How To Report An Accident In Spokane County



Similar documents
DELAWARE COUNTY. Supersedes June 15, 1988, March 22, 1999

Record your fleet vehicle information in the following spaces. This information will be needed when filing a claim.

ACCIDENT, INJURY, AND INCIDENT REPORTING PROCEDURES

DEPARTMENT OF PUBLIC WORKS MANAGEMENT MANUAL ADOPTED BY THE BOARD OF PUBLIC WORKS, CITY OF LOS ANGELES. June 20, 2007 PERSONNEL DIRECTIVE NO.

Workers Compensation Policy and Procedure

19. Injury, Accident, and Loss Reporting

Brigham and Women s Hospital Human Resources Policies and Procedures

STATE POLICE TROOPER

STANDARD TORT CLAIM FORM PACKET

#6-604 Accident Reporting Policy Page 1 of 5

MOTOR VEHICLE ACCIDENT CLAIM FORM

PHILADELPHIA POLICE DEPARTMENT DIRECTIVE 5.19

STANDARD OPERATING PROCEDURE SOP Sec. 5.4 Workers Compensation Incident Reporting

LOS ANGELES COMMUNITY COLLEGES PERSONNEL GUIDE B 417 INDUSTRIAL ACCIDENT PROCEDURES

Workers Compensation Procedure

REPORTING POLICE VEHICULAR ACCIDENTS AND DAMAGE

What is a definition of insurance?

Accident Investigation Program

Table of Contents Scope General Motor vehicle (including aircraft) accidents. 2

MODEL POLICY TO COMPLY WITH NEW OSHA INJURY REPORTING REQUIREMENTS

Florida Fish and Wildlife Conservation Commission Division of Law Enforcement ACCIDENT INVESTIGATIONS AND DEATH NOTIFICATION

SOUTH CAROLINA BAR. Auto Accidents and the Law

Standard Tort Claim Form Packet

Present in Person or Mail the Standard Tort Claim Form and Supporting Documents to:

University Fleet Services

what to do in case of an auto accident

MAINE COMMUNITY COLLEGE SYSTEM

WORKERS COMPENSATION CLAIM REPORTING PROCEDURES

LAKE CITY POLICE DEPARTMENT GENERAL ORDERS MANUAL

Section 97 ACCIDENT REPORTING

Standard Tort Claim Form Packet

Employee Injury/Illness Reporting and Managed Return to Work. April 15, 2011 HR 23. Human Resources Responsible Key Business

(No. 104) (Approved June 27, 2011) AN ACT

Standard Tort Claim Form Packet

INSTRUCTIONS ON COMPLETING THE WORKERS COMPENSATION- FIRST REPORT OF INJURY REPORT

PUD No. 1 of Clallam County Standard Tort Claim Form Packet

Virginia Commonwealth University Police Department

14B NCAC 07A.0116 ROTATION WRECKER SERVICE REGULATIONS (a) The Troop Commander shall include on the rotation wrecker list only those wrecker services

2. Employees will receive regular pay for the hours scheduled on the day of injury.

Consumer Legal Guide. Your Guide to Automobile Insurance and Accidents

Your Accident Fact Kit

CITY OF EUREKA POLICE DEPARTMENT GENERAL ORDER 89

A Consumer s Guide to: Auto Insurance. Choosing and using your auto insurance coverage. Washington State Office of the Insurance Commissioner

Incident/Injury Reporting and Investigation Policy Township of Tudor and Cashel

TABLE OF CONTENTS MOTOR VEHICLE ACCIDENTS REPORTING AND FORMS RESPONSIBILITIES OF FIRST AND SECOND LINE SUPERVISORS

CLAIM REPORTING GUIDE

VERSABAR SAFETY MANAGEMENT SYSTEM

OREGON TRAFFIC ACCIDENT AND INSURANCE REPORT

SERVICE STANDARD FLEET INSURANCE FOR NSW RFS APPLIANCES

Van Services. Table of Contents

History: 1949, Act 300, Eff. Sept. 23, 1949; Am. 1958, Act 35, Eff. Sept. 13, 1958; Am. 2005, Act 3, Imd. Eff. Apr. 1, 2005.

IIT Office of General Counsel Education Program. Insurance and Risk Management

Chimacum School District. Standard Tort Claim Form Packet

SUNY OSWEGO ENVIRONMENTAL HEALTH AND SAFETY

Your Accident Fact Kit

Standard Tort Claim Form Packet

What to Do When an Accident Occurs - Work Comp Procedures

Workers Compensation Claims Reporting. What do I do after a Workers Compensation accident occurs?

