Injury Reporting

Parishioner or visitor injuries

To document any injury that a parishioner or visitor suffers at your location, use the Incident Report. This form can be emailed to [email protected] or you can call 1-800-228-6108 x2456 or x2441 to immediately report any injury. The Incident Report can also be used to notify your leadership of unsafe conditions, ensuring proper action is taken to rectify the situation. Completed Incident Reports should be kept on file at the parish or school. This file should be in a separate, locked location from personnel files.

Volunteer injuries

If a volunteer is injured performing duties at the direction of the church or school, please contact the Human Resources Department for the appropriate form. All incidents should be reported, regardless of whether medical treatment is necessary.

Employee injuries

If an employee suffers an injury that is a life threatening emergency, call 911.

If an employee suffers an injury that is not life threatening and the employee has not yet received any outside medical care, the supervisor/manager (with the employee present) should contact the Church Mutual Nurse Hotline at (844)322-4662. The Nurse Hotline should be utilized anytime the injury likely requires "more than a Band-Aid but less than an ambulance ride"

If an employee notifies you of an injury after they have already sought outside medical care, you should not call the Nurse Hotline number above. Instead, report the injury as a claim by calling Church Mutual directly at (800) 554-2642 Option 2. 

With any injury, no matter when you receive notice that the injury occurred, immediately follow these steps:

• fill out a First Report of Injury (FROI) and submit it via fax to Church Mutual (715) 539-4651;
• give a copy of the FROI to the employee along with an Employee Information Sheet.

Completed First Reports of Injury should be kept on file at your parish or school. Your location will be receiving information sent out by Church Mutual in regard to the claim. All of these documents should be kept in a separate, locked location from the personnel files. 

OSHA requirements

If the injury is reportable under OSHA requirements, Human Resources will contact your parish or organization to fill out the required record-keeping documentation. In January of each year, Human Resources will assist qualifying locations with their OSHA Forms as required under Minnesota State Law.