SECTION 6: INCIDENT AND ACCIDENT REPORTING AND INVESTIGATION

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1 SECTION 6: INCIDENT AND ACCIDENT REPORTING AND INVESTIGATION Scope This section sets out the requirements and procedures for the initial actions, reporting and investigation of incidents and accidents. These procedures will be used in all Company workplaces and is also to be enforced among all contractors. Clients may have their own policies, procedures and forms. Where it is a requirement that client procedures and forms are used, these will be in addition to the those in this section. This section applies to: Incidents or accidents involving Company or contractor employees or property. Accidents involving persons who are not Company or contractor employees in areas under the control of the Company and arising from Company activities. Damage or loss of property not owned by the Company or its contractors, in areas under the control of the Company and arising from Company activities. Definitions An Accident is an unexpected and unplanned event which causes personal, vehicle or property damage that results in a loss to the Company and/or individual injury. Accident Investigation involves the identification of all factors that may have contributed to the accident so that action may be taken to prevent a recurrence by controlling those factors. An Incident or Near Miss Incident is an unexpected and unplanned event which has the potential to cause loss to the Company and/or individual injury. Investigation Team in the case of a serious accident is to include the area supervisor or manager, the safety coordinator and a senior representative of the contracting company (if applicable). According to the Mine Safety and Health Administration, an MSHA accident is defined as: A death of an individual at a mine; An injury to an individual at a mine which has a reasonable potential to cause death; An entrapment of an individual for more than thirty minutes; An unplanned ignition or explosion of gas or dust; An unplanned mine fire not extinguished within thirty minutes of discovery; 6-1

2 An unplanned ignition or explosion of a blasting agent or an explosive; An unplanned roof fall at or above the anchorage zone in active workings where roof bolts are in use; or, an unplanned roof or rib fall in active workings that impairs ventilation or impedes passage; A coal or rock outburst that causes withdrawal of miners or which disrupts regular mining activity for more than one hour; An unstable condition at an impoundment, refuse pile, culm bank which requires emergency action in order to prevent failure, or which causes individuals to evacuate an area; or, failure of an impoundment, refuse pile, or culm bank; Damage to hoisting equipment in a shaft or slope which endangers an individual or which interferes with use of the equipment for more than thirty minutes; and An event at a mine which causes death or bodily injury to an individual no at the mine at the time the event occurs. MSHA Occupational Illness - an illness or disease which may have resulted from work at a mine or for which an award of compensation is made. MSHA Occupational Injury - any injury which occurs at a mine for which medical treatment is administered, or which results in death or loss of consciousness, inability to perform all job duties on any day after an injury, temporary assignment to other duties, or transfer to another job. For the purposes of this section, a Serious Accident is an accident which results in a fatality, hospitalization of more than one employee, amputation or third party medical attention. It also includes property damage incidents of greater than $2,000. Legislative Requirement Under most safety legislation all accidents causing injury and near miss incidents must be investigated by management. The report must usually be on the prescribed form and must be by the end of the work shift. Serious injuries must be reported immediately, or as soon as practicable i.e., after care is given to injured. While most legislation stipulates non-disturbance and preservation of the site of any serious accident, this must not interfere with the tasks of rescuing and treating injured personnel or actions taken to stabilize the situation and make the area safe. 6-2

3 Policy All accidents occurring on Company work sites will be investigated. Wherever applicable contractor staff will be requested to join the investigation team to provide expertise and input. The Company will ensure that the accident reporting system is capable of accepting reports of close call incidents not causing injury or damage. Reporting of these close call incidents is a fundamental requirement of this section and a basic condition of employment. It must therefore be encouraged. The Company will develop and implement a system for the long term storage of accident and incident data and will use this data, in conjunction with industry data to identify trends, prioritize remedial work and encourage pro-active prevention strategies. Information on any accident occurring on any site will be reported to all other business units at least quarterly, while serious accident information will be passed as soon as possible. This information will include a brief description of the accident and the events leading up to it, the basic causes of the accident and any immediate measures taken to prevent a recurrence. Responsibility It will be the responsibility of every employee to ensure that all accidents and near miss incidents are reported in the proper manner. Field Management has the responsibility to complete the on-line accident/incident report form for all incidents. This completed document is electronically forwarded to the Worker s Compensation Department, Safety Department and appropriate District management. It is important that District management actively encourage the reporting of all accidents and near miss incidents, among their subordinates. The Worker s Compensation Department will have the responsibility of filing state injury reporting and insurance compensation claim documentation. This includes classification of injury. The Corporate Safety Department will be responsible for the storage, statistical analysis and distribution of these reports from each District. It will also ensure that all accident reports are received, and that they are logged and distributed, as required. 6-3