1004 VEHICLE AND FLEET SERVICE POLICY. I. Legislative Authority:

VEHICLE ACCIDENT REPORTING KIT

Fleet Management Policy Table of Contents

Accident Reporting & Investigation Policy and Guidance

ASU SUPERVISOR S ACCIDENT/ILLNESS INVESTIGATION FORM

Motor Accident Report Form

THE TEXAS A&M UNIVERSITY SYSTEM (TAMUS) FLEET VEHICLE USE GUIDELIINES

Wesley Theological Seminary Motor Vehicle Operation Policy

MOTOR VEHICLE ACCIDENT CLAIM FORM

The ASI Risk Management Program

Workers Compensation Program Review and Approval Authority

Worker s Compensation Claims Reporting Procedures

Motor Vehicle and Fleet Management Policy and Procedures. Facilities Management

INSTRUCTIONS FOR COMPLETING A TORT CLAIM FORM. General Liability Claim Form #SF 210

ADMINISTRATIVE PROCEDURE

Anne Arundel Community College Motor Vehicle Policy and Procedure

WHAT SHOULD I DO IF I HAVE AN AUTO ACCIDENT? 1. If I have an auto accident, do I have to stop? 2. What should I do if someone is injured?

UNION COLLEGE MOTOR VEHICLE POLICY

AN EMPLOYER S GUIDE TO WORKERS COMPENSATION IN NEW JERSEY

PLEASE NOTE: Why was my vehicle impounded?

Revision Date: Title: REPORTING PROPERTY DAMAGE AND PERSONAL INJURIES Page 1 of 2. Approved By: President, MABAS Div. III Date

PROBATION AND PAROLE BUREAU STANDARD OPERATING PROCEDURES

Standard Tort Claim Form Packet

INSURANCE CODE TITLE 10. PROPERTY AND CASUALTY INSURANCE SUBTITLE C. AUTOMOBILE INSURANCE CHAPTER 1952

Section. Page. Authority. V. Definitions. I. Policy

Licensure of Ground Ambulance Services. (1) Applicability.

Lowcountry Injury Law

DMV. OREGON TRAFFIC ACCIDENT AND INSURANCE REPORT Tear this sheet off your report, read and carefully follow the directions.

Originator Date Section ID Description of Change Reason for Change

Auto Accident Rights & Responsibilities

Accident/Incident Investigation & Reporting Procedure

Injury and Work- Related Illness Prevention Program

Reporting Work-Related Injuries and Illnesses

Transcription:

Spokane County Accident Prevention Program 1.7 ACCIDENT REPORTING POLICY I. SCOPE Policy No. 1.7 Revised: August 2007 Reporting accidents/incidents that result in an injury to a Spokane County employee, injury or property damage that result from County operations and County property damage is mandatory! II. POLICY A. The Risk Management Office is responsible for ensuring full employee Workers Compensation benefits for employees and reasonable liability adjustments made, at the lowest cost, against the County. This, however, is totally dependent upon the proper and timely reporting of accidents. B. It is required by law (RCW 51.28.010) to report all occupational injuries and illnesses, regardless of the degree of the incident. Employees must report any injury, no matter what severity to their supervisor immediately! C. Spokane County also requires that the Risk Management Department be notified for the following accidents/incidents: 1. All accidents involving a county vehicle. 2. All accidents involving a county employee operating a vehicle for county business. 3. All on-the-job county employee accidents resulting in injuries or property damage. 4. All incidents occurring on county property resulting in injury or property damage. 5. All accidents occurring on county roadways that result in serious injury or death. NOTE: Risk Management must be notified of these listed incidents twenty-four (24) hours a day, seven (7) days a week. III. INJURIES and/or ILLNESSES REQUIRING PHYSICIAN S TREATMENT A. If medical attention, other than basic first aid, is required as a result of an occupational injury, the employee s supervisor or a Risk Management Loss Control Specialist will immediately arrange transportation via ambulance or county vehicle to the nearest emergency treatment facility for care. SCARP 9/15/2009 Page 1 of 6

