Accident Injury Report

Question 1

What is Hazard ?

Answer 1

A work place condition that might result in injury, health impairment, illness, disease, or death to any worker who is exposed to the condition, or which might result in damage to or loss property or equipment

Question 2

What is Hazard severity ?

Answer 2

An assessment of the wort potential consequence is likely to occur as a result of deficiencies

Question 3

What is injury?

Answer 3

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

Question 4

What is mishap ?

Answer 4

Any unplanned or unexpected event causing death, injury occupational illness

Question 5

What is mishap provability ?

Answer 5

The likelihood that a hazard will result in a mishap or loss

Question 6

what is WESS

Answer 6

Web enabled safety system (WESS) safety mishap collection and reporting system developed for the NAVY and USMC by COMNAVSAFECEN

Question 7

Which is the mishap notification, investigation, reporting and record keeping instruction ?

Answer 7

DODI 6055.07

Question 8

which is the Navy & marine corps mishap and safety investigation, reporting and records keeping manual

Answer 8

OPNAVINST 5102.1D/MCO P5102.1B

Question 9

Naval aviation management system instruction?

Answer 9

OPNAVINST 3750.6S

Question 10

What is the purpose of mishap investigation and reporting ?

Answer 10

• Identify potential, frequent and severe mishaps
• identify hazards that could cause future mishaps
• To identify unsafe acts and conditions and apply corrective measures -

Question 11

What is the reporting required condition that is related to some disorder and diseases ?

Answer 11

Any medically diagnose work related illness and injury such as cumulative trauma disorders or musculoskeletal disease

Question 12

List the 3 types of class A mishap ?

Answer 12

a. resulting total cost of damages to government and other property is $2 million dollars or more
b. DoD aircraft is destroyed
c. An injury or occupational illness results in fatality or permanent total disability

Question 13

List the 3 Class B mishaps ?

Answer 13

a. total cost of damage to goverment and other property is $500,000 or more, but less than $2 million
b. An injury or occupational illness permanent partial disability
c. When 3 or more personnel are hospitalized for inpatient care as a result of a single mishap

Question 14

Class C mishaps ?

Answer 14

a. property damage or loss to government and other property is $50,000 but no more than $500,000
b. nonfatal injury or illness that results in 1 or more days away from work

Question 15

Class D mishaps ?

Answer 15

a. resulting total cost of property damages is $20,000 or more, but less that $50,000
b. Recordable injury or illness not otherwise classified as a Class A, B, C mishap

Question 16

What is the role of the MDR regarding the accident and injury report ?

Answer 16

will submit the report as directed by the CO on all injuries treated in sickbay in accordance with ships policy and provide a copy to the safety officer

Question 17

What is SIREP what are the ways to submit it ?

Answer 17

Submit to commander Naval Safety Center (COMNAVSAFECEN)

Via WESS or using WESS-DS Via email if internet connectivity is a problem

Question 18

What is HAZREP ?

Answer 18

Submitted for near mishaps and situations where lessons learned should be share

Question 19

When a mishap occurs how do you notify the safety officer ?

Answer 19

Via injury report, deck log entry, or by the department head

Question 20

Who is responsible for ensuring an investigation is conducted, who appoints the investigation board, how many members and who is appointed if a fatality was involved and who is not a member but may assist ?

Answer 20

the safety officer make sure there is an investigation and the ISIC appoints the board with minimum 3 members with a medical member is a fatality was involved

Question 21

Within what time frame is a MIR be submitted

Answer 21

30 days

Question 22

Which are the injury recording forms ?

Answer 22

SF600
SF558 emergency treatment record
SF 513 consultation
SAMS report or local form