Presentation on theme: " Sample Training PowerPoint. Overview of workers’ compensation accident investigation process Value of investigation following an accident (whether."— Presentation transcript:
Overview of workers’ compensation accident investigation process Value of investigation following an accident (whether compensable or not) Elements of Accident Investigations
Increase your knowledge of the workers’ compensation accident investigation process Identify methods of investigation Determine the causes of accidents Identify tools used in the investigation process Fine tune your accident investigation skills
Why: To notify the employer that the employee had an injury at work so that the incident can be investigated.
(Insert your agency’s reporting policy and key process steps) Immediate written notice required Enables prompt investigation of facts Allows employer to provide necessary medical attention If the employer does not investigate, may not be able to prove the facts.
Injured worker should immediately notify his/her supervisor The supervisor should investigate or notify whoever is responsible for agency investigation immediately! Submit claim within 24 hrs.
Injury arises from a risk not shared by the general public There is a causal connection between the injury and the employment Employee exposed to a particular danger The risk is peculiar to the employment
On-Site Investigator’s Role In Workers’ Compensation Claims
Needed to assist claims staff Determine cause Document scene Document what people said and saw Prevent future accidents
Document information you hear Document the scene through photographs, sketches, written descriptions, video recordings Document evidence of non-work injury Investigate facts that contradict injured workers’ version Investigate personnel or disciplinary problems that impact the claim situation
Insert information here on your agency’s policy Do you have internal forms? Where does the investigator get the forms? Who does the documentation go to for forwarding to the claims staff? What timeframes are in place for completing the investigation? Any timeframes for follow-up for correction of hazards?
Gather contact information on witnesses & supervisors Obtain witness and supervisor names, phone numbers, best time to contact Provide this information to agency personnel to forward to WSI claims staff
Why are photographs so important ? Support facts Document scene Become the “eyes” for people not in the field May be required if litigated
Document: Who is the source Was there any possible transmission of disease Contact with cuts, scrapes Contact with eyes, nose, mouth
Insert your agency’s policy on how to handle exposure incidents here.
Claims staff receives information from agency Will investigate the Who, What, Where, When and How questions May call with additional questions or to obtain the injured worker’s or witness’s statement Claims staff determines compensability
Any unplanned event that results in personal injury or in property damage. Not intended Not reasonably anticipated
It is the reason for an action or condition; something that brings about an effect or result. (Webster’s dictionary)
The failure of people, equipment, supplies or surroundings to behave or react as expected causes most accidents. Accident investigations determine how and why these failures occur. Conduct with prevention in mind – NOT to place blame!
Assist workers’ comp claims process To be the “eyes and ears” in the field To gather facts on-site To preserve evidence that may be lost over time To determine cause of the accident To identify ways to prevent accidents from recurring
Make sure the injured worker is taken care of first Secure the scene to preserve the integrity of the scene Gather all necessary equipment to begin investigation
Do: Go to the accident site Investigate and document the cause Document supervisor and witnesses Preserve the evidence Don’t: Speculate on coverage Conduct formal interviews Give advice
Agency investigator should: Survey, secure and document the site Identify the cause Look for contributory hazards Report conclusions and recommendations
INVESTIGATE IMMEDIATELY! Don’t assume anything Obtain all possible facts Preserve the evidence Take photographs of the site Take measurements and diagram if necessary
Gather the facts What did the injured worker say happened? What did witnesses see? What did the injured worker tell witnesses? Talk to the supervisor
What did the injured worker tell you? Where and when did the accident occur? Were there any witnesses? How was the employee injured? Was training provided for this task? Were the safety rules followed?
Was the employee doing an assigned task? Had the employee been trained on the task? Had the employee ever done this task before? How often is this task performed?
Before you preserve it, let’s define it: Evidence is data, which helps to prove the event Next, decide what evidence is important Immediate photographs are critical The site could change the next day and evidence would be lost
Sites of accidents, including: Defects Hazards Unusual Conditions Conditions that differ from what the employee describes Areas or furniture in need of maintenance Housekeeping issues
Liquid substances or objects on a floor Worn treads Slippery floor (heavy wax) Loose rungs on a ladder Frayed or torn carpet Type of shoes Anything being carried Anything out of the ordinary
Sunny and clear? Rainy? Foggy? Icy? Temperature Cold Hot
Clear, unobstructed walkways Passageways and aisles free of protruding nails, loose boards Debris Unwanted Clutter Boxes in aisles Obstacles/barriers
May include the following elements: Stairs Ladders (portable, extension, etc.) Machinery, i.e. power saws Any room, i.e. training, sleeping quarters Walls Furniture, such as tables or chairs Vehicles Sidewalk cracks (take measurements)
“I was working at my desk and all of a sudden I noticed pain in my left wrist…”