Accident and Injury Report

Question 1

DODI 6055.07 (6 Jun 2011)

Answer 1

• Mishap Notification, Investigation, Reporting and Record
  Keeping.

Question 2

OPNAVINST 5102.1E

Answer 2

– Navy & Marine Corps Mishap and Safety
Investigation, Reporting and Record Keeping Manual

Question 3

OPNAVINST 3750.6S

Answer 3

• Naval Aviation Safety Management System

Question 4

Class A Mishap

Answer 4

Total damage of $2m or more
Loss of a ship
Death or total disability of a person

Question 5

Class B Mishap

Answer 5

500k- 2M of equipment destroyed
Permanant partial disability of a person
3 or more people hospitalized in a single event

Question 6

Class C Mishap

Answer 6

50k- 500k loss of equipment
Nonfatal injury resulting in 1 or more days of work missed

Question 7

Class D Mishap

Answer 7

20k- 50k of equipment lost
Other injury or illnesses not listed as class A, B, C

Question 8

Mishap Report Types

Answer 8

Accident and Injury Report
Safety Investigation Report
Hazard Reports

Question 9

What does the saftey Officer do when a mishap is reported to them?

Answer 9

Conducts an Investigation

Question 10

How many people need to be on an investigation board? Who assigns them?

Answer 10

3, ISIC

Question 11

Max time you can wait to submit a Mishap Investigation report (MIR)?

Answer 11

30 days

Question 12

Forms used in recording Occupational injuries

Answer 12

SF 600
ETR SF 558
SF 513 Consultation sheet
Accident Injury Report

Question 13

Manual for Navy and Marine corps mishap and safety investigation reporting?

Answer 13

OPNAV 5102.1E

Question 14

Conditions where a mishap report and investigation are needed. (3 most important)

Answer 14

10db or more hearing loss
Government vehicle incidents resulting in 5000 damage
Any medically diagnosed work related injury or illness

Question 15

Mishap report types

Answer 15

Accident and injury report
Safety investigation report
Hazard Report`

Question 16

Who appoints a mishap investigation board?

Answer 16

ISIC

Question 17

Mishap Investigation and Reporting Purposes

Answer 17

To identify hazards with potential to cause frequent and severe mishaps.
To identify unsafe acts and conditions and apply corrective measures.

Question 18

Who submits a A&I report?

Answer 18

Medical and a copy to the Safety O

Question 19

Who is a Safety Investigation Report submitted to?

Answer 19

CO of Naval safety Center

Question 20

Mishap investigation and reporting purposes

Answer 20

To identify hazards with potential to cause frequent and severe mishaps
To identify unsafe acts and conditions and apply corrective measures