1. ACCIDENT INVESTIGATION FOR SUPERVISORS

2. Kelley Ireland Worker’s Compensation Program Manager Tucson, AZ Tucson, AZ 520-792-1450 ext 6082 Kelley.ireland@va.gov

3. Purpose  Broaden and develop knowledge of proper accident investigation  Work together as a team with Safety during accident investigations and the development of accident prevention countermeasures

4. Purpose  Identify/analyze accident trends  POWER Initiative – Target reductions in accidents/injuries

5. Objectives How accident investigations relate to WC case management  VA Form 2162 - Incident Report  CA 1 & 2 Preserve critical information at accident scene  What supervisors need to know  Information collection techniques & tips  Determine root causes

6. Reduce potential for similar employee injuries  Hazard recognition - mitigate subsequent injuries  Foster alliance with Safety/Workers’ Comp/TORT  Create safer work environment Reduce operational costs  Direct costs versus indirect costs  (Medical bills are not the end of the story)

7. Observe and analyze trends  Countermeasures and observations are key to prevention  Near miss today could mean accident tomorrow Compare accident reports to CA forms  WC writes better/more timely challenges based on information gained from good supervisory investigations  Why VA Form 2162 and CA-forms must match

8. …and finally Save VA money  Claims pay outs on questionable WC claims  TORT Claims and associated legal costs  Provide accurate information that can be used in litigation

9. POWER Initiative On July 19, 2010, President Obama established a 4-year “Protecting Our Workers and Ensuring Reemployment” (POWER) Initiative The scope of POWER is to extend prior workplace safety and health efforts of the Federal Government by setting more aggressive performance targets Each Federal agency is to improve performance in seven areas

10. What are the initiatives and what do they really mean? 1. Reduce total injury and illness case rates (Less claims = safer employees and workplaces) (Less claims = safer employees and workplaces) 2. Reduce lost time injury and illness case rates (Lost time injuries and illnesses are the most severe so we want to reduce them) (Lost time injuries and illnesses are the most severe so we want to reduce them) 3. Analyze lost time injury and illness data (Identify trends - what injuries are happening where, why and by whom to enlist improvements) (Identify trends - what injuries are happening where, why and by whom to enlist improvements)

11. 4. Increase timely filing of workers’ comp claims (Claims processed immediately aid injured worker in getting benefits and in healing) 5. Increase timely filing of wage loss claims (Injured employee gets paid on time – no loss of income) 6. Reduce lost production day rates (Less injury time more production to unit)

12. 7. Speed employee’s return to work in cases of serious injury or illness (Reduces financial and emotional impact of injury when employee is back at work. Employee is “back in the saddle again”)

13. Form 2162 Incident Report  Must be completed for all accidents regardless of extent of injury or amount of damage  Should not differ from information on CA forms  Data mined from Incident Report ensures correct data is captured for Bureau of Labor Statistics & OSHA Log  Stats can be used to monitor, create and alter current workplace safety programs  Data can be used to identify trends and generate accident countermeasures

14. What is the definition of an accident? The National Safety Council defines an accident as: “An undesired event that results in personal injury or property damage.”

15. Definition of “Near Miss” Near miss describes events where no property was damaged and no personal injury sustained, but given a slight shift in time or position, damage and/or injury could easily have occurred. Near miss describes events where no property was damaged and no personal injury sustained, but given a slight shift in time or position, damage and/or injury could easily have occurred.

16. OSHA Regs - Accident Investigation 1960.29(d) The investigative report of the accident shall include appropriate documentation on date, time, location, description of operations, description of accident, photographs, interviews of employees and witnesses, measurements, and other pertinent information. A copy of the investigative report required by this section shall be forwarded to the official in charge of the workplace, the appropriate safety and health committee, and the exclusive employee representative, if any.

17. When should an investigation be conducted? Immediately after all incidents, whether near miss or actual injury/damage event Who should do it? The supervisor in charge of the activity or operation and for severe or serious injury, the facility Safety Professional

18. Why Me? (Or… “Is this why I make the big bucks?”)  Supervisors are in charge of the operation or activity  You know the ropes, the job tasks and the employees involved - you’re experienced!  You know the terminology and how work should be conducted  You know the hazards  You know the layout of the area and the equipment

19. Who should support me in every work related Injury/Illness Investigation? Safety Officer The Safety Officer is responsible for obtaining an investigative report for every accident which must be retained for a minimum of 5 years and is subject to review and inspection by the Department of Labor.

