HPM 10.7 - Injury Illness and Prevention Program Manual Flashcards
What is an occupational injury? Cut, fracture, sprain, amputation, from a single causative event incident
Cut, fracture, sprain, amputation, from a single causative event incident
What is an occupational illness?
Abnormal condition or disorder, other than occ. injury, from exposure to environmental factors
What is a record only injury?
Nondisabling injury/illness not requiring first aid or medical treatment
What is a first aid injury/illness?
Non disabling injury or illness requiring one time medical treatment
Non disabling injury or illness?
Employee requires more than first aid, and may need further medical treatment, but is able to return to work the date following the injury.
What is considered a disabling injury/ illness?
Employee is unable to return to work following the date of injury/illness
Who determines the preventability of an injury or illness?
- Supervisor
- Occupational Safety Unit
- Office Occupational safety chairperson
- Commander
Commander
If an employee’s injury is deemed preventable, can they appeal it?
What happens then?
Yes, to the Command Occupatinal Safety Committee
They can recommend to Commander to change it, but he/she doesn’t have to
How often are Commanders or designees required to contact SCIF to review status of cases of employees off duty?
At least monthly
Policy for attendance at SCIF Worker’s Comp Appeals Board hearings or trials?
A supervisor or manager from the employee’s command familiar with the case shall attend trials and may attend hearings
The CHP 121D is a list of employees assigned to limited duty or off duty for injuries. Where in the office is it posted?
Nowhere, it shall not be posted
How often is CHP 121D reported to Division?
Policy on who goes on it?
Reported monthly by 10th of month
MAY put employees on limited or off duty for 30 calendar days or less but SHALL put if 30
c. days or more
If, during a comprehensive review of injury or illness incident, a supervisor becomes aware of a video or audio recording of event, what is done?
The supervisor shall do the review and if an audio/video is available, SHALL make a copy of it
Policy on attendance at medical appointments?
2
- SHALL accompany employees to initial appt
To determine work status - SHALL not attempt to be present when employee is examined by Dr.
Supervisor responsibility when employee is not making an effort to medically rehabilitate self?
SHALL notify Commander of this occurrence
Employees who are off duty as a result of occupational injuries and illnesses have what work assignment?
Shall be assigned to their residence, hours of
8-5, Monday to Friday
When is the STD 634 due for an employee with an injury/illness?
No later than the first working day following a pay period
An employee death or serious injury requires reporting via Comm-net to appropriate Asst. Commissioner and Disability Retirement Unit (DRU) within what time frame?
Within 8 hours of occurrence
An employee death or serious injury requires reporting via Comm-net to Division of Occupational Safety and Health within what time frame?
8 hours of occurrence by telephone
Illnesses or injuries sustained by applicants are included in Dept. Occ. Safety statistics.
True or False
False, they SHALL NOT be
Are Volunteers eligible for Worker’s Comp. benefits?
No, they are not considered employees
If an employee has a reoccurrence of an injury or illness, what is required?
A memo within 24 hours of reoccurrence
If an employee has a reoccurrence of an injury or illness and cannot complete a memo as required, what is done?
Supervisor is required to write an interim memo until the employee can complete it his/her self.
Must say what injury/illness is and why employee couldn’t complete
How many OSHA 300 logs are required to be maintained by Academy?
Three
Permanent and Temp employees
Trainees
Cadets
In what time frame are injuries/illnesses required to be placed on OSHA 300 log?
Within 6 working days of knowledge of event
Questionable injuries/illnesses.
Are they recorded on the OSHA 300 log?
Yes until denied by SCIF, then lined out
If there is a status change of injury/illness within ________ years, the OSHA 300 log must be updated?
Five years
When are OSHA 300 logs required to be sent to next level of Command?
Areas, HQ Command, Comm Ctr – Jan 15
Field Divisons, complied by Feb 15, to OSU
HQ Divisions – Feb 15 to OSU
OSU – By March 31, composite to Dept Labor
Each entry on the OSHA 300 log requires what?
A CHP 121 to be maintained for the injury/illness
Each worksite with an OSHA 300 log is required to post a OSHA 300A composite from when?
February 1 to April 30 of year following year covered by log (post by Feb 1, 2011 for 2010 log)
How long are OSHA 300 and CHP 121s required to be maintained at area?
Five years each
The CHP 121 _______ be completed by __________ within ____________ hours of an alleged occupational injury/illness?
Shall/Should/May
Employee/Manager/Supervisor
24/36/48
Shall
Supervisor
24
Can the CHP 121 be handwritten?
No, shall be typed
Employee signature required on 121 within what time frame of injury/illness?
Unless not possible.
Shall be signed within 24 hours of reporting
If employee is unable to sign 121 within 24 hours of injury/illness, what must be done?
Supervisor SHALL document the circumstances which prevented the signing and have employee sign as soon as possible
What if employee refuses to sign?
Supervisor writes “refused to sign” in employee signature box and documents reason in comments
Time frame for Commander to sign 121?
Within three days of notification of injury/illness
Time frame to have 121 filed with SCIF?
