HPM 10.7: INJURY AND ILLNESS CASE MANAGEMENT

Question 1

What is an Occupational Injury?

Answer 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. (Ch1)

Question 2

What is Occupational illness?

Answer 2

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. (Ch1)

Question 3

What is Record-Only Injury or illness?

Answer 3

Nondisabling injury or illness which does not
require first aid or medical treatment. Record-only incidents shall be documented on a CHP 121E, Supervisor’s Incident Report-Record Only (Ch1)

Question 4

What is nondisabling Injury or illness?

Answer 4

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. (Ch1)

Question 5

What is a disabling injury or illness?

Answer 5

Injury or illness which results in an employee being unable to return to work following the date of the injury or illness. (Ch1)

Question 6

What is serious injury or illness?

Answer 6

Disabling injury or illness which requires overnight
hospital care other than for observation, a lengthy disability status, or disability
retirement. (Ch1)

Question 7

What is the difference between a recurrence or an injury or illness or an aggravation?

Answer 7

An aggravation of an injury or illness has an
identifiable new incident of injury or illness and shall be processed as a new injury
or illness. A recurrence of an injury or illness which does not have a new, clearly defined incident to cause injury or illness. It is a
spontaneous reappearance of a prior condition. (Ch1)

Question 8

What is a questionable injury or illness?

Answer 8

An injury or illness claim for which there is reason to question whether the injury or illness is work-related. (Ch1)

Question 9

Commanders shall direct
uniformed employees who are off duty, as a result of an ___ or ___ ____ or ____ where a physician has diagnosed that the employee is not capable of
performing the 14 critical physical activities, they should avoid engaging in any activity requiring the use of peace officer powers.

Answer 9

industrial or nonindustrial
injury or illness (Ch2)

Question 10

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

Answer 10

psychological reason (Ch2)

Question 11

May Commanders suspend employee’s secondary employment if the employee is out injured?

Answer 11

Yes, however they must reinstate upon receipt of written authorization from employee’s medical care provider (Ch2)

Question 12

Supervisors, if practical, shall accompany employees to their initial medical appointments and discuss ___ with the employee’s medical care providers.

Answer 12

work capability (Ch2)

Question 13

In no event shall supervisors ___ when employees are being examined by medical care providers

Answer 13

attempt to be present (Ch2)

Question 14

The possibility
of assignment to ___ ___ when medically appropriate shall be reviewed with medical care providers and an estimated date of return to duty obtained.

Answer 14

limited duty (Ch2)

Question 15

Discussions between supervisors and medical care providers shall be briefly documented in the comments section of the ___.

Answer 15

CHP 121 (Ch2)

Question 16

Within 24 hours of reporting a recurrence of an injury or illness, the employee shall prepare a ____, detailing the circumstances surrounding the recurrence and a
description of the injury or illness.

Answer 16

CHP 51, Memorandum (Ch3)

Question 17

Injuries and illnesses sustained by job applicants ___ be included in
departmental occupational safety statistics

Answer 17

shall not (Ch3)

Question 18

Injuries and illnesses shall be recorded on the CAL/OSHA Log within ___ ___ ___ following knowledge of an injury or illness. The Log shall be updated when a status change of an injury or illness occurs.

Answer 18

six work days (Ch4)

Question 19

The following injuries and illnesses shall be recorded on the CAL/OSHA log (3):

Answer 19

(1) All occupational illnesses.
(2) All occupational deaths.
(3) All occupational injuries other than record only or first aid without medical
expenses. (ch4)

Question 20

Injuries and illnesses which occur to employees on temporary assignment shall be recorded on the Log of the command of temporary assignment unless the assignment is for ___

Answer 20

control of civil disturbance (Ch4)

Question 21

Injuries and illnesses occurring while an employee is traveling to or
from a temporary assignment shall be recorded on the Log of the
command where the employee is ____ at the time of the
injury or illness.

Answer 21

permanently assigned (Ch4)

Question 22

All injuries (unless record only or first aid without medical expenses) and illnesses shall be entered on the Log and lined out if
subsequently ___ by State Fund

Answer 22

denied (Ch4)

Question 23

By ___ each year, Areas, communications centers,
enforcement facilities, and headquarters commands shall total their previous year’s Logs and forward signed copies to their respective Divisions

Answer 23

January 15 (Ch4)

Question 24

CHP 121 shall be completed (typed) by the employee’s supervisor within ___ of notification of an alleged occupational injury or illness

Answer 24

24 hours (Ch5)

Question 25

If the employee is incapable of signing the field injury file copy of the CHP 121 within 24 hours of reporting an injury or illness, the supervisor shall _________ in the comments section of the CHP 121

Answer 25

document the circumstances which prevented the signing of the form (Ch5)

Question 26

If the employee refuses to sign the field injury file
copy of the CHP 121, the supervisor shall ___ in the
employee’s signature block and document the refusal in the comments section

Answer 26

type or print “refused to sign” (Ch5)

Question 27

the commander or designee shall ensure the CHP 121 (unless record only or first aid without medical expenses incurred) is filed with the appropriate SCIF
office within ___
___ of notification of an injury or illness.

Answer 27

five days (Ch5)

Question 28

A ___ shall be completed and signed by the employee within
24 hours of reporting an injury or illness

Answer 28

CHP 121B (Ch5)

Question 29

If the employee refuses to complete
or sign the CHP 121B, the supervisor shall type or print ___ in the employee’s signature block and document the refusal in the comments
section of the CHP 121A.

