Workplace Injuries

The Worker’s Compensation and Occupational Disease Act of Indiana provides protection for you if you are injured while carrying out assigned work duties both on university premises and while traveling on university business.

Workplace Injuries: What to Do?

If an injury occurs at work, do the following:

If emergency medical treatment is necessary, call 911.
If non-emergency medical treatment is necessary, visit an authorized work comp provider location.
Notify the supervisor as soon as possible of the injury.
The supervisor completes and submits a First Report of Injury (FROI) Form. The FROI form must be completed when a work-related injury occurs on campus. The FROI is available via DocuSign. Click here First Report of Injury (FROI) form.
- Enter the name and email of the person completing the form (in most cases this will be the supervisor). Enter the name and email of the injured employee’s supervisor. Then click “Begin Signing“
- Complete all required fields of the DocuSign Form
- Click “Finish“
- The supervisor will receive an email confirming the submission. Supervisor opens the DocuSign Form, reviews the information and submits. The form can be printed or saved electronically as a PDF.
- Notify Human Resources of the injury. (hr@pnw.edu or 219-989-2251)
If applicable, the supervisor completes and submits a Witness Report Form
- The Witness Report Form can be printed or saved electronically as a PDF.
- Send the completed witness report form via email to hr@pnw.edu or fax to Human Resources at 219-989-2185 (Hammond) or 219-785-5540 (Westville)

Working for Purdue from Another State?

If you are employed by Purdue Northwest and work inside the United States but outside of the State of Indiana, there are additional steps to take when injuries occur. Please contact your Purdue Northwest benefit administrator at 219-989-2251.

Authorized Workers Compensation Provider Locations

Franciscan WorkingWell Munster – Hammond Clinic (3.3 mi)
7905 Calumet Avenue
Munster, IN 46321
Phone: (219) 836-4690

Mon-Fri: 8 am – 6 pm

Community Occupational Health – St. Catherine Hospital (4.6 mi)
4320 Fir Street, Suite 313
East Chicago, IN 46312
Phone: (219) 392-7424

Mon-Fri: 7:30 am – 4 pm

Community Occupational Health – Lake Business Center (5 mi)
(across from Community Hospital)
9200 Calumet Avenue, Suite N-502
Munster, IN 46321
Phone: (219) 440-5286

Mon-Fri: 7:30 am – 7 pm

Franciscan WorkingWell St. John (12.2 miles)
8345 Wicker Ave
St. John, IN 46373
Phone: 219-365-5577

Mon – Sat: 8 am – 6 pm

Franciscan St. Margaret Health Hospital (4 mi) After Hours or in Emergency
5454 Hohman Avenue
Hammond, IN 46320
Phone: (219) 932-2300

Open 24 hours

Franciscan WorkingWell Michigan City (6.5 mi)
4111 S. Franklin Street
Michigan City, IN 46360
Phone: (219) 879-5400

Monday through Friday: 8 A.M. – 6 P.M.

Franciscan WorkingWell Valparaiso (12.2 mi)
2307 LaPorte Ave, Suite 8 (Eastgate Plaza)
Valparaiso, IN 46383
Phone: (219) 464-7073

Monday through Saturday: 8 A.M. – 6 P.M.

Northwest Health Occupational Medicine Valparaiso (12.3 mi)
1251 Eastport Centre Drive, Suite B
Valparaiso, IN 46383
Phone: (219) 462-9205

Mon – Fri: 8 am – 5 pm

Northwest Health Occupational Medicine LaPorte (13.7 mi) – Written Authorization Is Required to be Treated at this Facility — Please contact a benefit administrator for paperwork.
311 Boyd Blvd.
LaPorte, IN 46350
Phone: (219) 326-2664

Mon – Fri: 8 am – 5 pm

Community Occupational Health – SouthPoint (15.4 mi)
1451 West Morthland
Valparaiso, IN 46385
Phone: (219) 286-3830

Mon-Fri: 7:30 am – 4 pm

Franciscan St. Anthony Health (9.1 mi) After Hours or in Emergency
Emergency Room
301 W. Homer Street
Michigan City, IN 46360
Phone: 219-879-8511
Open 24 Hours

Chesterton Health & Emergency Center (9.6 mi) After Hours or in Emergency
770 Indian Boundary Road
Chesterton, Indiana 46304
Phone: 219-921-2000

Open 24 Hours

Community Occupational Health – SouthPoint (5.3 mi)
1451 West Morthland
Valparaiso, IN 46385
Phone: (219) 286-3830

Mon-Fri: 7:30 am – 4 pm

Northwest Health Occupational Medicine Valparaiso (9.4 mi) – Written Authorization Is Required to be Treated at this Facility — Please contact a benefit administrator for paperwork.
1251 Eastport Centre Drive, Suite B
Valparaiso, IN 46383
Phone: (219) 462-9205

Mon – Fri: 8 am – 5 pm

Franciscan WorkingWell Hobart (9.8 miles)
101 West 61^st Avenue
Hobart, IN 47342
Phone: 219-945-9530

Mon – Sat: 8 am – 6 pm

Community Occupational Health – St. Mary Medical Center (9.9 miles)
(across from St. Mary Hospital)

1354 South Lake Park Avenue
Hobart, IN 46342
Phone: 219-947-6495

Mon – Sat: 7:30 am – 4 pm

Franciscan WorkingWell Portage
3283 Willowcreek Road
Portage, IN 46368
Phone: 219-764-8439

Mon – Sat: 8 am – 6 pm

Community Occupational Health – Willowcreek Health Center
3170 Willowcreek Road
Portage, IN 46368
Phone: 219-947-6628

Mon – Fri: 7:30 am – 4 pm

Franciscan WorkingWell Crown Point (23.4 miles)
12800 Mississippi Pkwy, Pavilion A, Suite A204
Crown Point, IN 46307
Phone: 219-662-5500
Mon – Fri: 7 am – 5 pm

Forms and Guidelines

First Report of Injury Form
A first report of injury should be completed for every injury regardless if medical treatment is sought.

Witness Report Form
A witness report form should be completed if there were witnesses present when an injury occurred.

Work-Travel Benefits
Employee travelers should register with ACE International Advantage to have access to helpful services, including 24 hours emergency response.

Work Comp Information for Supervisors
All PNW employees are covered by Indiana Workers Compensation administered by JWF Specialty. This includes faculty, staff, graduate staff, student employees, full-time employees and part-time employees.

Workers Comp FAQs
Learn key workers compensation information, including: what are the benefits, who pays for my treatment, what if I have to be off work, what should I do if I get sick or injured on the job, and more.