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Accident Investigation . Name, Job Title Phone number E-mail address. Purpose of Presentation. Overview of workers’ compensation accident investigation process Value of investigation following an accident (whether compensable or not) Elements of Accident Investigations. Goals & Objectives.

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Accident Investigation

Name, Job Title

Phone number

E-mail address

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Purpose of Presentation

  • Overview of workers’ compensation accident investigation process

  • Value of investigation following an accident (whether compensable or not)

  • Elements of Accident Investigations

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Goals & Objectives

  • Increase your knowledge of the workers’ compensation accident investigation process

  • Identify methods of investigation

  • Determine the causes of accidents

  • Identify tools used in the investigation process

  • Fine tune your accident investigation skills

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Employee Must Provide “Notice”

Why: To notify the employer that the employee had an injury at work so that the incident can be investigated.

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Employee Notice of an Accident

  • (Insert your agency’s reporting policy and key process steps)

  • Immediate written notice required

    • Enables prompt investigation of facts

    • Allows employer to provide necessary medical attention

    • If the employer does not investigate, may not be able to prove the facts.

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Best Practices

  • Injured worker should immediately notify his/her supervisor

  • The supervisor should investigate or notify whoever is responsible for agency investigation immediately!

  • Submit claim within 5 days

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Investigate to Determine Greater Risk

  • Injury arises from a risk not shared by the general public

    • There is a causal connection between the injury and the employment

    • Employee exposed to a particular danger

    • The risk is peculiar to the employment

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How Can You Help?

On-Site Investigator’s Role

In Workers’ Compensation Claims

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Why Investigate WC Claims?

  • Executive Order 52 (99)

  • Needed to assist claims staff

    • Determine cause

    • Document scene

    • Document what people said and saw

  • Prevent future accidents

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  • Document information you hear

  • Document the scene through photographs, sketches, written descriptions, video recordings

  • Document evidence of non-work injury

  • Investigate facts that contradict injured workers’ version

  • Investigate personnel or disciplinary problems that impact the claim situation

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Insert information here on your agency’s policy

  • Do you have internal forms? Where does the investigator get the forms?

  • Who does the documentation go to for forwarding to the claims staff?

  • What timeframes are in place for completing the investigation?

  • Any timeframes for follow-up for correction of hazards?

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What Else?

  • Gather contact information on witnesses & supervisors

  • Obtain witness and supervisor names, phone numbers, best time to contact

  • Provide this information to agency personnel to forward to claims staff

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  • Why are photographs so important to OWC?

    • Support facts

    • Document scene

    • Become the “eyes” for

      people not in the field

    • May be required if litigated

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Exposure to Bloodor Other Body Fluid


  • Who is the source

  • Was there any possible transmission of disease

    • Contact with cuts, scrapes

    • Contact with eyes, nose, mouth

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Exposure to Bloodor Other Body Fluid

Insert your agency’s policy on how to handle exposure incidents here.

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Claims Staff Role

  • Claims staff receives information from agency

  • Will investigate the Who, What, Where, When and How questions

  • May call with additional questions or to obtain the injured worker’s or witness’s statement

  • Claims staff determines compensability

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§32.1-45.1 Code of VirginiaDeemed Consent

  • Covers health care workers, law-enforcement officers and 1st responders

  • Source can be required to give blood sample for testing

  • Employee or their agency has the right to access the test results

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What is an “Accident”?

  • Any unplanned event that results in personal injury or in property damage.

  • Not intended

  • Not reasonably anticipated

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So What is a “Cause”?

  • It is the reason for an action or condition; something that brings about an effect or result. (Webster’s dictionary)

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Accident Investigations

  • The failure of people, equipment, supplies or surroundings to behave or react as expected causes most accidents.

  • Accident investigations determine how and why these failures occur.

  • Conduct with prevention in mind – NOT to place blame!

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Why Should the Agency Investigate?

  • Assist workers’ comp claims process

  • To be the “eyes and ears” in the field

  • To gather facts on-site

  • To preserve evidence that may be lost over time

  • To determine cause of the accident

  • To identify ways to prevent accidents from recurring

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Best Practices

  • Make sure the injured worker is taken care of first

  • Secure the scene to preserve the integrity of the scene

  • Gather all necessary equipment to begin investigation

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What is the Investigator’s Role?

  • Do:

    • Go to the accident site

    • Investigate and document the cause

    • Document supervisor and witnesses

    • Preserve the evidence

  • Don’t:

    • Speculate on coverage

    • Conduct formal interviews

    • Give advice

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Guidelines for Investigators

  • Agency investigator should:

    • Survey, secure and document the site

    • Identify the cause

    • Look for contributory hazards

    • Report conclusions and recommendations

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Investigative Techniques


  • Don’t assume anything

  • Obtain all possible facts

  • Preserve the evidence

  • Take photographs of the site

  • Take measurements and diagram if necessary

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Don’t Make Assumptions

  • Gather the facts

    • What did the injured worker say happened?

    • What did witnesses see?

    • What did the injured worker tell witnesses?

    • Talk to the supervisor

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What Do You Ask?

  • What did the injured worker tell you?

  • Where and when did the accident occur?

  • Were there any witnesses?

  • How was the employee injured?

  • Was training provided for this task?

  • Were the safety rules followed?

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Additional Questions for the Supervisor

  • Was the employee doing an assigned task?

  • Had the employee been trained on the task?

  • Had the employee ever done this task before?

  • How often is this task performed?

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Preserve the Evidence

  • Before you preserve it, let’s define it:

    • Evidence is data, which helps to prove the event

  • Next, decide what evidence is important

    • Immediate photographs are critical

    • The site could change the next day and evidence would be lost

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What Do You Photograph or Videotape?

  • Sites of accidents, including:

    • Defects

    • Hazards

    • Unusual Conditions

    • Conditions that differ from what the employee describes

    • Areas or furniture in need of maintenance

    • Housekeeping issues

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What to Look For???

  • Liquid substances or objects on a floor

  • Worn treads

  • Slippery floor (heavy wax)

  • Loose rungs on a ladder

  • Frayed or torn carpet

  • Type of shoes

  • Anything being carried

  • Anything out of the ordinary

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  • Sunny and clear?

  • Rainy?

  • Foggy?

  • Icy?

  • Temperature

    • Cold

    • Hot

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  • Clear, unobstructed walkways

  • Passageways and aisles free of protruding nails, loose boards

  • Debris

  • Unwanted Clutter

    • Boxes in aisles

    • Obstacles/barriers

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  • May include the following elements:

    • Stairs

    • Ladders (portable, extension, etc.)

    • Machinery, i.e. power saws

    • Any room, i.e. training, sleeping quarters

    • Walls

    • Furniture, such as tables or chairs

    • Vehicles

    • Sidewalk cracks (take measurements)

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What’s wrong with this picture?“I was working at my desk and all of a sudden I noticed pain in my left wrist…”

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What’s wrong with this picture?“I’ve fallen (and I can’t get up…)”

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(Agency Name)Most Common Accidents

  • Struck by/ strike against

  • Material Handling

  • Slips, Trips, Falls

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Need Assistance ???

We’re here to help!

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  • Remember:

    • Think “out of the box”

    • Trust your instincts

    • Use common sense