4 Procedures 6.1 General Reporting Requirements All personal injury, vehicle and property damage accidents are to be immediately reported to a supervisor or other responsible person, followed as soon as possible with a completed, on-line accident/incident report ( Immediately following the report of any serious accident the supervisor must notify District management who will, in turn notify SEHS. A decision will then be made regarding if immediate reporting is required to regulatory agencies. An on-line accident/incident report ( must be sent to the Corporate Safety Department and Worker s Compensation Department within 24 hours of any serious accident. Reports of any serious accident must also be forwarded to the Division President, Regional Vice President and Director of Safety of Layne Christensen Company within the 24 hour time frame. On-line Internet accident reporting is available at Submission of this report is mandatory and meets all of the above requirements. Copies of all Accident Report forms can be found in Appendix D. 6.2 Serious Injury Reporting Requirements All accidents which involve a fatality or the hospitalization of 3 for more employees must be reported immediately to the Insurance and Workers' Compensation Manager so that a follow-up report to OSHA may be made within 8 hours, as called for under applicable regulations. Whether or not an incident is immediately reportable, if it results in the death of an employee or the hospitalization of 3 or more employees within 30 days of the incident, OSHA requires the employer to report the fatality/multiple hospitalization within 8 hours after learning of it; so it is critical that you submit your report to the Insurance and Workers' Compensation Manager immediately. Each District should establish a reporting flow for serious injuries. A successful flow requires one caller to notify two people. Each of those two people notify two people until notifications are complete. Callers should stay within the flow and not call back up the flow, keeping phone lines open. An example of a successful flow would be as follows: Site Supervisor ----> Operations Manager and District Manager District Manager -----> Regional Vice President and Safety Department 6-4

5 Regional Vice President ----> Division President and Worker s Comp. Manager Safety Department ----> Director of Safety and Legislative Body (OSHA, DOT, etc.) Director of Safety ----> Predident and CEO and Chief Counsel 6.3 MSHA Injury Reporting Requirements The accident reporting form MSHA Form is completed by SEHS from information received from the accident report submitted to the Workers' Compensation Supervisor. Specify the mine name and the mine's MSHA identification number when reporting accidents occurring on mine sites. MSHA requires reportable and lost time accidents to be submitted within 10 days. Serious accidents (as defined in Section B of the form) must be reported to MSHA immediately. Part 50 states injuries shall be considered as "immediately reportable accidents" if they are so serious as to have a reasonable potential to cause death. NOTE: The State of Nevada requires any and all accidents occurring on mine sties to be reported to the State Mine Inspectors office. If an accident occurs on a Nevada mine site inform the Workers' Compensation Supervisor when reporting accident details. 6.4 Vehicle Accident Reporting Requirements In the event of a vehicular accident the driver should: Stop immediately - if possible pull off traveled portion of roadway Warn other motorists - set out emergency flares, etc. Check for injuries - have someone call for medical assistance If injuries or serious property damage occurred - call police. Get names and addresses of witnesses - forms are enclosed in the Accident Reporting Kit. Exchange driver and vehicle information with other parties involved. Do not make statements or argue as to who was at fault - do not sign an admission of fault. Do not discuss the accident with anyone except: - Police - Layne Christensen supervisor or management personnel - Your insurance representative Complete an Emergency Accident Report (contained in the Accident Reporting Kit) at scene. 6-5

6 Report the accident to your supervisor immediately by phone. If the supervisor is not available, contact the Workers' Compensation Manager. If the accident involves a spill of hazardous materials contact the Layne Safety Department. On-line Internet accident reporting is available at Submission of this report is mandatory and meets all of the above requirements. 6.5 DOT Reportable Vehicle Accident Reporting Requirements Department of Transportation (DOT) reportable vehicle accidents must be entered into the company's accident register. The reportable criteria is determined from information received from the accident report submitted to the Workers' Compensation Supervisor. On-line Internet accident reporting is available at Submission of this report is mandatory and meets all of the above requirements. 6.6 DOT Hazardous Material Incident Reporting Requirements IMMEDIATE notification of hazardous material incidents which involve any of the following conditions must be immediately reported to SEHS. Be aware of these conditions when gathering information to report to SEHS. DOT. Hazardous Material Incident is when the hazardous material is directly responsible for: Death of a person(s). Injury requiring hospitalization of any person(s). Estimated damage to carrier or other property exceeding $50,000. An evacuation of the general public lasting one or more hours. One or more major transportation arteries or facilities are closed or shut down for one hour or more. The operational flight pattern or routine of an aircraft is altered. Fire, breakage, spillage, or suspected contamination involving a shipment of radioactive materials. Shipments involving fire, breakage, spillage, or suspected contamination of a shipment of etiologic agents. Discharge of hazardous materials into or upon a navigable waterway. 6-6

