1. ACCIDENT REPORTING
updated 7/22/13

2. Accident / Work Related Injury Reporting
Employee Responsibilities
- all accidents, injuries, work related illnesses, and near
miss accidents are to be reported to the Departmental
Supervisor immediately
Supervisor Responsibilities
- notify first aid personnel or send to MedPro or
- secure the area
- notify Safety / Loss Control Manager
- complete accident report within 24 hours
updated 7/22/13

3. Continued
If the employee is to be drug tested, injured employee is to be escorted to and from provider site (mandatory in auto accident)
updated 7/22/13

4. Forms to Complete Accident Report Form Accident Investigation Form
Employee Return to Work Information
If lost time, complete weekly until employee returns to work without restrictions
updated 7/22/13

5. The Investigation The Supervisor / Department Head or
Safety / Loss Control Manager will conduct
the investigation
Witness Reports are recommended
The supervisor will complete the corrective action following the investigation
updated 7/22/13

6. Recordkeeping OSHA Form 200 will be completed by the
Safety / Loss Control Manager
Records will be posted February 1st until
April 30th following the recorded year
Records to be retained 5 years
updated 7/22/13