Occupational Injury/Illness Report

Close up of and African American hand filling out a "work Injury Claim Form"

To file an occupational injury/illness report at Case Western Reserve University through the Office of Risk Management and Insurance, please download the Injury Report document, print out and complete the form and have it signed by both the employee and the supervisor.

Return the form via fax or email a scanned copy to both:

Dina Leinweber
Email: dina.leinweber@case.edu or
Fax: 216.368.5481

Felice Porter
Email: felice.porter@case.edu or 
Fax: 216.368.2236