HPM 10.7 - Injury & Illness Case Management Manual Flashcards
Nondisabling injury or illness which does not require first aid or medical treatment.
Record-Only Injury or Illness
* Note: Documented on a CHP 120E (Supervisor’s Incident Report-Record Only)
Minor nondisabling injury or illness (splinter, scratch, cut, burn, etc.) which does not involve medical treatment.
First Aid Injury or Illness
* Note: Documented on a CHP 121E (Supervisor’s Incident Report-Record Only)
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.
Non-disabling Injury or Illness
Injury or illness which results in an employee being unable to return to work following the date of the injury or illness.
Disabling Injury or Illness
Disabling injury or illness which requires overnight hospital care other than for observation, a lengthy disability status, or disability retirement.
Serious Injury or Illness
Commanders _____ 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. In those instances where commanders identify extenuating circumstances, the commander may provide justification through channels to the Office of the Commissioner, requesting a waiver.
Shall
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.
Monthly
Supervisors _____ assist employees in receiving prompt and proper medical care if such care is believed necessary by either management or the employee.
Shall
Supervisors, if practical, _____ accompany employees to their initial medical appointments and discuss work capability with the employee’s medical care providers.
Shall
* Note: In no event shall supervisors attempt to be present when employees are being examined by medical care providers. The possibility of assignment to limited duty when medically appropriate shall be reviewed with medical care providers and an estimated date of return to duty obtained.
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.
Their residence
Within _____ _____ of reporting a recurrence of an injury or illness, the employee shall prepare a CHP 51, Memorandum, detailing the circumstances surrounding the recurrence and a description of the injury or illness.
24 hours
* Note: If the employee is incapable of preparing the CHP 51 within 24 hours of reporting the recurrence, the employee shall prepare the CHP 51 as soon as possible. In the interim, the employee’s supervisor shall prepare a CHP 51 detailing the reported circumstances surrounding the recurrence to include a description of the injury or illness and the reason(s) for the employee’s inability to document the incident.
CHP 121 shall be completed by the employee’s supervisor within _____ _____ of notification of an alleged occupational injury or illness.
24 hours
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.
Five (5) days
Within _____ _____ of notification of an injury or illness, the supervisor shall provide the employee with a copy of _____.
24 hours / CHP 601 (Coping With Your Injury)
SCIF 3301 (Employee’s Claim for Workers’ Compensation Benefits) shall be initiated by the supervisor and provided to the employee within _____ _____ of notification of an alleged injury or illness other than record only or first aid.
24 hours
