Listed below are procedures to follow in the event of an employee work related incident.
Medical Treatment Locations
For all work injuries, employees must receive care from treatment locations authorized by the workers compensation insurance claims administrator in Des Moines to receive benefits for medical payments and work absences.
First Report of Injury Form
The First Report of Injury form needs to be filed electronically at the HR Self-Service site within 24 hours of the incident. (This form is located within Self-Service under the Personnel tab, Benefits, Workers Compensation - First Report of Injury.) Any employee on campus may complete a First Report of Injury. Once the report is submitted to the UI Benefits Office, automatic e-mail notifications will be sent to the injured employee, their supervisor, and the HR Unit Representative.
Required Departmental Notifications
Departments are required to immediately notify EHS (335-8501) or Human Resources (335-2676) if there is a death, if an employee is hospitalized, suffers an amputation or the loss of an eye due to a work-related incident, or if an employee dies at work from a heart attack.
Investigation of the Incident
It is important that an incident investigation be conducted by department supervision as soon as possible when an employee is injured on the job. This also includes incidents that were near misses that could have caused a very serious injury. Incident investigations are fact finding, not faulting finding missions. The following steps should be included in your investigation:
- Secure and Collect Evidence. When applicable secure the area where the incident occurred to preserve as much evidence as possible. Photographs, etc., can also be a very valuable aid for future reference.
- Identify Potential Witnesses. Determine if any employees or others saw, heard or detected anything that could contribute to the investigation.
- Conduct interviews. Talk to each employee and witness separately, focusing on who, what, when, where, why, how of the incident. Ask open-ended questions to allow the person interviewed to respond openly and freely. Take written notes of responses made by individuals.
- Review all Data. Collect and study all data and reports that are relevant to the case looking for root causes that were involved or contributed to the incident, including what in the management system operation failed.
- Prepare the Incident Investigation Form. Record only facts, not your opinions.
- Implement Corrective Action. Determine what corrective action is needed and implement the necessary change to prevent future incidents.
- Follow-up. Check back to make sure that the appropriate remedies are in place and working as intended.
Be prepared that as a result of the investigation you may not always like what you have found or want to accept the facts reveled at the moment. Occupational Safety is about maintaining a productive quality of life through work processes that encourage good work habits, attitudes and management leadership.
- This form should be used to investigate a work related employee injury or illness.
- If you have questions about how to do an incident investigation, ICON course W526OS ‘Incident Investigation Training’ is available to assist you with the process.