POLICY RE A2218 REDLINE.PDF

MARICOPA COUNTY INTERNAL POLICY
Policy Title: Policy Number: A2218
REPORTING OF INDUSTRIAL INJURY OR
ILLNESS Current Adoption 5-20-2015
Date:
Board Agenda
Approved by: Number:
BOARD OF SUPERVISORSROY PEDERSON Original Adoption 11-1991
Date:
I. PURPOSE
To establish guidelines for reporting iIndustrial iInjuries and illnesses.
Industrial Injuries: An injury or illness that results from an event or exposure in
the work environment arising out of and within the scope and course of
employment.
II. APPLICATION AUTHORITY AND RESPONSIBILITY
A. It is the responsibility of designated agency and department and special district
employees to promptly properly and accurately submit the appropriate Risk
Management Incident Reporting Web Form (http://ebc.maricopa.gov/RM/ insert
link)prepare all industrial injury reports. These reports must be submitted
forwarded to the Risk Management Department within 24 hours of ten (10)
calendar days following the injury. The employee’s supervisor is also responsible
for directing the employee to the nearest approved occupational health facility,
arranging for transportation if the employee cannot transport themselves via
County vehicle or ambulance ,and collaborating with the County’s Risk
Management Workers Compensation division on all work status documents and
providinge modified transistionaltransitional work assignments. as outlined by the
treating physician (Ssee Policy A2216, Transporting Injured/Ill County
Employees).
1. Risk Management will provide assistance to any employee who requires
assistance inEmployees needing assistance completing the appropriate the
proper completion of the Risk Management Incident Reporting Web Form.
may Ccall 602-506-8041. for assistance.industrial injury or illness paperwork.
B. It is the responsibility of Risk Management to:
1. Manage claims administration under the County’s Risk Management Trust
Fund..
2. It is also their responsibility to eEvaluate and initiate cost containment
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Policy Title: Policy Number: A2218
REPORTING OF INDUSTRIAL INJURY OR
ILLNESS Current Adoption 5-20-2015
Date:
programs, manage defense counsel, record all injuries and pursue
recoveries from parties that caused or contributed to or caused injury to
covered to employees.
C. It is the responsibility of the injured employee to:
1. Notify their supervisor of the injury bye the end of their shift on the day
business date of the date of the injury, if possible,
1.2. If the injury is serious go to the nearest approved occupational health
facility or hospital emergency room.
2.3. Attend all medical appointments
4. Receive approval for therapy and follow-up doctor’s appointments during
their regular working hours (employees may use sick or vacation time for
these appointments),
3.5. Promptly pPresent to their supervisor btain a doctor’s written release
to work status with or without restrictions and present that to their supervisor
and Risk Management
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.
A.B. IndustrialOccupational Injury or Illness: An injury or illness that results
from an event or exposure in the work environment arising out of and within the
coursescope and scopecourse of employment.
Reportable Incident: WhenA medical treatment is sought as a result of personal
injury by accident arising out of and in the course of employment, and medical
treatment is sought. It can also be an injury caused by willful act of a third
partyperson directed against an employee because of their employment (A.R.S. §
23-901).
IV. POLICY
A. All accidents and injuries, regardless of severity, are requiredneed to be
reported by the end of the business day of the incident immediately to the
Appointing authority elected official, department director, or their
designeeappointee. a designated person in the agency or department. Failure to
report the incident within 24 hours may jeoparadizejeopardize the benefit eligibility
of the injured or /ill employee.
Occasionally, Risk Management will contract with an adjustment agency to handle
the investigation of claims or accidents. All elected officials, department directors,
and employees must fully cooperate with investigators who have properly
identified themselves and presented appropriate credentials.
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Policy Title: Policy Number: A2218
REPORTING OF INDUSTRIAL INJURY OR
ILLNESS Current Adoption 5-20-2015
Date:
Cooperation and conscientious reporting by all employees isare required to ensure
the most effective benefits of this program for both the County and the injured or ill
employee.
In the event of an industrial injury or illness, the agency or department or special
district designee must complete, within 24 hours of being notificed, the Risk
Management Incident Reporting Web Form hereprepare all applicable reports and send
them to the Risk Management Department.
B. If an accident involves serious injury, the report should be submitted hand-
delivered to Risk Management the same day. If it involves deatha fatality, an
immediate initial telephone report shallneeds to be made to Risk Management,
followed by the Risk Management Incident Reporting Web Form here.
D. insert linka detailed written report the same day.
C. 3. All forms must be typed or hand-printed and be legible on all copies.The Web Form
reports are is to be completedsigned by the injured employee's supervisor or manager
who has knowledge of the occurrence. Under no circumstances should the injured
employee complete the Web Form on their own behalf.
Revision History
Version Revision Date Description of Revision
1 Nov 1991 Initial version
This policy has been modified to conform to ARS §
23-901 and modified policy A2216 Transporting
2 20 May 2015 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.
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