20. Can anyone else help me investigate? In the event more expertise is required or after a serious event, of course!  Police or emergency services  Safe Patient Lifting Coordinator  Patient Safety Advocate  Employees at the scene  Environmental services – Industrial Hygiene  Ergonomist

21. Where do I begin? Start with the 6 key questions Who?What?Where?When?Why?How?

22. Investigation Tips Get to the scene as quickly as possible Preserve critical information Photos Photos Measurements Measurements Lighting Lighting Layout Layout Hazards present Hazards present Get witness statements immediately  Though they witnessed the same event, stories vary because of perceptions  Stories change when people talk  People forget very quickly

23. The Ebbinghaus Curve How quickly we forget In 1885, Herman Ebbinghaus did an experiment where subjects memorized a list of meaningless three letter words and tracked how quickly his subjects forgot the words Learners rapidly forget information In the case of meaningless information, only 20 minutes afterward, they only remember 58% of the information

24. Investigation Tips  Secure the accident scene and ensure your own safety  Distinguish fact from opinion  Conduct thorough interviews with those involved who have knowledge of the incident  No such thing as too much information  Don’t ask “leading questions” of employees or witnesses …”You weren’t wearing your seat belt, were you?”

25. Investigation Tips  Don’t assign blame  Get witness statements immediately  Just the facts ma’am, just the facts  Opinions, gossip and hearsay don’t matter  Listen carefully  Document everything  Look for causal factors (there are usually several factors that lead to the accident – not just one thing!)

26. Make sure you have the tools you need to conduct your investigation  Container for investigation materials  Paper and pens/pencils  Tape measure or other measuring device  Clipboard  Camera  Flashlight/extra batteries  Protective gear

27.  Barricade tape  Nitrile or latex gloves  Digital or tape recorder  Witness forms  Sign-in sheet (for employees on scene at the time of the incident)  Sticky notes  Business cards  Baggies (sealable)  Flares  Water  Accident forms  Maps  Rain gear

28. Contributing factors  Weather  Work hours  Layout  Ergonomics  Traffic patterns  Short-cutting  Haste  Lack of training/experience  Obstructions  Work practice methods  Equipment condition  Environmental or physical hazards  Skills/abilities of worker  Lack of enforcement

29. And now the report… Write in a narrative style Remember the 6 key questions! Who?What?Where?When?Why?How?

30. Which narrative is best to describe an accident that happened at your facility? Worker slipped and hurt his knee when he fell to the floor

31. Or… On Thursday, May 24, Nurse’s Aid Adam Briscoe, slipped and fell on water tracked into the building from a rain storm at the hospital’s north entrance. Adam struck his right knee against the floor. He was not wearing shoes with slip resistant soles. He was texting as he walked into the hospital to report for work and didn’t notice the water. He was treated by his physician who diagnosed a right knee strain/contusion. No weather matting or signs were in place near the door. Maintenance had been called earlier to mop and put signs up, but had not yet responded.

32. Why?  6 key pieces of information were identified  Hazards were identified  Contributing factors identified  Root cause can be determined from information  Preventive measures can be put in place  Future accidents/injuries can be prevented

33. What will this accident cost? It Depends! Every workplace accident or injury has both Direct and indirect costs. The direct costs, we recognize right away. Can you name some direct costs? Can you name some direct costs?

34. Direct Costs  Ambulance bill  Diagnostics – MRI, CT Scan, X Rays  Medication$  Physical therapy – Often 16 visits  $urgery  Damaged equipment or materials  Continuation of Pay (COP)

35. What is meant by “indirect costs?”  Indirect costs are “behind the scenes” costs that add additional expenses to the direct costs of an accident/injury that we often don’t even consider  Can you think of some indirect costs?

36. Indirect Costs  Hours taken for supervisor to investigate and fill out reports  Replacement costs for injured worker  Workers’ Compensation  Overtime  Lost productivity  Low morale (sick calls, short staffing)  OSHA complaints

37. Class Exercise Housekeeping Aid filed CA-2 for groin pain he sustained when stacking chairs. Date of injury: on or about 6-1-2011 Date employee filed claim: 6-30-2011 Employee took 3 weeks off between date of injury and date claim was filed, using all his accrued leave. He helped his family move household goods & belongings onto a large truck during a wildfire and moved his family to another city. The employee notified his supervisor of this before he took A/L but never mentioned an injury until after he returned to work, saying he hurt himself on June 1 and it “worsened over the month.” The employee requested COP for his time off. The supervisor was never aware that the worker had allegedly sustained an injury until his return to work, so no investigation was done, and no reports were completed. Employee took 3 weeks off between date of injury and date claim was filed, using all his accrued leave. He helped his family move household goods & belongings onto a large truck during a wildfire and moved his family to another city. The employee notified his supervisor of this before he took A/L but never mentioned an injury until after he returned to work, saying he hurt himself on June 1 and it “worsened over the month.” The employee requested COP for his time off. The supervisor was never aware that the worker had allegedly sustained an injury until his return to work, so no investigation was done, and no reports were completed.

