HPM 10.7 Chapter 1-4

Question 1

1. The injury and illness case management program has been developed to reduce the _______ and _______ impacts occupational injuries and illnesses have on employees and the Department.

Answer 1

Human and Fiscal 1.1,2

Question 2

. Define SCIF

Answer 2

State Compensation Insurance Fund 1-3,m

Question 3

Give examples that are associated with Cumulative Trauma.

Answer 3

Noise induced hearing loss, bursitis, heart attack, hemorrhoids (Celaya Specific) 1-4,s

Question 4

What are the four units of the Health and Safety Section?

Answer 4

Occupational Safety Unit
Disability and Retirement Unit
Physical Standards/Wellness/Reinstatements Unit
Data Entry/Clerical Support Unit
1-5,y

Question 5

What four notices that are required to be posted in a conspicuous place by employers?

Answer 5

1. STD 621 – Notice to State Employees
2. Safety and Health Protection on the Job
3. Cal-OSHA S-11 – Access to Medical and Exposure Records
4. OSHA No. 200 – Log and Summary of Occupational Injuries and Illnesses
   1-5,a-d

Question 6

What shall be documented on the CHP 121 for review?

Answer 6

Information relevant to the extent of the injury, illness, or exposure and its causes, including prior injuries, illnesses, or exposures.
2-3,c

Question 7

If there is any reason to question the claim of a work related illness/injury where should it be documented?

Answer 7

CHP 121 (2-3,1d)

Question 8

Who determines the preventability of an illness/ injury/ hazardous exposures?

Answer 8

Commander 2-3, e1

Question 9

Commanders or their designees _______ personally meet with the employees to review the reasons their injuries, illnesses, or hazardous exposures were deemed preventable.

Answer 9

Shall 2-3,e2

Question 10

Employees ________ appeal the determination of preventability to their command’s occupational safety committees.

Answer 10

May 2-4, 3

Question 11

Medical Bills received by the command _____ be expeditiously forwarded directly to ____________ _____________ __________.

Answer 11

Shall – Fiscal Management Section 2-4, g

Question 12

Commanders ___________ prepare attachments to their personalized memorandums which outline departmental policy regarding occupational injury and illness case management and employee rights and responsibilities.

Answer 12

Shall 2-4, i

Question 13

What is a CHP 225?

Answer 13

California Highway Patrol Officer Task Statements 2-4, k

Question 14

Commanders ______ revoke a uniformed member’s peace officer powers and secure all state-issued firearms whenever the uniformed employee is off duty as a result of a psychological reason, to include stress.

Answer 14

Shall 2-4, i

Question 15

How often shall injury case management activity be reported to Division?

Answer 15

Quarterly 2-7, 4

Question 16

What is a CHP 121D and when does it have to be submitted to Division?

Answer 16

Injury/Illness Status Report/ submitted by the 10th of each month 2-7, s2

Question 17

What may be required to verify secondary employment will or will not impede an employee’s ability to recover from an occupational illness/injury?

Answer 17

Written authorization from employees medical care providers 2-6,q3

Question 18

What is the time frame in which a commander shall provide a Comm-net to the appropriate Assistant Commissioner, Division Commander, DRU and Human Resources Section of an employee who is off-duty as a result of an occupational injury or illness?

Answer 18

After the employee has been off for 30 days or more 2-7

Question 19

Supervisors, if practical, ____accompany employees to their initial medical appointments and discuss work capability with the employee’s medical care providers.

Answer 19

Shall 2-8 2e

Question 20

Employees shall advise medical care providers if an injury or illness is believed to
be occupational. Employees shall also provide their physician with a ________________

Answer 20

CHP 443, Limited Duty Assignment – Physician’s Report. 2-9,3c

Question 21

Employees who are off duty as a result of occupational injuries and illnesses shall be assigned to _______________, with an assigned work shift of
0800 hours to 1700 hours, Monday through Friday.

Answer 21

Their Residence 2-9, 3d

Question 22

_________________________shall review injury, illness, and hazardous exposure documentation forwarded by commands to ensure documentation is accurate and complete.

Answer 22

The Division Health and Safety Coordinator 3-1, 1b

Question 23

What four notifications shall be made in the event of death, serious injury or illness?

Answer 23

Division and Appropriate Commissioner Immediately by phone

Comm-Net Message – Appropriate Assistant Commissioner and DRU within 8 hours.

Reporting to Department of Industrial Relations – within 8 hours

SCIF – by phone as soon as possible

3-1,3

Question 24

What codes exclude volunteers from the definition of employee?

Answer 24

California Labor Code, Section 3352 and State Administrative Manual, Section 2580.3 (3-2,5)

Question 25

Within what timeframe shall an employee reporting a recurrence of an injury or illness, prepare a memorandum detailing the circumstances surrounding the recurrence and a description of the injury or illness.

Answer 25

24 hours 3-2, 6

Question 26

When should an injury or illness be recorded on the OSHA 300 – Log and Summary of Occupational Injuries and illnesses?

Answer 26

Within 6 working days following knowledge of an injury

Question 27

What should be recorded on the OSHA 300 Log?

Answer 27

1. All occupational illnesses
2. All occupational deaths
3. All occupational injures other than record only or first aid
   4-4,d

Question 28

The OSHA 300A, Summary of Work-Related Injuries and Illnesses, shall be prominently posted at the work site by ________ of the year following the year covered by the Log, and shall remain posted until __________. Negative reports shall be prepared and posted.

Answer 28

February 1 / April 30 4-7,5