HPM 10.7 Injury and Illness Case Management

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. (HPM 10.7, 1-4)

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. (HPM 10.7, 1-4)

Answer 2

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, Supervisor’s Incident Report-Record Only. (HPM 10.7, 1-4)

Answer 3

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. (HPM 10.7, 1-4)

Answer 4

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. (HPM 10.7, 1-4)

Answer 5

Nondisabling Injury or Illness

Question 6

____: Injury or illness which results in an employee being unable to return to work following the date of the injury or illness. (HPM 10.7, 1-4)

Answer 6

Disabling Injury or Illness

Question 7

____: Disabling injury or illness which requires overnight hospital care other than for observation, a lengthy disability status, or disability retirement. (HPM 10.7, 1-4)

Answer 7

Serious Injury or Illness

Question 8

____: Exposure to any chemical, biological, or physical agent which does not result in injury or illness. (HPM 10.7, 1-4)

Answer 8

Hazardous Exposure

Question 9

____: An injury or illness claim for which there is reason to question whether the injury or illness is work-related. Injury and illness claims should not be deemed questionable simply because they are not witnessed or are a result of cumulative trauma. If, based on facts and information obtained during preparation of the employee’s CHP 121, Employer’s Report of Occupational Injury or Illness, there is reason to question whether the injury or illness is work-related, the claim should be deemed questionable pending State Fund’s decision of acceptance or denial. 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. (HPM 10.7, 1-4)

Answer 9

Questionable Injury or Illness

Question 10

Commanders shall determine ____of injuries, illnesses, and hazardous exposures and shall implement appropriate corrective measures. (HPM 10.7, 2-3)

Answer 10

preventability

Question 11

____ 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 psychological reason, to include stress. (HPM 10.7, 2-4)

Answer 11

Commanders

Question 12

12. Commanders will require ____ from the employee’s medical care providers indicating their secondary-employment will not affect their ability to recover in those cases where employees are on sick leave, assigned to limited duty, or placed off duty due to medical conditions. (HPM 10.7, 2-5)

Answer 12

written authorization

Question 13

Commanders or their designees shall contact State Fund at least ____ to review the status of those cases in which employees have been placed off duty or on limited duty. (HPM 10.7, 2-6)

Answer 13

monthly

Question 14

Supervisors, if practical, ____ accompany employees to their initial medical appointments and discuss work capability with the employee’s medical care providers. In no event shall supervisors attempt to be present when employees are being examined by medical care providers. (HPM 10.7, 2-8)

Answer 14

shall

Question 15

If a death, serious injury, or illness occurs, the commander or designee shall ensure required notifications are made. Division and the appropriate ____ shall be notified immediately by telephone. (HPM 10.7, 3-3)

Answer 15

Assistant Commissioner

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. (HPM 10.7, 3-5)

Answer 16

CHP 51, Memorandum

Question 17

The California Occupational Safety and Health Act (Cal/OSHA) of 1973, California Labor Code, Section 6410, and California Code of Regulations, Title 8, Section 14301, require employers to compile a log of specific occupational injuries and illnesses. The ____, Log of Work-Related Injuries and Illnesses, hereinafter referred to as the Log, shall be used for this purpose. Each field Division, Area, communications center, and enforcement facility shall maintain a Log. (HPM 10.7, 4-3)

Answer 17

Cal/OSHA Form 300

Question 18

Injuries and illnesses shall be recorded on the Log within ____ work days following knowledge of an injury or illness. The Log shall be updated when a status change of an injury or illness occurs. All injuries (unless record only or first aid without medical expenses) and illnesses shall be entered on the Log and lined out if subsequently denied by State Fund (HPM 10.7, 4-4)

Answer 18

six

Question 19

Commands must save the OSHA 300 Log, the privacy case list (if one exists), and the annual summary for ____ following the end of the calendar year that these records cover. CHP 121s shall also be maintained ____ for each injury or illness recorded on the Log. (HPM 10.7, 4-7)

Answer 19

five years

Question 20

CHP 121 shall be completed by the employee’s supervisor within ____ of notification of an alleged occupational injury or illness. (HPM 10.7, 5-1)

Answer 20

24 hours

Question 21

If the employee refuses to sign the field injury file copy of the CHP 121, the supervisor shall type or print ____ in the employee’s signature block and document the refusal in the comments section. (HPM 10.7, 5-1)

Answer 21

“refused to sign”

Question 22

Pursuant to California Labor Code, Section 3760, and the State Administrative Manual, Section 2581.4, 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. (HPM 10.7, 5-1)

Answer 22

five days

Question 23

If the employee refuses to sign the ____, 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. (HPM 10.7, 5-5)

Answer 23

CHP 121C

Question 24

As soon as possible after notification a uniformed employee sustained an injury or illness requiring medical treatment beyond first aid, the supervisor shall provide the medical care provider with a ____ to assist in determining if the employee may perform full or limited duty. (HPM 10.7, 5-5)

Answer 24

CHP 225

Question 25

Within ____ of initial notification of, or any status change of, an employee injury, illness, or hazardous exposure, the supervisor shall record or update ethe incident on the employee’s CHP 442. (HPM 10.7, 5-5)

Answer 25

three days

Question 26

As soon as possible after notification of a nondisabling injury or illness which requires assignment of limited duty, the supervisor shall provide the employee’s medical care provider a ____. (HPM 10.7, 5-5)

Answer 26

CHP 443

Question 27

Within 24 hours of notification of an injury or illness, the supervisor shall provide the employee with a copy of ____, ____, and ____. (HPM 10.7, 5-6)

Answer 27

CHP 600, CHP 601, and SCIF 3301