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HomeMy WebLinkAbout700-03O R T ti ° PC)LI Y & PRQCEDURE a9 4a P rE4 SEPtE O Subject; Index: SAFETY ACC[DENT EZEPQRTING N z' EM PLOY.EE-V EHICLE-PROPERTY) 700-03 Effective Date. Supersec es: Page Of3 Prepared by: Approved by: 1-1-1987 6-1-198Q M. McDowell L DA3t.,J!},'11'i OC 1.0 Pt7RPOSE: To establish pracedures for acczdent reparting. 0 ORCxANI7_,ATIONS AFFECTED: All departmentsJdivisions. 0 REFERENCES: Not applicable. a a..lc T: 1 1 an effort to prevent costly accidents, improve ineffective wark habits and procedures, ravide picture of accident causes and indications of safety and training deficiencies, all accidents involving injury to City ernplayees or private individuals through some action of tlie C:ity or daniage to City vehicles or property, or damage by City vehicles or employees to private property shall be reported according to the following procedures. 0 DEFINITIC}NS: Not applicable. G.0 PROCEDURE: 6.1 fivery incident invoiving injury to eznployees or private individuals thraugh some actiaz of the City ar damage to City property, equapment or vehicies by employees ar lamage to private property caused by the City wilt be ir vestzgated by the appropriate supervisor. Circumstances and conditions surroundil g the incident, assessnlent of respoi sibility and recommendations for prevention will be notetl. At t}xe discretion of the supervisor, or upan request of the employee, the Cl airm n of ihe Central S fety Committee or tl e Safety Coordinator may be called to the sce xe. 700-03 ACCIDENT REPORTING (EMPLOYEE-VEHIGLE-PRC7PERTY) PAGE 2 6.2 Na later than two working days from the date of the incident, the correct reporting forms must be completed and forwarded as speci£ied in the fallawing sub-sections. 6.2.1 Vehicle Accidents When an incident involves damage to a City vehicle or damage is caused ta a private vehicle, the supervisor must complete a City of Renton Vehrcle Accident Report (Form# lOF-28) and forward it to the Safety Coordinator in the Personnel Department. A Gallagher Bassett, Inc. form, Accident Report, Auto and `ruck {Form# G-112R}, must also be completed and farwarded to the Claims Coordinator in the Finance Department. Capzes af bath forms are in envelopas marked "Accident and Property Loss Reporting Procedures," which are kep# in the glove campartment of City vehicles. If an envelape containing the forms is missing from the vehicle, replacements may be obtained from the Finance Department. 6.2.2 Dama,e to Citv Pror ertv Other Than Vehicles In the case of loss or damage ta City praperty other than vehicies, the Gallagher Bassett, Ine. form, Loss R port-Property (Form# G-220R}, shauid be completed and forwarded to tha Claims Coordinator, Finance Department. This form can also be found in the envelope marked "Accident anfl Property Loss Reporting Procedures° Qr may be obtained from the Finance Department. 6.2.3 Boclilv Iniurv to Private Citizens or Dama e to Private Pronertv Badily injury ta someone wha is not emplayed by the City of Renton or wha daes not serve the City in an o£ficial capacity as weli as damage caused by the City to private praperty, except for damage to private vehicles, must be reported on the Gallagher Bassett, Inc. form, Aecident Report- Gerzeral/Prc duct Liability (Form# G-113R), and forwarded to the Claims Coardinator, Finance Department. The farm is part of the package in the envelope marked "Accident and Property Loss Reporting Procedures." Copies rnay atso be obtained from the Finance Departm nt. 6.2.4 EmpiOVee InjurV 1. All injuries to employees at work must be investigated and City af Renton form, Supervisor's Repar t of Ir cicter t (Form# IOF-27}, cornpleted by the supervisar for accidents involving gener-al emplayees. For emplayees covered by the LEOFF system, anothex City of Rentan form, ,Supervisor's Accident/Irijur.v Rep r•t-Police ancZ Fire (LE FF) Persnrmet (Farm# IOF-24}, should be used in place of Form# lOF-27. These forms are for internal reporting purpases t nly and should be submitted for all en playee injur}t incidents whether or not medical care is required. In both cases, the form should be forwarded to the Safety Coordinatar in the Personnel T epartment. Forms are available ir department offices and the Personnel Department. 740-Q3 ACCIDENT REFORTING (EMPLOYEE-VEHICLE-FROPERTY) PAGE 3 2. When an empioyee's on-the-job injury requires the attention of a physician, the physician should be provided with a Washington State Department of Labor and Industries form, Physrcians Initiat Report, for self-insured empioyers. The injured employee and his{her supervisor must complete a second Department of Labor and Industries forrn, Sel f Insurers Accident Repart (Forrn# SIF-2) and forward it to the Safety Caordinator, Personnel Department. Both forms may be found in envelopes marked "Industrial Injury Claims Package," which are available in departrnent offices and the Persannel Department. 3. If an injured empiayee misses work in addition to the day of injury because of an on-the-job accident, the supervisor must comptete Supervisor's Report, 4n-the-Job Irzjury 1'ime Loss Report (Form# lOP-31) forms for the entire period of the employee's absence. The white copy shauld be forwarded to the Safety Coordinator, Personnel Department, the yellaw copy sent to the Payroll Clerk in the Finance Department, and the pink copy sent to the department payroll clerk. The form is available in department affices and the Personnel Department. 4. More detailed infarmation on reporting procedures for on-the-job injuries may be found in City of Renton Policy and Procedure nurnber 700-09. 5. The procedures outlined in sub-section 6.2.4(2) concerning injuries requ3ring medical attention do not apply to LEUFF I Palice and Fire persannel. LEOFF I persannel shoutd abtair medical caz-e through their C3ty medicat insurance plan as they wauld far non- vork related injuries and illnesses, but physicians and ather providers of inedical or related services shauld be informed that treatment is required because of an on-the-job injury. The provisions of sub-sections 62.4(1) and 6.2.4(3) apply to all City employees, including LEOFF I personnel. 6.2.5 Maior Accidents In the case of a majar accident resulting in severe injury, death or significant property ]ass, the City"s ansurance elaims adjuster, Gallagher Bassett, Inc., should be notified immediately by telephone (455-4054} on a 24-haur per day basis. Severe injury or death should also be reported to the Personnel Department (2556) immediately ar, if the accident occurs after normal affice hours, at t17e beginning of the next work day. G.3 The lag af occupational injurzes and illnesses required by OSH.j VISHA is maintained in the Personnel Department and 'zs availabie for inspection upon req est.