HPM 10.7

Question 1

Any injury, such as a cut, fracture, sprain, amputation,
etc., which results from an occupational incident or exposure involving a single
causative event in the work environment. Conditions resulting from bites, such as
insect or snake bites, or from one-time exposure to chemicals are considered to be
injuries.

A. Occupational Injury
B. Occupational Illness
C. First Aid injury or illness
D. None of the above

Answer 1

Occupational Injury

Question 2

Any abnormal condition or disorder, other than one
resulting from an occupational injury, caused by exposure to environmental factors
associated with employment. This includes acute and chronic illnesses or
diseases which may be caused by inhalation, absorption, ingestion, cumulative
trauma, stress, or direct contact.

A. Occupational Illness
B. Occupational Injury
C. Miscellaneous Injury
D. None of the above

Answer 2

A. Occupational Illness

Question 3

Nondisabling injury or illness which does not
require first aid or medical treatment. Record-only incidents shall be documented
on a CHP 121E,

A. Occupational Illness
B. Occupational Injury
C. Miscellaneous Injury
D. Record only injury or illness

Answer 3

D. Record Only Injury or Illness

Question 4

Minor nondisabling injury or illness (splinter, scratch,
cut, burn, etc.) which does not involve medical treatment. Record-only and first aid
incidents shall be documented on a CHP 121E

A. First Aid Injury or Illness
B. Occupational Injury
C. Miscellaneous Injury
D. Record only injury or illness

Answer 4

A. First Aid Injury or Illness

Question 5

Injury or illness which requires more than first
aid, may require more than one-time medical care, and the employee is able to
return to work (full or limited duty) following the date of the injury or illness

A. First Aid Injury or Illness
B. Occupational Injury
C. Non Disabling Injury
D. Record only injury or illness

Answer 5

C. Non Disabling Injury

Question 6

Injury or illness which results in an employee being
unable to return to work following the date of the injury or illness.
A. First Aid Injury or Illness
B. Disabling Injury
C. Non Disabling Injury
D. Record only injury or illness

Answer 6

B. Disabling Injury

Question 7

True/False: Reasons for questioning the claim shall be
documented in detail on the employee’s CHP 121. Any additional supporting
documentation shall be attached to the CHP 121.

Answer 7

True

Question 8

True/False: A CHP 121 filed by an employee who is currently under an internal
investigation shall be marked “questionable.”

Answer 8

True

Question 9

Supervisors_________ conduct a comprehensive review of facts surrounding injury, illness, or hazardous exposure incidents.
A. Should
B. Shall
C. May

Answer 9

B. Shall

Question 10

__________ if practical shall accompany employees to their initial medical appointments and discuss work capabilities with the employees medical care providers.

a) Commanders
b) CAHP Rep
c) Supervisors
d) Managers

Answer 10

c) Supervisors

Question 11

True/False- The Division Health and Safety Coordinator shall review injury, illness, and hazardous exposure documentation forwarded by commands to ensure documentation is accurate and complete. If the documentation requires amendment, the Coordinator shall contact the originating command and resolve the issue.

Answer 11

True

Question 12

How shall a applicant injury or illness be reported?
a) CHP 121e
b) CHP 201
c) CHP 121
d) CHP 51

Answer 12

CHP 121 and in the salary portion none shall be marked

Question 13

True/False- The documentation for a volunteers injury is the same as for an employees injury.

Answer 13

True

Question 14

What shall be filled out within 24 hours of the recurrence of an injury or illness?
a) 121e
b) 121
c) 51
d) 301

Answer 14

c) CHP 51 detailing the circumstances surrounding the recurrence

Question 15

Area offices are not required to maintain a CAL/OSHA Form 300, Log of Work Related injuries and illness.

Answer 15

False They are required to be maintained at all levels from HQ down.

Question 16

How many days from the report of injury/illness do you have to log the event on the form 300?
a) 2
b) 5
c) 6
d) 1

Answer 16

c) 6

Question 17

True/False-The following injuries and illnesses are the only ones that shall be recorded (see
Annex A):
(1) All occupational illnesses.
(2) All occupational deaths.
(3) All occupational injuries

Answer 17

True

Question 18

Where are injuries and illness to be recorded on the log of an employee who is injured during a civil disturbance?
a) Division
b) Local Area
c) Area of Permanent Assignment
d) HQ

Answer 18

c) Area of Permanent Assignment

Question 19

What date do all stats on the log need to be totaled by and forwarded to their divisions?
a) June 30
b) January 1
c) January 15
d) December 31

Answer 19

c) January 15

Question 20

How long must the form 300 be maintained at the area office?
a) 1 year
b) 3 years
c) 5 years
d) None

Answer 20

c) 5 years from the end of the calendar year

Question 21

True/False- Logs must be available for inspection and copying
by representatives of the U.S. Department of Labor, the U.S. Department of Health and
Human Services, the California Dep

Answer 21

True

Question 22

Who is responsible for completion of the CHP 121?
a) Employee
b) Manager
c) Supervisor
d) Division Coordinator

Answer 22

c) Supervisor

Question 23

How long after the reporting of the injury does the employee have to sign the completed CHP 121?
a) 3 days
b) 12 hours
c) 24 hours
d) 5 business days

Answer 23

c) 24 hours

Question 24

If on temporary assignment who is required to complete the CHP 121?
a) Division
b) Area of Assignment
c) Area where incident occurred
d) None of the above

Answer 24

c) Area where the injury occurred

Question 26

True/False-If the employee refuses to sign the CHP 121C, the supervisor shall advise the employee that, pursuant to SCIF policy and procedures, refusal to sign the form may be cause for delay or denial of workers’ compensation benefits. If the employee continues to refuse to sign the CHP 121C, the supervisor shall type or print “refused to sign” in the employee’s signature block and document the refusal in the comments section of the CHP 121A.

Answer 26

True

Question 27

True/False- A doctor does not have to agree to be a pre designated provider before an injury occurs?

Answer 27

False

Question 28

True/False- A commander can order an FFD on an employee whether or not the employee has an on file injury with state fund.

Answer 28

True

Question 29

Commanders ______________ provide temporary assignments that are consistent with the employee’s medical restrictions. When considering options, consider having the employee work in other commands such as a Division or a communications center when appropriate Should Shall May

Answer 29

Shall

Question 30

Commanders shall concurrently revoke the peace officer powers and secure all state-issued firearms whenever a uniformed employee is on limited duty as a result of a _______________________, to include stress. a) Psychological reason b) Stress Reason c) Medical Reason d) None

Answer 30

a) Psychological Reason

Question 31

True/False- Employees on limited duty are allowed to drive a patrol vehicle.

Answer 31

True

Question 32

CHP 443 is utilized for what purpose? a) Secondary Injury b) Return to work c) Limited Duty Assignment d) None

Answer 32

c) Limited Duty Assignment

Question 33

Limited Duty assignments will not exceed _____ years. a) 5 b) 1 c)3 d) 2

Answer 33

d) 2

Question 34

If an employee refuses to perform the medically approved and Department-ordered limited duty, the employee shall be removed from pay status, and action to __________ employment shall be initiated. a) Suspend b) Terminate

Answer 34

b) Terminate

Question 35

Employee returning from limited duty that extends past twelve contiguous months and up to two years shall be re trained where? a) Area Office b) Division c) Academy

Answer 35

c) Academy