Parishioner or Visitor Injuries
To document any harm that a parishioner or visitor suffers at your location, use the Incident Report. This form can be used to document an injury and 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. This file should be in a separate, locked location from personnel files.
- 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 form (FROI) and submit it via fax to Church Mutual (715)539-4651
- Fax the FROI to Mary Rasch in Human Resources at (218)724-1056. Please call to advise that a fax is on its way (218)724-9111.
- 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 the parish or school. These documents should be kept in a separate, locked location from the personnel files.
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.
Diocese of Duluth
2830 East Fourth Street
Duluth, MN 55812