POLICY RE A2218 REPORTING OF INDUSTRIAL INJURY OR ILLNESS FINAL.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 SUPERVISORS Original Adoption 11-1991
Date:
I. PURPOSE
To establish guidelines for reporting Industrial Injuries and Illnesses.
II. AUTHORITY
A. It is the responsibility of designated department and special district employees to
promptly and accurately submit the appropriate Risk Management Incident
Reporting Form (http://ebc.maricopa.gov/RM/). These reports must be submitted
within 24 hours of the injury. The employee’s supervisor is responsible for directing
the employee to the nearest approved occupational health facility, arranging for
transportation if the employee cannot transport themselves , collaborating with the
County’s Risk Management Workers Compensation division on all work status
documents and providing modified transitional work assignments. (See Policy
A2216, Transporting Injured/Ill County Employees).
1. Employees needing assistance completing the appropriate Risk Management
Incident Reporting Form may call 602-506-8041.
B. It is the responsibility of Risk Management to:
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.
C. It is the responsibility of the injured employee to:
1. Notify their supervisor of the injury by the end of their 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.
3. Attend all medical appointments
4. Receive approval for therapy and follow-up doctor appointments during their
Page 1 of 2

Policy Title: Policy Number: A2218
REPORTING OF INDUSTRIAL INJURY OR
ILLNESS Current Adoption 5-20-2015
Date:
regular working hours (employees may use sick or vacation time for these
appointments)
5. Promptly present to their supervisor a doctor’s written release to work status
with or without restrictions
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. 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.
In the event of an industrial injury or illness, the department or special district
designee must complete, within 24 hours of being notified, the Risk Management Incident
Reporting Form here.
B. If an accident involves a fatality, an immediate initial telephone report shall be
made to Risk Management, followed by the Risk Management Incident Reporting
Form here.
C. 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.
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.
Page 2 of 2