NOTE: Spokane County employees that suffer an occupational injury requiring treatment at an emergent care treatment facility must not be allowed to drive themselves to the medical facility. B. The supervisor or Loss Control Specialist shall inform the medical facility that the employee has suffered an occupational injury and inform them of Spokane County s self-insurance status. C. After diagnosis and care has been administered, and upon release from the medical facility, a written medical release describing return-to-work limitations must be obtained from the emergency facility or physician. D. Following an occupational injury in which the employee receives medical treatment by a physician, the employee must report to the Risk Management Office the next working day for completion of the required paperwork. This report of the injury/illness initiates the opening of a workman s compensation claim. Worker s and Employer s report of Occupational Injury or Disease (SIF2) is the mandatory form used for reporting injuries and filing compensation claims for injuries and diseases. NOTE: In the case of employees who are not released for duty, a Job Analysis (JA) and Physical Capacities Evaluation (PCE) will be provided to the employee by the Risk Management office. The employee shall give this to the attending physician to determine if light duty or further time loss is warranted. A status report will be required from the physician detailing what is to transpire. This medical information is then submitted to the Risk Management Office. In most cases a Loss Control Specialist will be available at the scene to assist in obtaining the required documentation, but in cases when he/she is not available, the Supervisor is responsible for compliance with this policy. All medical releases, for job and non-job related injuries or illnesses, must be approved by the Risk Management office prior to allowing the employee to return to work. IV. SUPERVISOR S ACCIDENT REPORT OF INJURY When an employee injury is reported, the supervisor must complete and submit a Supervisor s Accident Report of Injury Form to the Risk Management Office within twenty-four (24) hours of the incident; in cases of a holiday or weekend, the next working day will suffice. These written reports are mandatory and assist the Claims Adjudicator and Claims Technicians with critical information needed to initiate and process worker s compensation injury claims. A. PROCEDURES: 1. A supply of these reports must be readily available by each supervisor at all times. The Risk Management Office has a supply of these forms for replenishment. SCARP 9/15/2009 Page 2 of 6

2. The Supervisor must conduct an investigation of the accident scene to include: a. Inspection of any equipment or machinery in use. b. Inspection of use of safety equipment and/or personal protective equipment (PPE) c. Review of task training. d. Review of sufficient direction and/or supervision. e. Review of work process and procedures. 3. Supervisors will attach to the accident report, any handwritten statements, from either the employee or any employees that might have witnessed the accident. Request these statements as soon as possible after the incident. 4. Supervisors will attach any other pertinent information such as pictures, drawings, and data to the accident report as well. 5. The Supervisor and Department Head must sign the completed accident report. 6. Each Supervisor s Accident Report of Injury is composed of two (2) copies and once completed are routed as follows: White copy Risk Management s copy Yellow copy Supervisor s copy NOTE: Supervisor s can not allow an employee to return to work following a work related injury/illness unless they receive a signed authorization from the attending physician and approval from the Risk Management Office, who will make every effort to return recovering, injured employees to work as soon as possible. V. SUPERVISOR S PROPERTY DAMAGE REPORT A. When employees are involved in an accident that causes damage to either Spokane County property and/or private property, they must inform their supervisor immediately and a written report, following an investigation, must be submitted to the Risk Management office. B. These written reports are mandatory and assist the claims adjudicators and techs with critical information needed to initiate and process liability compensation claims. They are also instrumental in documenting accident and damage conditions. Accurate reporting records facts and circumstances related to incidents and assists Spokane County in placing themselves in a defensible position for litigation filed against the County. VI. VEHICLE ACCIDENT PROCEDURES A. If a county owned vehicle or an employee operating their privately owned vehicle (POV) for county business is involved in a traffic accident, the following procedures must be followed: SCARP 9/15/2009 Page 3 of 6

