Accident and Injury Reporting

Question 1

What is a hazard?

Answer 1

Work place condition that might result in injury, health impairment, illness, disease, or death to any worker who is exposed to the condition. Or might result in damage to or losss of property or equipment

Question 2

What is a hazard severity?

Answer 2

Assessment of the worst potential consequence is likely to occur as a result of deficiencies

Question 3

What is an injury?

Answer 3

Traumatic wound or other condition of the body caused by external force including stress or strain

Question 4

What is a mishap?

Answer 4

Unplanned or unexpected event causing death, injury, occupational illness, including days away from work, job, transfer, or restriction and material loss or damage

Question 5

What is a mishap probability?

Answer 5

Likelihood that a hazard will result in a mishap or loss

Question 6

What is a near mishap?

Answer 6

An act or event which injury or damage was avoided merely by chance

Question 7

What is the Web-Enabled Safety System (WESS)?

Answer 7

Web-based safety mishap data collection and reporting system

Question 8

What instruction is the DODI 6055.07?

Answer 8

Mishap Notification, Investigation, Reporting and Record Keeping

Question 9

What instruction is the OPNAVINST 5102.1D/MCO P5102.1B?

Answer 9

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

Question 10

What is the OPNAVINST 3750.6S?

Answer 10

Naval Aviation Safety Mgmt System

Question 11

What is the purpose of Mishap Investigation and Reporting?

Answer 11

1. Indentify hazards with potential to cause frequent and severe mishaps
2. Indentify hazards that could cause future mishaps
3. Identify unsafe acts and conditions
4. Indentify mishap causal factors and develop appropriate corrective actions

Question 12

What conditions require Investigation and Reporting?

Answer 12

1. Class A,B, and C gov’t property damage mishaps

2. Class A,B and C on duty DOD civilian mishaps and military on/off-duty mishaps

Question 13

What specific conditions need to be reported?

Answer 13

1. Any work related illness or injury that involves medical treatment beyond first aid
2. All on-duty military training-related fatalities and any high or moderate risk training mishaps that result in:
   a. Loss of one training day
   b. Rolling back or disenrollment of the student from a course

Question 14

Are needle sticks required to be reported?

Answer 14

Yes, any need-stick injury or cut from a sharp object that is contaminated with another person’s blood

Question 15

Does work-related tuberculosis infection need to be reported?

Answer 15

Yes

Question 16

What is Class A Mishap?

Answer 16

1. Resulting total cost of damages to Gov’t and other property is $ 2 million
2. DOD aircrafe is destroyed
3. Injury or occupational illness results in a fatality or permanent total disability

Question 17

What is a Class B Mishap?

Answer 17

1. Resulting total cost of damages to Gov’t and other property is $500,000, but less than $2 million
2. When 3 or more personnel are hospitalized

Question 18

What is a class C Mishap?

Answer 18

1. Total cost of property damages to Gov’t and other property is $50,000 or more, but less than $500,000

Question 19

What is a Class D Mishap?

Answer 19

1. Damages is $20,000 or more but less than $50,000

2. Recordable injury or illness not otherwise classified as Class A,B, or C Mishap

Question 20

Who is responsible for submitting an Accident and Injury Report?

Answer 20

1. Medical Dept will submit an A&I Report as directed by the CO, on all injuries treated by sickbay
2. Copy goes to the Safety Officer

Question 21

What is a SITREP?

Answer 21

1. Safety Investigation Report

Question 22

Who is the SITREP submitted to?

Answer 22

1. Naval Safety Center

2. Submitted through WESS

Question 23

Why are Hazard Reports Submitted?

Answer 23

Submitted for near-mishaps and situations whre lessons learned should be shared

Question 24

Who appoints a mishap investigation board?

Answer 24

ISIC or higher authority

Question 25

How many members make up the Mishap Investigation Board?

Answer 25

Minimum of 3 Members

Question 26

When does a member of medical have to be apart of the mishap investigation board?

Answer 26

If a fatality was involved

Question 27

When does a Mishap Investigation Report (MIR) need to be submitted?

Answer 27

Within 30 days to the Navy Safety Center

Question 28

What is an SF 513?

Answer 28

Consultation

Question 29

What is a Local Form or SAMS Program?

Answer 29

Accident and Injury Report