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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

Accident Investigation

Name, Job Title

Phone number

E-mail address

purpose of presentation
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
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
employee must provide notice
Employee Must Provide “Notice”

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

employee notice of an accident
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.
best practices
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
investigate to determine greater risk
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
how can you help
How Can You Help?

On-Site Investigator’s Role

In Workers’ Compensation Claims

why investigate wc claims
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
  • 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

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?
what else
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
  • 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
exposure to blood or other body fluid
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
exposure to blood or other body fluid15
Exposure to Bloodor Other Body Fluid

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

claims staff role
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
32 1 45 1 code of virginia deemed consent
§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
what is an accident
What is an “Accident”?
  • Any unplanned event that results in personal injury or in property damage.
  • Not intended
  • Not reasonably anticipated
so what is a cause
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)
accident investigations
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!
why should the agency investigate
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
best practices23
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
what is the investigator s role
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
guidelines for investigators
Guidelines for Investigators
  • Agency investigator should:
    • Survey, secure and document the site
    • Identify the cause
    • Look for contributory hazards
    • Report conclusions and recommendations
investigative techniques
Investigative Techniques
  • Don’t assume anything
  • Obtain all possible facts
  • Preserve the evidence
  • Take photographs of the site
  • Take measurements and diagram if necessary
don t make assumptions
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
what do you ask
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?
additional questions for the supervisor
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?
preserve the evidence
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
what do you photograph or videotape
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
what to look for
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
  • Sunny and clear?
  • Rainy?
  • Foggy?
  • Icy?
  • Temperature
    • Cold
    • Hot
  • Clear, unobstructed walkways
  • Passageways and aisles free of protruding nails, loose boards
  • Debris
  • Unwanted Clutter
    • Boxes in aisles
    • Obstacles/barriers
  • 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)
What’s wrong with this picture?“I was working at my desk and all of a sudden I noticed pain in my left wrist…”
agency name most common accidents
(Agency Name)Most Common Accidents
  • Struck by/ strike against
  • Material Handling
  • Slips, Trips, Falls
need assistance

Need Assistance ???

We’re here to help!

  • Remember:
    • Think “out of the box”
    • Trust your instincts
    • Use common sense