NAVOSH 5-6-2 Accident and Injury Report

Question 1

OPNAVINST 3750.6

Answer 1

Naval Aviation Safety Program

Question 2

OPNAVINST 5102.1 & MCO 5100.29

Answer 2

Navy and Marine Corps Mishap and Safety Investigation Reporting and Record Keeping Manual

Question 3

DoDI 6055.07

Answer 3

Mishap Notification, Investigation, Reporting and Record Keeping

Question 4

Hazard

Answer 4

A work place condition that might result in injury, illness, or death.

Question 5

Hazard Severity

Answer 5

The worst potential consequence likely to occur.

Question 6

Injury

Answer 6

Traumatic wound or condition of the body caused by external force.

Question 7

Mishap

Answer 7

Unplanned or unexpected event causing death, injury, illness, etc.

Question 8

Mishap Probability

Answer 8

The likelihood a hazard will result in a mishap or loss.

Question 9

Near Mishap

Answer 9

Act or event which injury or damage is avoided by chance.

Question 10

Web-Enabled Safety System (WESS)

Answer 10

A web based safety mishap data collection and reporting system.

Question 11

Who developed WESS?

Answer 11

Commander, Naval Safety Center (COMNAVAFECEN)

Question 12

What are the purposes to a Mishap Investigation and Reporting?

Answer 12

-Identify hazards with potential to casue frequent and severe mishaps
-Identify Hazards that could cause future mishaps.
-Identify unsafe acts and conditions
-Identify mishap causal factors and develop corrective actions

Question 13

What is a Class A Mishap?

Answer 13

-Resulting total cost of damage to gov. and other property is ≥$2 Million
-DOD aircraft is destroyed
-Injury results in fatality or permanent disability

Question 14

What is a Class B Mishap?

Answer 14

-Resulting total cost of damage to gov. and other property is ≥$500,000 but <$2 Million
- Injury results in permanent partial disability.
-When 3 or more personnel are hospitalized for inpatient care from a single Mishap

Question 15

What is a Class C Mishap?

Answer 15

Resulting total cost of damage to gov. and other property is ≥$50,000 but <$500,000
-Nonfatal injury or illness resulting in 1 or more days away from work including day of injury.

Question 16

What is a Class D Mishap?

Answer 16

Resulting tot cost of damage to gov. and other property is ≥$20,000 but <$50,000
-Recordable injury/illness not classified in A/B/C

Question 17

What are the different types of mishap reports?

Answer 17

1. Accident and Injury Report
2. Safety Investigation Report (SIREP)
3. Hazard Report (HAZREP)

Question 18

Accident and Injury Report

Answer 18

-All injuries treated in sickbay IAW ships policy
-Submitted by medical as directed by CO.
-Copy to the Safety Officer

Question 19

Safety Investigation Report (SIREP)

Answer 19

Submitted to Commander, Naval Safety Center using WESS

Question 20

Hazard Report

Answer 20

Submitted for near mishaps and situations where lessons learned should be shared.

Question 21

When a mishap occurs who is notified through the injury report, deck log entry, or by the DH?

Answer 21

Safety Officer

Question 22

Who is responisible for ensuring the investigation is conducted?

Answer 22

Safety Officer

Question 23

Who appoints a mishap investigation board?

Answer 23

ISIC

Question 24

What’s the minimum number of members on a Investigation board?

Answer 24

3 Member Team

Question 25

If a fatality occurred who would be appointed on the board?

Answer 25

Medical member

Question 26

If assisted by technical representatives or NAVSAFECEN are they official members on the board?

Answer 26

No

Question 27

When must Mishap Investigation Reports (MIR) be submitted and to whom?

Answer 27

30 days to the Naval Safety Center via COC

Question 28

What are the occupational injury recording forms?

Answer 28

SF 600
ETR SF 558
SF 513
Accident Injury Report