Office of Procedures, Records, and Forms Safety Policies and Procedures Manual

GENERAL WORKPLACE SAFETY
2.24
Revised 7-17
Environmental Health and Safety
509-335-3041
Human Resource Services
509-335-4521
Risk Management Services
509-335-6893

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Reporting Accidental Injuries and Work-Related Illnesses

Reporting

University faculty, staff, volunteers, and students are to promptly report all accidental injuries and work-related illnesses to immediate supervisors for evaluation and possible investigation.

Supervisors of University departments coordinating the use of University facilities or University-sponsored activities are responsible for reporting all accidental injuries incurred by individuals who are not employed by WSU.

Supervisors must report major accidents immediately. Major accidents include work-related fatalities, inpatient hospitalizations (i.e., admitted into a hospital), amputations (including finger tip), and loss of an eye. Contact the applicable offices listed in the Reporting Major Accidents table.

For all other incidents, supervisors must report work-related injuries and  illnesses within 24 hours of occurrence (see Accidents/Illnesses).

EXCEPTION: Supervisors must report any accidental injury or work-related illness affecting a swing- or graveyard-shift employee within 48 hours of occurrence.

Accidents/Illnesses

Accidental injury and work-related illness reporting includes the following:

  • Notification of emergency medical assistance when required; telephone 911.
  • Immediate notification of appropriate University offices when a major accident occurs (see Major Accidents and the Reporting Major Accidents table).
  • Submission of an online Incident Report by the responsible supervisor within 24 hours (or within 48 hours for a swing- or graveyard-shift employee). See Incident Report Form Completion.
  • Notification by the supervisor to the unit’s top administrator and the appropriate safety committee chair of all major accidents.

Major Accidents

Immediately report all major accidents affecting WSU personnel or nonemployees to the offices indicated in the Reporting Major Accidents table. (See also Nonemployee Injuries regarding nonemployees.)

NOTE: If unable to contact personnel at the appropriate University office (see the Reporting Major Accidents table), contact WSU Police Services; telephone 509-335-8548.

The offices indicated in the table below investigate major accidents and notify other appropriate University units and/or request assistance as needed. See SPPM 2.26 for investigation procedures.

Non-Pullman Locations, All Injured Persons

The local Environmental Health and Safety (EH&S) unit takes the lead in major accident investigations at non-Pullman locations and coordinates with appropriate WSU Pullman departments (see the Reporting Major Accidents table). If no EH&S staff are assigned to a specific location, the chief administrator assigns investigation responsibility to a trained local investigator and/or coordinates with Pullman departments.

Reported Information

Report the following:

  • Names and telephone numbers of victim(s) and witnesses
  • Date, time, and location of the incident
  • Description of the incident
  • Involved University department(s) and units
  • Contact person and telephone number
REPORTING MAJOR ACCIDENTS

If the Injured Person is a:Contact Investigating Office(s):Telephone:
Student (nonemployee)

PRIMARY:  Risk Management Services
(Coordinating with Public Safety as needed.)

SECONDARY:  Environmental Health and Safety (EH&S)

In Whitman County:
509-335-3041 during business hours;   
911 after business hours

Outside of Whitman County:   
509-332-2521 (24 hours/day)

Residence hall occupantResidence Life--Central Staff509-339-0285
USDA-ARS employeeUSDA-ARS Safety, Health, and Environmental Management Office509-335-3238
Any employee (including student employees) and/or
Any volunteers


Both EH&S


AND
In Whitman County:
509-335-3041 during business hours;   
911 after business hours

Outside of Whitman County:   
509-332-2521 (24 hours/day)
Human Resource Services509-335-4521 during business hours
509-335-1760 after business hours (voicemail message only)
VisitorPRIMARY:  Risk Management Services
(Coordinating with Public Safety as needed.)

SECONDARY:  EH&S

In Whitman County:
509-335-3041 during business hours;   
911 after business hours

Outside of Whitman County:   
509-332-2521 (24 hours/day)

Student Accidents

For any injuries to students, Human Resource Services (HRS) forwards a copy of the completed Incident Report to the Dean of Students office upon submission.

Work-Related Accidents

Supervisors must report any accidental injury or work-related illness within 24 hours of occurrence (or within 48 hours of occurrence for a swing- or graveyard-shift employee) by submitting an Incident Report (see Incident Report Form Completion).

Investigation of Major Work-Related Accidents

Environmental Health and Safety and WSU Police related accidents which result in death or in-patient hospitalization.

The reporting party reports to both EH&S and WSU HRS to coordinate notification to the State of Washington Department of Labor and Industries, Division of Occupational Safety and Health.

Equipment Removal

Do not move equipment involved in a major work-related accident or workplace fatality unless removal is necessary for victim extraction or to control hazards.

Time Loss

Supervisors immediately telephone HRS to report work-related injuries and illnesses involving lost time from work; telephone 509-335-1760.

More Than One Work Shift

Send a copy of the Leave Report or Time Report to HRS when time loss exceeds one work shift.

Supervisor’s Accident Investigation Report

In addition to submitting the online Incident Report, the supervisor is to complete a Supervisor’s Accident Investigation Report when:

  • Employee receives medical treatment.
  • Employee is unable to work the next full or subsequent shift(s) as a result of an injury or work-related illness.
  • Events and conditions related to a near miss or minor accident indicate that a potentially serious injury or illness could result from a similar situation.