Within five days of notification of injury/illness
What reasons is it acceptable to delay filing 121 with SCIF?
None, nothing shall delay it
Time frame from completion of 121A and by whom?
121A – Supervisory Review of Occupational Injury/ Illness or Exposure
Must be completed by employee’s supervisor within 24 hours of notification of injury/illness/exposure
121A, can it be completed by hand?
Yes, it shall be typed or written neatly in ink
Time frames for signature of 121A?
Same as 121
Employee – 24 hours
Commander – 3 days
Time frame and who completes 121B?
121B = Employee report of injury
Employee completes and signs within 24 hours of injury/illness
121C – Medical Information release authorization
Time frame for completion and by whom?
It only needs to be signed by employee within 24 hours of reporting an injury/illness
CHP 442 , Individual accident, injury and safety recognition record
Within ______ days of initial notification of, or status change in, employee injury/ illness or exposure, _____________ _________ record or update 442.
3
Supervisor SHALL
Time frame for supervisor to give employee CHP 600, Right to privacy, Occupational injury, illness and vehicle accident report?
24 hours
CHP 601, Coping with your injury
Supervisor time frame to give to employee?
24 hours
SCIF 3301, Employee’s claim for Workman’s Comp
Time frame for supervisor to provide to employee?
24 hours ( not first aid or record only(
Commander’s memo and attachment
Commander or designee must review with employee within?
24 hours (first aid or record only not done)
What can the Dept. do if the potential exists that an employee is emotionally or physically unable to complete the essential duties of his/her employment classification?
The Dept. may obtain a fitness for duty examination
Policy of Commissioner regarding Fitness for Duty examination requested by Commanders?
Commissioner says it will be utilized whenever a Commander deems it appropriate
What must a supervisor do when he/she becomes aware of an employee suffering from a medical condition that may limit performance of his/her essential duties?
The supervisor SHALL notify the Commander
In a Dept. ordered FFD examination, what form SHALL the employee be requested to sign to allow for medical records examination?
The CHP 121C
When a CHP 121C is signed by the employee, how far back will Dept. check medical records for related conditions?
10 years
Is a vacant employee position required to assign an employee to limited duty?
No, not necessary
Restrictions to assignment of an officer on limited duties (what type of duties can he/she perform?)
Only non-enforcement related duties
Policy on uniform when on limited duty?
Officer SHALL NOT wear a uniform, display a badge or operate an enforcement vehicle
When an employee is assigned duties on limited duty status, who is involved in discussion of those duties?
Commander, supervisor and employee
What are the two responsibilities supervisors have regarding employee rehabilitation and recovery?
- Notify commander is employee is not making a good faith effort to recover/rehab
- Notify commander of significant status change of an employee’s injury
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 ______ year(s)?
Two years
Who authorizes limited duty assignments of:
One year or less?
More than one year?
How often are they re-authorized/evaluated?
Commander
Appropriate Asst. Commissioner and its re-evaluated/authorized every 3 months after
All limited duty assignments will have a _______ ______ set by the medical provider or they may not be approved.
Termination date
Employees awaiting medical retirement per LC 4800.5, ________ be assigned to limited duty not to exceed two years?
SHALL
Employees who have depleted available leave credits and are awaiting a disability retirement decision, and have attained the minimum age for service retirement, ___________ be approved for limited duty assignments.
SHALL NOT
Retraining requirements of employees returning from limited duty/off duty?
(3)
- Less than one year, at command
- One to two years, refresher at Academy
- More than two years, re-instatement at Academy
If an employee’s disability retirement request through CalPERS is denied, what is done with employee?
They are returned to full duty unless appealing decision
Are supervisors allowed to contact SCIF regarding an employee’s injury/illness?
They MAY do so to manage employee injury and illness cases
Is Departmental attendance at a Worker’s Compensation Appeals Board (WCAB) hearing required?
At a trial?
Not required in hearing unless requested by SCIF
Mandatory at a trial, SHALL be arranged
Is an employee or witness who his/her witnesses entitled to state time for attendance at WCAB trial?
No, no state time
Is Dept. employee attending a WCAB trial as Dept. representative entitled to state transportation?
Yes, allowed and a travel claim is allowed also if necessary
Prior to an employee participating in the voluntary Annual Fitness Challenge, what must be done?
(3)
- Resting heart rate
- Resting blood pressure
- sign waiver
Staffing at an Annual Fitness Challenge (AFC) requires an _______ with _______ and _______ bag?
EMT
Oxygen
EMT
Injuries sustained preparing for the Annual Fitness Challenge are reported on a CHP 121 following normal injury reporting procedures?
True or False
False, they are your own responsibility
What is the max paid overtime available for the Annual Fitness Challenge?
None, all CTO if commander approved (may)
During actual participation in the Annual Fitness Challenge, how is your injury documented?
Standard procedure, but only while ACTUALLY PARTICIPATING
Wellness program
All physical activities organized through the wellness program shall be conducted ______________________________________.
Off state property and off-duty time
An options letter is used when an employee is medically determined to be _____________ ____________ from returning to regular job duties?
Permanently precluded