Answer 29

“refused to complete or
sign” (Ch5)

Question 30

The employee shall sign CHP 121C within ___ of reporting an injury or illness

Answer 30

24 hours (Ch5)

Question 31

If the potential exists that an employee may be impaired in the
performance of the assigned duties due to a physical or psychological condition, the Department may ___ to determine the extent of such impairment.

Answer 31

obtain a medical examination (Ch7)

Question 32

A Department-ordered ____ is a medical examination
performed by a physician chosen by the Department to determine an employee’s ability to perform the essential duties of the employment
classification.

Answer 32

FFD examination (Ch7)

Question 33

A FFD examination will determine an employee’s
ability to _____ of the employment classification and determine if the employee is able to return to their usual and customary position.

Answer 33

perform the essential duties (Ch7)

Question 34

A supervisor shall notify ___ when the supervisor becomes aware an employee is suffering from any condition which
might limit the employee’s physical or psychological ability to perform the essential duties of the employment classification

Answer 34

the commander (Ch7)

Question 35

The ___ shall prepare a memorandum summarizing the need for the HPM 10.7 7-6
Department-ordered FFD examination.

Answer 35

commander (Ch7)

Question 36

For an Dept ordered FDD, the employee has the right to deny the request to sign the CHP 121C or identify previous treating medical care providers. Tru/false

Answer 36

true (Ch7)

Question 37

In the interest of employee health and well-being, ___ is committed to assisting disabled employees in returning to work as soon as medically appropriate

Answer 37

the Department (Ch8)

Question 38

It is imperative that ___ efforts are made to accommodate individual employee needs when assigning limited duty.

Answer 38

reasonable (Ch8)

Question 39

Commanders shall assign appropriate limited duty based on (3):

Answer 39

(1) the employee’s medically approved activities, (2) employee classification, and (3) the needs of the Department

Question 40

Examples of limited duty assignments are as follows:

Answer 40

Reviewing accident investigation reports, answering phones at a communications center, front desk, filing court cases, training officer, evidence officer, assist school bus officer, public affairs assignment, and investigation assistant.

Question 41

While on limited duty, employees shall not (3):

Answer 41

(1) wear a uniform, (2) display a badge, or (3) operate an enforcement vehicle

Question 42

Commanders shall ensure that every effort is made to ___ an employee when assigning limited duty.

Answer 42

reasonably accommodate

Question 43

The ___ shall discuss the limited duty assignment with the employee and the employee’s supervisor

Answer 43

commander

Question 44

Commanders shall notify ___ of any limited duty assignment, extension, modification, or termination.

Answer 44

ICU

Question 45

Supervisors shall notify the __ of any significant status change of an employee’s injury or illness

Answer 45

commander

Question 46

Supervisors shall notify the ___ if it appears an employee is not making a good-faith effort toward prescribed medical rehabilitation

Answer 46

commander

Question 47

The duration of the limited duty assignment shall be directed by the nature of the injury or illness and the needs of the Department on a case-by-case basis not to exceed ___

Answer 47

two years

Question 48

___ may authorize limited duty assignments of less than one year

Answer 48

Commanders

Question 49

Commanders shall request authorization from the appropriate ___ to extend a limited duty assignment beyond one year for positions other than within an Executive Office

Answer 49

Commissioner

Question 50

___ may request a Department-ordered fitness-for-duty examination if the potential exists that the employee’s medical condition may be deemed permanent

Answer 50

Commanders

Question 51

Employees under the minimum age for service retirement who have depleted available leave credits and are awaiting a disability retirement decision ___ be assigned limited duty, not to exceed the two-year maximum duration, to prevent financial hardship.

Answer 51

may

Question 52

Commanders and supervisors are responsible for maintaining __ __ with temporarily disabled employees and for arranging a return to full duty as soon as medically appropriate.

Answer 52

ongoing communication

Question 53

Employees absent or returning from limited duty of less than ___ ___ shall be retrained and recertified at their currently assigned commands.

Answer 53

one year

Question 54

Employees absent or returning from limited duty of more than _______________ are required to complete Refresher Training at the Academy prior to resuming field-related duties at their assigned command

Answer 54

12 contiguous months to 2 years

Question 55

Employees absent or returning from limited duty of more than ___ are required to complete Reinstatement Training at the Academy prior to resuming field duties at their assigned command

Answer 55

two years

Question 56

___ is responsible for determining if an injury or illness
claim will be accepted as occupational and ensuring that benefits, including medical treatment and the supplemental job displacement benefit, are provided in a timely
manner.

Answer 56

State Fund

Question 56

___ are required to maintain ongoing
communication with State Fund to cooperatively manage injury and illness cases

Answer 56

Commanders

Question 57

___ shall contact State Fund directly to
cooperatively manage injury and illness cases

Answer 57

Supervisors

Question 58

An employee who is attending their own WCAB hearing or trial, or who attends on behalf of the claimant employee, is or is not eligible
for the use of state time?

Answer 58

Is not (ch11)

Question 59

Commanders shall ensure that an employee who is medically determined to be permanently precluded from returning to their regular job duties is promptly
provided an ___

Answer 59

Options Letter