7 Refer to the Layne Christensen Fleet Safety Manual for DOT Reportable Vehicle Accident or DOT Hazardous Material Incident reporting procedures. 6.7 Property Damage/General Liability Reporting You must immediately notify your supervisor and Layne Christensen's General Counsel of incidents involving: Significant property damage to company building, surrounding premises, building contents or machinery or property of others (other than accidents involving a Layne Christensen vehicle). Any personal injury or death to a third party (someone other than a Layne Christensen employee) that occurs on our property or in connection with work performed by the company. Complete a General Liability Notice of Occurrence/Claim (ACORD 3-D (11/85)) and send to Layne Christensen's General Counsel. 6.8 Claims Management It is the responsibility of every manager and supervisor to make decisions and provide the leadership which will prevent accidents and injuries from occurring. Necessary steps for an effective safety program are included throughout this manual. When an accident and related damages or injuries occur, it is your responsibility to again make decisions and provide the leadership necessary to minimize our losses in the claim. Contact the Insurance and Workers' Compensation Manager with questions concerning the handling of Worker's Compensation claims or issues Insurance vs Self-Insured Layne Christensen Company does not have insurance as we know it for worker's compensation, vehicular damages, general liability or product liability to third parties. We contract with our insurance company and adjuster to provide certain services. All expenses paid through these companies for worker's compensation or vehicular claims are passed back directly to Layne Christensen Company. We pay for these expenses right off our bottom line When An Accident Occurs Require all employees to notify their supervisor immediately of any and all accidents when property damage occurs or when injuries require treatment by a physician. 6-7

8 Seek appropriate medical attention for the employee. Whenever possible, utilize a physician or industrial clinic recommended by the Insurance and Workers' Compensation Manager (Post the names of your preferred providers in a conspicuous place in the office). In states where the employee has choice of physician, we can still suggest that they see our doctor. Report all on the job injuries immediately. Treat all reported or alleged injuries as legitimate and report any concerns or questions when initially calling in the claim. Advise the Insurance and Workers' Compensation Manager of any problems with the claim. After the doctor has treated the employee, he should supply your employee with a written note for you stating diagnosis and whether the employee is released to full or modified duty. If the employee is released to modified duty, you should make every effort to accommodate such temporary light duty to avoid costly TTD payments and long absences from work. The employee should understand that this modified duty is temporary. If the doctor takes the employee off work the Insurance and Workers' Compensation Manager will contact the doctor and inquire about restrictions. Modified duty will be offered if appropriate. In some cases, the employee simply cannot return to modified or full duty for some time. In that event, it is advisable to maintain weekly or even more frequent contact with the employee, reflecting Layne Christensen Company and your concern for him/her. On lost time cases, maintain close contact with the Insurance and Workers' Compensation Manager on concerns and problems. We aggressively pursue investigation of suspected fraudulent claims. If you question the validity of a claim or suspect malingering report this information to the Insurance and Workers Compensation Manager. If an employee has questions about his/her claim, refer the employee to the Insurance and Workers Compensation Manager. If the employee is represented by an attorney, we must not discuss the claim with him/her. Do not hesitate to call the Insurance and Workers' Compensation Manager if you have questions or need assistance. 6-8

9 6.9 Accident Investigation Accident investigation is an important tool in an organized accident prevention program. It is of the utmost importance to a successful safety and health program that all accidents be reported immediately to the designated responsible person so that the investigation can begin as soon as possible after the event. Also, to comply with various legislative requirements and to identify high risk areas or tasks, it is necessary to keep accurate records of accidents and injuries. As discussed in the Policy, all accidents are to be investigated. There are three main stages of the accident investigation process, namely: Observation - The study of all factual evidence to gain a full description, then Analysis - The study of the description to identify related factors, followed by Evaluation - The study of the related factors to determine how they may be controlled. It is extremely important that the basic objective of accident investigation be clearly fixed in the investigators' minds; to obtain all the relevant facts concerning the accident and to develop and plan corrective action to prevent a recurrence. All serious accidents must be thoroughly investigated by a team comprising of the operations manager, safety coordinator and area supervisor. Serious accidents involving contractor employees will also require the contractor manager or safety advisor to be present and take part in the investigation. As a guide, the following should be remembered about the process of accident investigation: The investigation should commence as soon as practicable. Where necessary, barricade the accident scene until an initial inspection is completed. Observe, photograph, take measurements and make sketches of the scene of the accident. Interview the person(s) involved in the accidents. If they are seriously injured or hospitalized, use compassion as employees may be traumatized. Interview all witnesses (individually), other members of the persons' work group and any other workers that are experienced in the same type of work. Gather evidence from specialists or experts, including manufacturers and suppliers, if necessary. Determine all contributory factors. Document the basic details concerning the accident using an incident report form. Initiate any immediate actions necessary to control or eliminate contributory factors to prevent a recurrence. 6-9

