Forms

Workers Compensation

Claims management requires prompt and accurate reporting of all incidents and injuries. Injured workers are required to complete a Notice of Injury Form (PDF) at the time of the incident. The occupational health coordinator will assist workers and supervisors in navigating any work-related return programs.

Accident and incident reporting

In Canada, worker’s compensation is a system of compulsory no-fault insurance for workplace injuries. In Manitoba this is legislated under The Workers Compensation Act. All staff at the University are covered under this system.

If you are an injured worker

If you are the supervisor of an injured worker

For serious incidents as defined by Workplace Safety and Health

Serious Incidents must be reported to Manitoba Workplace Safety and Health (WSH) immediately. Serious incidents include:

  • Fatalities
  • Injury resulting from electric contact
  • Unconsciousness as the result of a concussion
  • Fracture of skull, spine, pelvis, arm, leg, hand or foot
  • Amputation of an arm, leg, hand, foot, finger or toe
  • Third degree burns
  • Permanent or temporary loss of sight
  • Cut or laceration that requires medical treatment at a hospital
  • Asphyxiation or poisoning
  • Collapse or structural failure of a building, structure, crane, hoist, lift, temporary support system or excavation
  • Explosion, fire or flood, an uncontrolled spill or escape of a hazardous substance
  • Failure of an atmosphere-supplying respirator

When a serious incident occurs, isolate the scene and do not clean up the area. Do not alter or move any equipment of materials that were involved in the incident, unless it is necessary to free an injured or trapped person, to avoid creating additional hazards, or to provide immediate/critical care.

For physical plant workers and supervisors

Ergonomic assessments

With the ever-expanding world of computer use, there is a growing concern over computer-related health problems. The goal of ergonomic evaluations is to help workers identify, evaluate and control computer-related health problems. This includes assessing the worker’s habits and equipment.

Request an ergonomic assessment

Complete the following form to request an ergonomic assessment of your workstation.

Have you reviewed Safe Work Manitoba Ergonomics: Adjusting the Office Workstation (PDF)?

Please review Safe Work Manitoba Ergonomics: Adjusting the Office Workstation (PDF) prior to your ergonomic assessment and make any necessary changes to your workstation based on the information provided in the resource.
I acknowledge that I have reviewed Safe Work Manitoba - Ergonomics: Adjusting the Office Workstation and made changes to my workstation based on the information provided in the resource.

Contact information

Supervisor's contact information

Request information

Assessment location

Which campus are you located on?
Indicate which environment you are requesting an assessment for?

Priority

Pictures of your workstation

Please email 3 pictures of you at your workstation to OHreport@umanitoba.ca so that we can get a sense of your workstation and equipment. Try to include different angles. Include a photo that shows the full workstation and a photo of you sitting at your workstation with hands on the keyboard.

After you have submitted your request and pictures, we will review your responses within one week and contact you to schedule an assessment. After the assessment, a report will be sent to both you and your supervisor.

Notice Regarding Collection, Use, and Disclosure of Personal Information and Personal Health Information by the University

Your personal information and personal health information is being collected under the authority of The University of Manitoba Act. The information you provide will be used by the University for the purpose of assessing your request and contacting you about your requestYour personal information and personal health information will not be used or disclosed for other purposes, unless permitted by The Freedom of Information and Protection of Privacy Act (FIPPA) or The Personal Health Information Act (PHIA). If you have any questions about the collection of your personal information or personal health information, contact the Access & Privacy Office (tel. 204-474-9462), 233 Elizabeth Dafoe Library, University of Manitoba, Winnipeg, MB, R3T 2N2.

We ask that you please do not include any personal health information in the form.

Hearing conservation

Environmental Health and Safety has developed a comprehensive program to help staff prevent hearing loss and meet requirements determined by Workplace Safety and Health. The program consists of education, training and annual hearing assessments on all staff exposed to noise greater than 85 decibels.

Noise monitoring is conducted upon request and areas requiring hearing protection are identified by signage. Follow-up and medical referrals are made as per Workplace Safety and Health Regulations, including an annual report forwarded to the Chief Occupational Medical Officer at the Workplace Safety and Health Division.

Immunization standard and post-exposure protocol

Immunization procedures ensure University of Manitoba staff and students are protected from occupational exposure to vaccine-preventable, potentially infectious diseases while working with or near animal or human blood/body fluids or other human pathogens at any research or clinical laboratory or animal care facility work site.

Immunization resources

Automated External Defibrillators (AEDs)

The University of Manitoba has placed AEDs in many areas throughout its facilities for use by untrained individuals in the event someone experiences a suspected heart attack. The AED is a portable device and is used in conjunction with CPR. When turned on, an automated voice directs the user in clear, easy to understand language.

Faculties or units are responsible for all costs associated with the AED, including installation, posting of signage, maintenance and/or repair costs, and monthly inspections.

The user must call 9-1-1 before using the AED to have Emergency Services dispatched.

AED resources

Training

Designated first aid training

Environmental Health and Safety offers training to workers willing to become designated first aiders in their work areas. The course is provided by a Red Cross certified trainer and is valid for three years.

Each department is asked to recruit potential designated first aiders for their own area and to provide a stocked first aid kit.

Contact the Environmental Health and Safety Office for details.

Occupational hygiene

Indoor air quality and heat or cold stress

Poor air quality can affect the comfort of staff and students in University facilities. We can investigate and assess comfort factors such as temperature and humidity in addition to assessing the effectiveness of the ventilation system.

Lead paint

Lead is a chemical that was used in paint until the 1980s. If a building has been renovated a number of times over the years, it may have a number of paint layers containing lead. Buildings built before the 1960s have a higher chance of containing lead paint.

Resources:

Mould remediation and control

Under certain conditions, mould can pose a health hazard to susceptible individuals. If your work area has experienced a water leak or flood, please contact Physical Plant immediately to have the water source stopped and fixed.

Physical Plant can answer questions regarding exposures and potential health effects of mould and can provide assessments and recommendations for control measures.

Factors that increase the risk of illness include:

  • Susceptible individuals: those allergic to mould; those with low immunity; and babies whose lungs are not completely formed.
  • High levels of exposure: exposure to large numbers of spores over a long period of time.
  • Species of mould: the more noxious moulds (high potential for mycotoxin production) pose the greatest health risks.

The best way to avoid mould problems is to address humidity and water intrusion events before mould has a chance to establish itself.

If you have any questions regarding mould management, please contact the Environmental Health and Safety Office at 204-474-6633.

Manitoba Labour – Mould Work Safe Bulletin (PDF)