A2218 CLEAN DRAFT.PDF

Maricopa County — Formal (2023-03-01)

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MARICOPA COUNTY INTERNAL POLICY 
 
Policy Title: 
REPORTING INDUSTRIAL INJURY OR 
ILLNESS 
Policy Number: 
A2218 
Current Adoption Date: 
MM-DD-YYYY 
Current Implementation Date: 
MM-DD-YYYY 
Approved by: 
BOARD OF SUPERVISORS 
Board Agenda Number: 
C-49-15-058-6-01 
Original Adoption Date: 
11-1991 
 
I. PURPOSE 
To establish guidelines for reporting Industrial Injuries and Illnesses. 
II. APPLICATION 
 
This Policy applies to all Maricopa County elected and appointed departments as well as the Flood Control 
District of Maricopa County, the Maricopa County Library District, and the Maricopa County Stadium District 
(Special Districts). The Board of Supervisors is authorized to jointly adopt policies applying to the Special 
Districts under the Intergovernmental Agreement, C-06-18-393-6-00, approved on April 11, 2018. 
 
III. DEFINITIONS 
A. Appointing Authority: An elected official, the single administrative or executive head of a 
Department/Special District, or the designated representative authorized to act in this capacity. 
B. Industrial Injury or Illness: An injury or illness that results from an event or exposure in the work 
environment arising out of and within the course and scope of employment. 
 
IV. POLICY 
A. Reporting Requirements 
For assistance completing the appropriate Risk Management Incident Reporting Form, call 602-506-
6828. 
1. All accidents and injuries, regardless of severity, are required to be reported by the end of the 
business day of the incident to the Appointing Authority or designee. Failure to report the incident 
within 24 hours may jeopardize the benefit eligibility of the injured or ill employee. 
 
2. In the event of an Industrial Injury or Illness, the Appointing Authority or their designee must complete 
the Risk Management Incident Reporting Form within 24 hours of being notified. 
 
3. If an accident involves a fatality, an immediate initial telephone report shall be made to Risk 
Management, followed by submission of the Risk Management Incident Reporting Form. 
 
4.  The Form is to be completed by the injured employee's supervisor or manager who has knowledge 
of the occurrence. Under no circumstances should the injured employee complete the Form on their 
own behalf. 
 
B. Employee Responsibilities 
1. Notify supervisor of the illness or injury by the end of shift on the day of the injury, if possible. 
 
2. If the injury is serious, go to the nearest approved occupational health facility or hospital emergency 
room.

Policy Title: 
REPORTING INDUSTRIAL INJURY OR 
ILLNESS 
Policy Number: 
A2218 
Current Adoption Date: 
MM-DD-YYYY 
 
Page 2 of 2 
 
3. Attend all medical appointments. 
 
4. Receive approval for therapy and follow-up doctor appointments during regular working hours 
(employees may use sick or vacation time for these appointments).  
 
5. Promptly present to supervisor a doctor’s written release to work status with or without restrictions.  
 
C. Supervisor Responsibilities 
1. Direct the employee to the nearest approved occupational health facility. 
 
2. Arrange for transportation if the employee cannot transport themselves (See County Policy A2216 
Transporting Injured/Ill County Employees). 
 
3. Collaborate with the County’s Risk Management Workers Compensation division on all work status 
documents 
 
4. Provide modified transitional work assignments. 
 
D. Risk Management Responsibilities 
1. Manage claims administration under the County’s Risk Management Trust Fund. 
 
2. Evaluate and initiate cost containment programs, manage defense counsel, record all injuries and 
pursue recoveries from parties that caused or contributed to injury to employees.  
 
 
 
 
Revision History 
Version 
Revision Date 
Description of Revision 
1 
11-1991 
Initial version. 
2 
5-20-2015 
This policy has been modified to conform to ARS § 23-901 and modified 
policy A2216 Transporting Injured-Ill County Employees. This revised 
policy now incorporates language related to the new Risk Management 
Incident Reporting Web Form that has been recently developed by OET. (C-
49-15-058-6-00) 
3 
8-31-2017 
Reviewed by Risk Management. Administrative update to correct hyperlinks, 
corresponding to new Intranet site.  No content or policy changes. 
4 
MM-DD-YYYY 
Update format and links, add Application section; move content of Authority 
section to Policy section.