1. Call 911 if involved in an injury accident or other emergency situation, or 2. If a situation does not require a response from Law Enforcement (i.e., vandalism, suspicious incidents, etc ) cal the Spokane Crime Reporting Center @ 532-9266 to place a Crime Report and you will be given a case number. 3. Notify your Supervisor immediately. Your Supervisor will report the accident to the Risk Management Department. If your supervisor is not reachable, immediately notify Risk Management so that a Loss Control Specialist can respond to render assistance and compile information for their investigation. 4. Complete the Vehicle Accident Check List located in the glove compartment of the vehicle. In county vehicles, this package is located in a yellow envelope. Employees that use their POV in conjunction with Spokane County are encouraged to obtain a Vehicle Accident Check List from the Risk Management Department and store it with their registration and proof of insurance in their glove compartment. 5. Do not leave the scene unless instructed to do so by Law Enforcement and/or a Risk Management Loss Control Specialist. Note: Accidents involving vehicles requiring to be operated by employees with a Commercial Driver s License (CDL) must be handled in accordance with Department of Transportation policies to include possible post accident drug/alcohol testing. VII. VEHICLE ACCIDENT REPORTS A. Any county vehicle or an employee using their personal vehicle for county business involved in an accident and accrues damages equal to or above seven hundred dollars are required to complete and submit a Collision Report to the State of Washington within four (4) days of the accident. B. RCW 46.52.0303 (1) Unless a report is to be made out by a law enforcement officer under subsection (3) of this section, the driver of any vehicle involved in an accident resulting in injury to or death of any person or damage to the property of any one person to an apparent extent equal to or greater than the minimum amount established by rule adopted by the Washington State Patrol ($700.00) in accordance with subsection (5) of this section, shall, within four days after such, accident make a written report of such accident to the Chief of Police of the city or town if such accident occurred within the incorporated city or town or the County Sheriff or State Patrol if such accident occurred outside incorporated cities and towns. C. Nothing in this subsection prohibits accident reports from being filed by drivers where damage to property is less than the minimum amount or where a law enforcement officer has submitted a report. D. In summary, when law enforcement reports to the scene, they will complete the vehicle collision report if they make the judgment that damages exceed the minimum dollar amount as set by the state. For accidents/incidents that law SCARP 9/15/2009 Page 4 of 6

enforcement does not report to render assistance at the scene, each driver involved must complete and mail in a collision report if damages are estimated to be over the state minimum ($700.00). NOTE: When called to the scene of an accident in which law enforcement has not responded, the Loss Control Specialist will make a best guess estimate on associated repair costs for determination on weather a collision report is required to be submitted. If repair costs are not originally identified as being equal to or above seven hundred dollars but later, such as at the repair shop, determined to be, a collision report must be submitted at that time. E. Damage to property includes: repair costs, replacement costs, shop rates, inspection costs or the cost of any work determined to be necessary to bring the property back to the original condition prior to the incident. Persons responsible for the repairs of the property will make the determination of cost. F. Vehicle towing costs are not included in the damage cost. However, damage during extraction of a vehicle that came to rest off the roadway could be included because it would be reasonable to expect that some vehicles simply can t be extracted without causing some damage. Excessive damage caused by the tow company as a result of incompetence or equipment failure shall be the responsibility of the towing company. VIII. PROPERTY DAMAGE (Facilities and Private Property) A. Notify your Supervisor immediately. If your supervisor is not reachable, immediately contact the Risk Management Department for reporting and assistance. B. Do not leave the scene unless instructed to do so by Law Enforcement and/or Risk Management representatives. NOTE: Supervisors must immediately notify a Loss Control Specialist and/or the Risk Management Supervisor twenty-four (24) hours a day, seven (7) days a week. (See contact numbers listed at end of this policy). IX. INCIDENT/NEAR MISS REPORT A. Close calls or near miss accident reports are exceptionally valuable as a training tool as well as a warning of impending problems. Supervisors must promote reporting these occurrences with their employees in written format so that the issue can be handled effectively. After evaluation, these reports shall be forwarded to the Risk Management Office for further evaluation and recommendation for corrective actions. NOTE: The accident scene shall be preserved until released by the Risk Management Office. In cases involving law enforcement, the law enforcement investigating officer is in charge. SCARP 9/15/2009 Page 5 of 6

X. RISK MANAGEMENT SUPPORT A. Risk Management Office hours are Monday through Friday from 8:30 am to 5 pm. B. Loss Control Specialists from the Risk Management Department support a seven (7) day a week, twenty-four (24) hour a day after hours and weekend On-Call schedule. C. If circumstances present an inability to contact a Loss Control Specialist, contact the Risk Management Supervisor. Notify the Risk Management Office or the On-Call Loss Control Specialist as soon as possible, regardless of when the accident occurred and is required 24 hours a day / seven days a week: STEVE BARTEL Risk Management Supervisor 477-6113 (office) 953-3234 (cell phone) 233-8424 (home) CINDY CLOSE Loss Control Specialist 477-6102(office) 991-2955(cell phone) 953-9173 (home) CLIFF BERG Loss Control Specialist 477-6101 (office) 953-2886 (cell phone) 928-0674 (home) JOHN FOSTER Loss Control Specialist 477-6102 (office) 209-0141 (cell phone) 299-6777 (home) SCARP 9/15/2009 Page 6 of 6