police at 318-357-5431

2.  Contact the EHS office at 318-663-0441 or 318-663-6080

3.  Contact your immediate supervisor

4.  As quickly as possible, complete the DA3000 form (accident/incident for students, visitors, or volunteers), or the DA2000 form (accident/incident form for faculty and staff), or the DA2041 for automobile accidents. Report all facts pertaining to the accident. Submit forms to the EHS Office at 998 South Jefferson (on campus).

 Important Notes to Remember with On-The-Job injuries:

a. If an employee is seen by an urgent care/emergency room facility and required further treatment, it is important that the employee follow up with their worker’s compensation claim adjustor, so that all further appointments can be approved.

b. If the employee did not return to work following the accident, he/she is REQUIRED to submit a “Return to Work Status Report”, from the attending physician.  Any limitations or exclusions would be helpful if listed on that work status report.

c.  The first seven (7) days of missed work are considered the “waiting week” and are not eligible for indemnity benefits unless the employee has missed 14 or more days as a result of the injury.  Otherwise, indemnity benefits will start on the 8th day, including the weekend, at 66.666 percent of wages or salary.

d. When the employee is approved to return to work, he/she is REQUIRED to submit a “Return to Work Status Report” with physician's clearance.  It must list any exclusions or limitations on the work status report.

e.  NSU does offer Transitional Return to Work, which may allow for light duty employment until the employee if fully released by their physician.



Vehicle Accidents:  (see the Vehicle Accident and Investigation Policy)

       1.   Automobile accidents that occur while on approved University business MUST BE REPORTED IMMEDIATELY.  Ensure that the police are contacted and that the police make a report.  The police report will contain contact information for any other vehicles involved and this information will be needed later in the accident process. 

2.   Accidents will be documented on a DA-2041 (vehicle accident report form) which can be located in all state vehicles.  The form is also on the EHS website.


Contact the EHS Office at 318-357-4424 with any questions.