See SPPM 2.26 for investigation procedures.

Motor Vehicle Accidents

For an accident involving a motor vehicle, regardless of how minor, the driver must immediately notify his or her supervisor, Risk Management Services, and the Motor Pool (if a Motor Pool vehicle was involved). See SPPM 7.20.

For an accident involving a motor vehicle with injuries, the driver must also immediately notify the local area law enforcement department. Law enforcement personnel should investigate all accidents resulting in any of the following:

  • Damage costing over $1000 to motor vehicles
  • Damage to other property
  • Injuries to individuals

The driver must submit a completed Vehicle Accident Report to Risk Management Services within two working days (see SPPM 7.20).

Nonemployee Injuries

University departments coordinating the use of University facilities or University-sponsored activities are responsible for reporting all injuries incurred by individuals who are not employed by WSU. Risk Management Services notifies the state of Washington’s Torts Claims Division of nonemployee injuries when required. The injured nonemployee may file a claim for damages against the state of Washington (RCW 4.92). Claim forms and instructions are available from Risk Management Services.

Nonemployee Students Injuries

For any injuries to nonemployee students, the responsible University department must submit a completed Incident Report to HRS within 24 hours (see Incident Report Form Completion). Human Resource Services forwards a copy of the completed Incident Report to the Dean of Students office upon submission.

Volunteers

For injuries to volunteers, the responsible University department must submit a completed Incident Report to HRS within 24 hours (see Incident Report Form Completion).

Visitors

For injuries to visitors, the responsible University department must submit a completed Incident Report to HRS within 24 hours (see Incident Report Form Completion).

Federal Employees

For injuries to federal employees, e.g., USDA-ARS, follow the procedures outlined in OOL (Office of Legal Counsel) Form CA-10: What a Federal Employee Should Do When Injured at Work. This form indicates actions a federal employee should perform after being injured at work.

For more information, see the U.S. Department of Labor website at:

www.dol.gov

CA-10 forms are available at applicable USDA-ARS units.

Incident Report Form Completion

The responsible supervisor is to complete an online Incident Report, within 24 hours (or within 48 hours for a swing- or graveyard-shift employee), to report any accident, injury, work-related illness, or workplace fatality that results from participation in any of the following activities:

  • University employment
  • Use of University facilities
  • University-sponsored activities
Accessing the Form

To access the online Incident Report system, go to the HRS Incident Report website at:

ihr.hrs.wsu.edu/forms/incident_report.aspx

Enter all pertinent information as prompted at each screen.

Verifying Circumstances

The supervisor verifies the actual circumstances of the incident by interviewing the injured person, witnesses, and other involved individuals.

Amending a Report

To amend a previously-submitted Incident Report, complete and submit another report. Include the employee’s name, date of accident, and the new or updated information. Enter the word “Amend” in the Complete Description of the Incident field.

Questions

Address questions regarding the Incident Report to EH&S; telephone 509-335-3041, HRS; telephone 509-335-4521, or Risk Management Services; telephone 509-335-6893.

Attachments

To submit any attachments, print a copy of the submitted Incident Report form. Attach the additional documents as needed. See Routing the Incident Report and Attachments for routing instructions.

To load and print a previously submitted Incident Report, select Load a Saved Form from the initial Incident Report screen.

Witness/Injured Person Statement (Optional)

If an injured person wishes to document an incident he or she may elect to complete and submit a Witness/Injured Person Statement form. Print the master Witness/Injured Person Statement to obtain supplies of the statement form.

The supervisor submits copies of this form to HRS and references the Incident Report submitted to HRS and the department’s safety committee.

Supervisor’s Accident Investigation Report

The supervisor is to attach a completed Supervisor’s Accident Investigation Report when applicable (see Supervisor’s Accident Investigation Report).

Workers’ Compensation

NOTE: Submittal of the Incident Report does not constitute the filing of a claim for Workers’ Compensation benefits. Refer to SPPM 2.30 for Workers’ Compensation claim procedures.

Routing the Incident Report and Attachments

Upon submission, the online system sends copies of the Incident Report form to HRS, EH&S, and the reporting supervisor. If the injured party is a student, the system also sends a copy of the report to the Dean of Students office.

Risk Management

If applicable, HRS forwards a copy of the Incident Report to Risk Management Services.

Human Resource Services (HRS)

If applicable, the supervisor routes a Supervisor’s Accident Investigation Report and any attachments to HRS. (See Supervisor’s Accident Investigation Report.) Reference the date of the Incident Report and the name of the injured party on all attachments.

Environmental Health and Safety (EH&S)

HRS retains the originals and forwards copies of the attachments to EH&S.

Safety Committee

The department prints and routes a copy of the Incident Report with any attachments to the department’s safety committee representative. The safety committee reviews the incident and forwards any recommendations to the unit administrator.

To load and print a previously submitted Incident Report, select View a Saved Form from the initial Incident Report screen at:

ihr.hrs.wsu.edu/forms/incident_report.aspx

Affected Party

Route a copy of the Incident Report and any attachments to the affected party.

Related Procedures

See SPPM 2.30 for workers’ compensation procedures.

See SPPM 2.32 for return-to-work procedures.

See BPPM 50.30 for workplace violence procedures.