DOCUMENT NUMBER: 401
ISSUE DATE: December 2003
SUBJECT: Accident Reporting, Investigation, and Notification Procedures

This policy supercedes Document Number 401, dated September 1996

OBJECTIVE: To develop prevention and control measures to prevent recurrence.

SCOPE: Applies to:

1. All UAF departments operating UAF owned, or rented/leased/hired/chartered vehicles.

2. Accidents involving bodily injury to persons.

3. Circumstances that have a potential to, or have contributed to, acute, or chronic, occupational illness.

4. Property loss, or damage, to University property.

5. Property loss to others (general public) caused by, or involving, University operations.

6. Near-miss accidents, and incidents, with a potential for serious injury, or property/environmental damage.

7. Incidents which may have an adverse impact on the University.

Accident investigation is a vital part of UAF Environmental Health, Safety, and Risk Management (EHS&RM). A thorough accident investigation is a necessary tool for the prevention of recurring accidents. Investigations should be directed not only at what did occur, but also the potential of what could have occurred. Accidents are investigated so that similar accidents may be prevented either by physical/mechanical improvement, or employee training and motivation.

II. PROCEDURE

A. Accident/Incident Notification

1. Individuals involved in an accident have the responsibility to notify supervisor (dean, director, or department head) as appropriate, immediately after the accident, or incident, has occurred. The supervisor/other responsible person will immediately notify EHS&RM (or Facility Services (FS) Safety Officer, 474-5949, if employee is an FS employee) of any accident requiring medical attention. Notification must be made immediately, regardless of time or day (includes after normal working hours, weekend, and holidays.) The supervisor/other responsible person also notifies the appropriate Safety Office (EHS&RM or FS) when the patient is treated and released back to work or home.

2. In the event the injury requires in-patient hospitalization, or if the injury was fatal, the supervisor/other responsible person in supervisory role, will immediately, upon their knowledge, report it to EHS&RM (or FS Safety Officer if patient is FS employee.) The report to EHS&RM (or FS Safety Office) must be made immediately, but in no event later than eight hours after receipt by the employer of information that the accident has occurred. EHS&RM or FS Safety Officer, once notified by the supervisor/other responsible person, will immediately report the accident and in-patient hospitalization to AKOSH DOL, per Alaska Statute 18.60.058(a). It is imperative that constant supervisor-injured employee contact be maintained while waiting, or during initial medical treatment. This will ensure prompt notification in the event the employee is later admitted/hospitalized.

3. While hospitalized, the supervisor/other responsible person maintains contact with the patient. The supervisor/other responsible person will notify appropriate Safety Office (EHS&RM or FS) of patient's status and/or discharge. If patient is incapacitated, the supervisor/other responsible person will make follow up contact with hospital regarding patient status and will notify EHS&RM or FS of any changes in patients progress/status.

4. Supervisors have the primary responsibility to attend to injured workers and track their medical condition and patient status (inpatient/outpatient) for all accidents.

5. See attached flow chart for specific notification/reporting responsibilities.

6. Serious disabling injuries, death, significant property loss or damage, environmental incidents (hazardous materials spills, etc.), and other emergencies should be immediately telephoned to the Emergency Dispatch Center, 911, or other emergency service providers (police, state troopers, etc.) for non-Fairbanks campus events. The Emergency Dispatch will ensure that necessary emergency services are notified and dispatched, and that EHS&RM is informed of all events.

B. Accident/Incident Reporting

1. Accident reports (State of Alaska Report of Occupational Injury or Illness), also referred to as the Workers' Compensation Form, should be completed for all accidents requiring medical treatment and/or hospitalization, or time off work due to work-related injury/illness, or when an injured employee loses consciousness. If in doubt, contact EHS&RM (or FS Safety Office for FS personnel) for guidance on when and how to complete this form. The supervisor/other responsible person will complete a Report of Occupational Injury or Illness within 10 days of the date of the accident. Completed accident forms should be distributed as follows: The Blue copy must be sent to the Alaska Workers' Compensation Board in Juneau, Alaska; the address can be found on the front of the form. The Pink copy should be sent to ESH&RM, the white copy must be sent to Statewide Risk Management, and the employee keeps the Yellow/Green copies.

2. Incident Report must be completed for incidents where an injury occurs without the need of medical treatment. These reports must be completed by the employee, employee's supervisor, and applicable safety office (EHS&RM or FS), in-turn. The incident report will be maintained in the same manner as Workers' Compensation forms. This report provides additional protection for the employee to document all events that result in an injury, particularly if there are complications in the future.

3. Each dean, director, or department head should assign someone to coordinate, complete and distribute forms, and report accidents. In some departments, Personnel Payroll Assistants (PPAs) or "Unit Safety Coordinators" have been established to perform this task. Completed accident forms should be reviewed and signed by the injured employee and the department, program, or project supervisor. A process for the regular review of accidents and report forms should be established by the dean, director, or department head. If unsure whether an accident, or incident, should be reported, contact UAF EHS&RM (474-5413), or SW Risk Management (474-7465).

4. Student or Visitor Accidents: Any faculty or staff member who witnesses, is involved in, or is informed of an accident with a student or a visitor should report the accident to Statewide Risk Management (474-7465), or the Emergency Dispatch Center (474-7721).

5. Except for vehicle physical damage incidents, accident claims handling and processing, is provided through the SW Risk Management Office. UAF EHS&RM is responsible for UAF vehicle damage claims handling, conducting and assisting departments with post-loss investigations, notification of regulatory agencies, and assisting departments with requests and claims documentation as necessary.

6. Contact UAF EHS&RM at 474-5413 or visit http://www.uaf.edu/safety for Incident Report forms and other related information. State of Alaska Report of Occupational Injury or Illness forms are not available on-line but can be picked up at EHS&RM or through your PPA. Facilities Services personnel can obtain information and further assistance by contacting the FS Safety Office directly at 474-5949 or by visiting their web site at http://www.uaf.edu/fs/

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