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Security & Safety Information

Notices

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Incident Report and Accident/Injury/Illness Form Instructions

  • Click here to access an Accident / Injury / Illness / Incident Report Form (SF 54387)
  • Email the completed report to: security@dwd.in.gov
  • If the incident involves a facility issue, a copy of the incident report must also be emailed to: DPalmer@dwd.in.gov (Dennis Palmer)
  • A copy of all incident reports involving a local office (only) must also be emailed to: JGarciahobbs@dwd.in.gov (Janet Garcia Hobbs)
  • Forward a copy of the completed report to your supervisor.

Bodily Injury and/or Property Damage:

  • If a DWD staff member is injured, State form #34401 must be completed and submitted to HR immediately. This form is available here.
  • Any person claiming injury or property damage, either on DWD property or by a vehicle owned and operated by DWD, and who indicates a desire to be compensated for the loss, should obtain a copy of “Claim for Personal Injury or Property Damage” form to complete and mail as instructed. See DWD Communication #2007-40, Tort Claim Procedures, dated May 16, 2008.

911 Changes

All IGC Complex staff are now instructed to call 911 first during an emergency and then follow up with a call to Security Control at (317) 234-4830. Staff will provide type of emergency, emergency location (address and suite number) along with any other information requested from emergency responders.

Examples of the address locations are below:
DWD Admin Office, address is Indiana Government Center South, 10 N Senate Ave
DWD Appeals, address is Indiana Government Center South, 10 N Senate Ave, Suite E012
DWD Review Board, address is Indiana Government Center North, 100 N Senate Ave, Suite N802
DWD IT/Contractors, address is Indiana Government Center South, 402 W Washington St, Suite W160

If anyone has questions or concerns, please feel free to contact: Facilities/Operations@DWD.in.gov

Form Completion:

The aforementioned reports and forms must be completed wholly and to the best of the individuals’ knowledge. The summary must be specific, clear and concise. In order to preserve the integrity of the information available, the preparer should complete the form immediately upon becoming aware of the circumstances to be reported but no later than 24 hours after the incident occurs.