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On The Job Injuries (OJI)

It is the intention of Mecklenburg EMS Agency, at all levels of the organization, to actively maintain and promote a safe working environment for all employees.  When an injury/illness does occur that may be job-related it is the Agency’s responsibility to ensure that the employee receives treatment and to assist the employee during their recovery.

The following is meant to assist the employee and supervisor through the OJI process. The Case Coordinator is the primary contact for all OJIs including Exposures. For more information about injuries and exposures, please see below.

Employees must contact the on-duty supervisor immediately if an OJI occurs.  Once the employee returns to Post100, they must call PMAcare24 immediately to report the injury at 833-549-1332.  Employees will be prompted to view/complete and submit the following:

MOU – Confidentiality Agreement

New OJIR Form


The reporting supervisor or designee must complete and submit the following:

Concentra Treatment Referral Form

Exposure Incident Report

Check List for Supervisor

  • If it is an exposure, complete and submit the Exposure Incident Report.
  • Ensure the employee completes their portion of the paperwork as listed on the Checklist for Supervisors or Designee.

Other important Information

PMAcare24 Wallet Card MEDIC

Treatment Locations

Pharmacy PMAMC First Fill Sample Form

If the OJI is an Exposure, the following paperwork must also be completed. Follow up on Exposures cannot be done without this paperwork.

7 – Blood Borne Exposure

6 – Determining Blood Borne Exposure

Exposure Incident Report

For treatment to begin, the injured employee must have one of the following forms completed upon arrival to the Urgent Care facility. 

Concentra Treatment Referral Form

Any employee who is out of work or on light duty for 90 days or more MUST complete the Return to Full Duty Work Process. 

9 – Return to Full Duty Work Form


ALL Completed paper forms must go to for processing.