2. Overview of workers’ compensation accident
investigation process
Value of investigation following an accident (whether
compensable or not)
Elements of Accident Investigations
3. 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
4. Why: To notify the employer that the
employee had an injury at work so that the
incident can be investigated.
5. Gather information
written statement from injured worker and witnesses
Take pictures of accident screen
Perform drug and alcohol test for everyone involved
If this is a medical emergency call 911 than perform
your investigation
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.
6. Injured worker should immediately notify his/her
supervisor
LP should investigate immediately and notify safety
coordinator!
Our goal is to submit the claim within 24 hrs.
8. Needed to assist claims staff
Determine cause
Document scene (Pictures)
Document what people said and saw
Prevent future accidents
9. 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
10. Why are photographs so important ?
Support facts
Document scene
Become the “eyes” for
people not in the field
May be required if litigated
11.
12. Any unplanned event that results
in personal injury or in property
damage.
Not intended
Not reasonably anticipated
13. It is the reason for an action or condition; something that
brings about an effect or result.
14. 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!
15. 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
16. 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
17. 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
18. INVESTIGATE IMMEDIATELY!
Don’t assume anything
Obtain all possible facts
Preserve the evidence
Take photographs of the site
Take measurements and diagram if necessary
19. 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
20. 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?
21. 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
minute and evidence would be lost
23. Remember:
Think “out of the box”
Trust your instincts
Use common sense
Editor's Notes
Personalize the slide with the following information:
Name
Job Title
Phone Number
E-mail addressIntroductions
Introduce yourself to the class. Discuss the following information with the class:
•Emergency exits
•Restrooms
•Breaks
•General rules of the class
Notes:
Accidents can be traumatic to both workers and fellow employees. Many injuries are not too serious, but sometimes an accident occurs that can impact an employee’s life for years to come.
Accident investigations are an important part of (insert agency name)’s efforts to create a safer workplace, prevent future accidents and reduce the cost of workers’ compensation claims. Prompt, thorough accident investigations will help our agency to analyze our accident history and develop goals and strategies to reduce work-related illness and injuries.
Today we’ll be talking briefly about why we should investigate workers’ compensation accidents and then we’ll focus on the elements of accident investigation. We’ll also touch on three types of accidents that frequently occur at (insert agency name).
This slide outlines the goals and objectives of the class. It details what you want the participants to be able to do after completing the course.
Notes:
By the end of this session, each of you will have a better understanding of the process of a workers’ compensation claim and the specific elements that impact coverage and handling of a claim.
We will discuss various methods of investigation. Not every method is appropriate for every accident. We will talk about the different tools you can use and give you information to help you decide which method is right for a given situation.
Determining the root cause of an accident is important. This piece of information can help the claims staff decide whether or not coverage is available under the North Dakota Workers’ Compensation Act.
Notes:
The first critical step in the claims process is NOTICE.
The initial notice should include the injured workers’ name, address, telephone number, job title, time, place and description of the injury or illness. Also include the cause as best as can be determined.
Notes:
Is there a written form? Who should ultimately receive the accident notification at your agency for filing the claim? What steps need to be followed? You may wish to provide participants with a copy of your policy and any internal accident investigation forms.
Immediate notice is required so that the employer can investigate the facts of the claim promptly and see that the injured worker receives any medical care needed. Also, if the investigation is delayed, important information may be lost.
Notes:
Notice of accident is what gets the ball rolling. The injured worker notifies his or her supervisor and the supervisor informs LP.
The accident investigation should be completed and the accident scene documented by photograph and in writing immediately, before evidence is lost or destroyed.
The Employers’ First Report of injury is to be filed with WSI within 24 hours.
An Incident Report is to be filed with Risk Management within 24 hours.
This slide opens the discussion of the on-site investigator’s role in the workers’ compensation claim process.
Notes:
The on-site investigator is important to help loss control and safety efforts, but is also important to the smooth processing of workers’ compensation claims.
Accident investigations are important both to Forem Facility and to the Office of Workers’ Compensation.
The accident investigation is a tool that agencies use to identify problem areas and take steps to fix the problems before someone else is injured.
WSI Claims Adjusters investigating workers’ compensation claims rely on investigations to assist with determining the cause of accidents or illnesses, to document the scene and to document what injured workers and witnesses said at the time of the incident.