38. The employee’s supervisor alerted WC that employee had hurriedly moved his family during the fire. He had loaded and unloaded belongings onto a large truck and could have been injured moving his family since he had not mentioned a work injury previously. Supervisor also stated the employee has a small ranch with horses and cattle to care for. He rides horses. The claimant stated he’d had a hernia repair 2 years prior and worried it might have returned. He was examined the day before he filed his claim and while being examined, he made no mention of a work related injury to the treating NP. All told, the employee visited 8 physicians or NP’s, had an ultrasound, a MRI and an Agency Medical Exam that all concurred there was no hernia.

39. See any potential issues with this claim?  What “red flags” do you see?  Could the supervisor still do an accident investigation?  Was the information he provided to WC helpful? If yes, in what way?  Was the employee entitled to COP for this injury?  What corrective actions or countermeasures could be taken after an accident of this type is claimed?

40.  Claimant was not entitled to COP because he filed an Occupational Illness, saying his pain “worsened over time”  Claimant chose NP for treatment - not authorized by OWCP  Supervisor CAN do “after the fact” accident investigation, but asking the 6 key questions, looking at the work area where the injury occurred, and observing the employee’s work methods  Maybe not as optimum as “on the spot” investigation, but still helpful  Supervisor’s information critical to WC because otherwise, no factors exist to disprove work injury

41.  Safe lifting training” (always document) for employee and others who do same work  Discussion with employee on proper accident reporting procedures  Periodic observations  On the spot corrections of unsafe practice or behavior  Change in written policy  Change in procedures for clearing room of furniture to minimize lifting Possible corrective actions

42. Hmmm… let’s see  Claimant reported injury “after the fact”  Claimant reported his intentions to move family to his supervisor and spoke of having done so after return to work  Claimant engaged in outside activities that could have caused a muscle strain  Claimant used all his leave because “he thought he should” without a physician's medical rationale supporting his idea

43. Recordkeeping Information on CA-1(Injury) and CA-2 (Illness) Forms should be compared to the information on VA Form 2162 This provides a means of checks and balances between Injury Compensation and Safety OSHA can audit this information. It should be the same

44. 1. Which form is completed by the supervisor of the employee involved in any accident regardless of the extent of the injury or amount of damage? a. No forms are necessary a. No forms are necessary b. VA Form 2162 b. VA Form 2162 c. Note to self c. Note to self

45. 2. The local facility retains their copy of the VA Form 2162/301/300 for a ____ year period per OSHA regulations a. 1 a. 1 b. 7 b. 7 c. 5 d. 2

46. 3. Writing a good accident report is important because A. It’s not important because nobody will see it after I send it in B. It is a legal document that can be used after- the-fact by attorneys, OSHA, OWCP, TORT C. It helps Safety with record keeping, Worker’s Comp to challenge claims successfully, OSHA for recordkeeping, and the TORT Claims Administrator D. Both B & C

47. 4. Which form is completed after an employee has a hazardous materials exposure incident. a. CA-1 or CA-2 b. VA Form 2162 c. Both a and b

48. 5. The information on a CA-1 or CA-2 form should match the information on a VA Form 2162. a. True b. False

49. 6. Which of the following questions should a supervisor ask when writing a successful accident investigation?  Who, what, where, when, why and how much?  Who, what, where, when, why and how?  Who is at fault, what, where, which, when and how many?  Who, which, where, how, why and when?

50. 7. Why should I investigate accidents? A. To determine contributing factors that may have caused the accident B. To try and prevent future accidents of this type from happening again C. To try and determine root causes or systems failures D. All of the above

51. 8. What’s the big deal about investigating near misses? A. Nothing, but it gets you out of the office for a while B. Near misses have the potential to become future accidents with injuries. By investigating them, you have a chance of mitigating those factors that could otherwise have led to an injurious event C. You can identify workplace hazards or unsafe practices D. Both B & C

52. 9. Why is the Power Initiative so important and what part do I play in it? A. When an employee files a claim form, I can fill out the supervisor’s part of the claim – the CA form and the VA Form 2162 immediately. B. I can assist Worker’s Comp in designing a temporary light duty job assignment C. I don’t play any part in this. It is not my job D. Both A & B

53. 10. There have been 6 lifting injuries in your unit. Would you classify them as A. A trend B. A category C. A cause D. A hazard

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