Part 4 - Injuries and Physical Examinations

Question 1

In order to monitor and maintain the physical well being of personnel, special risk employees will receive an obligatory physical examination every ___ months.

Answer 1

24

Question 2

RECORDING MAJOR AND MINOR INJURIES:

Major injuries are those injuries or exposures to illness or disease that require professional medical attention; e.g., treatment from a physician or other licensed medical health professional, or result in _______.

Answer 2

lost time from work

Question 3

RECORDING MAJOR AND MINOR INJURIES

If treatment is required after the date of the accident or for follow-up treatment, Internal Services Department (ISD) _______ must be contacted for approval.

Answer 3

Risk Management

Question 4

Reporting Major Injuries:

When injuries occur that require professional medical attention or result in lost time from work, the supervisor will contact ______ as soon as possible after the accident, but no later than the end of the injured employee’s shift.

Answer 4

TeleClaim

Question 5

A _______ or Illness should be completed by the concerned supervisor only if the employee is not in the TeleClaim data base or the supervisor is unable to contact a TeleClaim representative because of equipment failure.

Answer 5

First Report of Injury

Question 6

Reporting Major Injuries:

A _______ Report of Employee Job Injury or Illness shall be completed by the concerned supervisor.

Answer 6

Supervisor’s Investigation

Question 7

Reporting Major Injuries:

The Employer’s Supplemental Report of Injury will be completed by the injured employee’s supervisor and sent to PMB, within ___ hours of any of the following:

• The employee loses time from work or receives professional medical attention, including time spent undergoing rehabilitative physical therapy, as a result of a previously reported injury.
• The employee returns to work (regardless of light or normal duty).

Answer 7

48

Question 8

Recording Minor Injuries:

If an injury does not require professional medical treatment or result in lost time from work, the _______ and the First Aid and ____ Injury Log shall be completed by the concerned supervisor as soon as practicable.

Answer 8

Minor Injury Report

Question 9

PMB is responsible for scheduling all physical examinations.

Employees will be notified in writing through the affected chain-of-command at least ____ days prior to the appointment.

Answer 9

seven

Question 10

After the completion of Phase 1 of the examination, the employee will schedule Phase 2 while at the examining facility.

Appointments will usually be scheduled ____ days after completion of Phase 1 and will be mutually agreed upon by the employee and the examining facility.

Answer 10

three

Question 11

Within ___ working days after notification of the scheduled physical examination, the employee will notify his element commander via memorandum through the appropriate chain- of-command, explaining why rescheduling is necessary and providing an alternate date for the appointment.

Upon approval, the element commander will forward a memorandum to PMB indicating the reason for rescheduling the appointment.

Answer 11

three

Question 12

If the scheduled physical examination must be canceled within ____ working days of the appointment date, a supervisor in the employee’s chain-of-command will telephonically contact PMB and advise of the cancellation.

Answer 12

three

Question 13

Supervisory Referral: Should a supervisor have a reasonable suspicion that an employee is, or has been, impaired or under the influence of a substance.

• The appropriate supervisor will telephonically contact the ___ Commander and relate specific concerns about the employee and the need for requesting the examination.

Answer 13

PMB

Question 14

Supervisory Referral:

• A Fitness For Duty-Physical Examination Request form will be prepared by the requesting element, submitted to the appropriate division chief and ____.
• The commander of the requesting element will issue written direction to the employee to report to the examining facility with copies of pertinent medical reports, if appropriate.

Answer 14

PMB

Question 15

Light duty as a result of an on-the-job injury:

The ________ physician recommends light-duty status and provides a written statement describing specific restrictions for the employee.

Answer 15

County-approved

Question 16

Light duty as a result of an off-duty injury/illness:

The employee is examined by his personal physician and obtains a written statement recommending light-duty status.

A copy of the physician’s written statement will be forwarded to ____.

Answer 16

PMB

Question 17

Employees in a light-duty status shall not:

Drive marked police vehicles. Wear departmental uniforms, or display departmental paraphernalia or equipment on their person, in the classifications of:

(1) Any sworn position
(2) _________

Answer 17

Public Service Aide

Question 18

Employees in a light-duty status shall not:

• Work overtime performing duties not assigned or inconsistent with their ______ assignment.
• Employee Identification Cards will be worn in accordance with Employee Identification.

Answer 18

light-duty

Question 19

Review of Light-Duty Status:

The affected immediate supervisor and concerned element’s health and welfare officer will review medical reports concerning the employee’s light-duty status_____ and document their findings.

Answer 19

biweekly

Question 20

Report Light Duty Cases:

Element Commanders will submit a Light Duty Quarterly Report, identifying each employee who is in a light duty status to the PMB Commander on a _____ basis. The report is due to PMB by the 10th day of January, April, July and October of each year.

Answer 20

quarterly

Question 21

Return to Duty:

When an employee is able to return to full-duty status, the employee shall have a _________ Form , or a comparable release form, completed by the employee’s physician and then submit it to the affected supervisor.

The concerned supervisor is responsible for notifying PMB of this action.

Answer 21

Physician’s Release