10 Ensure the relevant Statutory Authority is advised where applicable. Unless necessary to prevent further injury, the scene of the accident should remain undisturbed until the investigation is complete. Where required, ensure the client's reporting procedures are followed. Accident investigation forms and directions may be found in Appendix D Near Miss Reporting Reporting near miss incidents is an integral part of preventing accidents. Communicating a near miss or close call to all personnel can prevent the next incident from occurring or becoming a workplace injury. A near miss can be as simple as noting broken seatbelt on a forklift or, sharing information involving product recalls or failures. It could also be a catastrophic event such as a wire line cable break while lifting a section of casing. We can learn from events that happen at home as well, such as falling off a ladder while changing a light bulb. The Layne Safety Department has a Near Miss Reporting program for use by all employees to record these incidents. All you need to do is note an incident which you feel should be communicated to all personnel on the form and forward it to Layne Safety. Names, dates and office numbers help, but are not required. Near miss reports will not be used for disciplinary purposes, only to make Layne Christensen Company a safer workplace. Forms may be sent to Layne Safety via inter-office mail, fax (913) or US mail; Layne Safety 610 South 38 th Street Kansas City, Kansas Near miss reports may also be filed via the internet by accessing and entering Near Miss Reporting Near Miss Investigations Near Miss Report will come into SEHS via either or hard copy. S hard copies should be received by Training Records Coordinator and input to form. S (s) will be copied to all Safety Coordinators. 6-10

11 A received Near Miss Report will be investigated by the Safety Coordinator assigned responsibility to that office. A Near Miss Evaluation form will be completed by the investigator. If a report does not contain an office location, it will be assigned to a Safety Coordinator by the Department Manager. If a Safety Coordinator is unavailable, the received report will be assigned to a staff member by the Department Manager. Near Miss Reports will be evaluated on the following criteria: Probability of Recurrence: Loss Potential Severity: Evaluate Probability of Recurrence by analyzing times per day the task is performed, number of crews/operations utilizing the equipment, previous similar accidents, and previous similar near miss incidents for the entire Company. Evaluate Loss Potential Severity by analyzing the number of employees exposed to the incident, potential injury, potential property damage cost, and previous similar accident costs for the entire Company. Depending on the evaluation, the results will be as follows: - Near miss incidents falling into the green zone will be recorded and monitored for future comparable incidents. - Near miss incidents falling into the yellow zone will be investigated and published in a monthly report to all locations. - Near miss incidents falling into the red zone will be investigated within 48 hours and a Supervisor Safety Alert will be sent to all Field Supervision and Management. When the evaluation is complete, attach the evaluation form to the near miss hard copy and forward to the Training Records Coordinator for database logging and filing. If the Safety Coordinator is out of the office, forms and attachments may be ed to the Training Records Coordinator for printing and filing. Near Miss Reports and Evaluations will be logged in a database by the Training Records Coordinator with the following information: date received, evaluated by, hazard potential, 6-11

12 hazard frequency, potential injury and brief description. District and employee submitting may be added if available. Offices will receive District Safety Competition points for near miss reporting (unless report is submitted anonymously). This will be processed by the Training Records Coordinator. Employee submitting report will receive a hard hat sticker and thank-you memo (unless report is submitted anonymously). This will be processed by the Training Records Coordinator. Supervisor Safety Alerts will be written in standard format and forwarded to SEHS Office Manager for proofing and formatting. They should be reviewed by at least one other Safety Coordinator. The form will then be ed to all offices under the heading ATTN: DISTRICT OR BRANCH MANAGER, OPS. MANAGER AND FIELD SUPERVISORS!! Supervisor Safety Alerts will also be posted on the website for future reference. 6-12

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