The ability of the agency to document facts immediately after an incident occurred and the accident scene as it existed at the time of the accident may be the difference between a lengthy investigation by WSI and a smooth transition of a claim from investigation to compensability decision.
The information obtained during the agency’s investigation should be provided to (Insert information here about who your agency authorizes to notify WSI, for example: Human Resources, Workers’ Compensation Coordinator, accident investigator, etc.
Notes:
The Agency should obtain photographs or a written description of any location where a slip, trip or fall occurred so that the most informed decision on coverage of the claim can be made. Photographs are a permanent record of the scene as it existed at the time of the accident. Also, we may need the photographs in certain circumstances to litigate a claim. Use photographs to document the facts for the claims adjuster.
If you feel that there was a defect in the property or a hazard, you can write a description of the hazard or defect and have it sent to the claims adjuster handling the claim. If your investigation does not reveal any defect or hazard, then a photograph should be taken to document exactly where the accident happened and the condition of the location. The sooner this is done after an accident, the better – remember, spills dry or are mopped up, objects can be moved.
The cameras do not see inside of racks WE NEED PICTURES as we have been receiving a lot of injury reports stating inside rack.
Ask participants to define accident.
Discussion
Read information on slide
Accidents are not expected.
Accidents are sudden events.
Have participants give an example of an accident.
Accidents are not intended.
Ask participants to define cause.
Discussion, strawberries, straps, liquid
Read information from slide:
Webster says a cause is the reason for the action.
The cause is what brings about the accident.
If the injured worker can’t identify a particular movement or action that caused a change in his body, then there must be further investigation as to what might have caused the injury.
Identifying the cause helps to establish how or if the injury is related to the employment.
If I tripped outside this morning, what was the cause? My shoes, my own misstep? A defect in the walkway or the boxes I was carrying?
Explain the value of accident investigation and its usefulness.
Notes:
Accident investigations are valuable tools to evaluate how and why accidents occurred. This information is useful both to the agency and to the WSI claims staff in determining compensability of a resulting workers’ compensation claim. Accident investigations are used to prevent similar accidents from recurring in the future – NOT to place blame!
Ask class participants for reasons why they should investigate.
Review the slide.
Notes:
It definitely helps speed the claims process along if we are able to get as much information as early as possible. You are in the best position to help collect that information. Be the eyes and ears in the field. Get out to the scene as quickly as possible before evidence is damaged or destroyed.
You’d be surprised how quickly vital pieces of information are lost or misplaced. Go to the site. Get photographs, talk to witnesses, the supervisor and the employee. Figure out what caused the accident. Document what people heard or saw. Were there any contributing hazards?
Look for fixes to prevent the same accident from happening in the future.
Think out of the box. Fixes can often be quick and inexpensive.
Review best practices with the class.
Notes:
The person investigating for the agency may need to secure the scene so that additional injuries or property damage don’t happen.
Look for contributory hazards, like damaged property or the environment or weather conditions.
**Have an incident investigation kit and communicate the contents that should be in it:
Camera
Tape measure, ruler
Rope, caution tape or other means to secure the scene
Note pad
Clip board
Pen
Tape
Ask participants for suggestions for additional tools.
Review the slide with the class
Give examples of possible causes to look for: water, defective equipment or property, safety rule violation
Ask participants for other suggestions for do’s and don’ts.
Review the slide with the class participants
Notes:
Investigate with an open mind. Don’t make any assumptions. Don’t let personal opinion guide the investigation.
Gather as many facts as possible.
Preserve the site.
Take plenty of photos.
Take measurements if the scene may need to be reconstructed.
Notes:
Make sure to take notes from any witnesses. The sooner you can document the facts, the less likely that a witness will forget or embellish the facts.
Avoid voicing opinions. Just the facts!
Ask the participants if anyone has performed accident investigation.
These are some key points that must be covered in an investigation. These questions can be posed to a number of people: eye witnesses, employees in the area of the accident, by-standers, the employee’s supervisor, paramedics, nurses, doctors.
Find out what information the injured employee has given to their supervisor and to other people at the accident scene and in the next few hours.
An important piece of the investigation is defining where and when the accident occurred. Document if there was an event at a specific moment in time or if the injury occurred gradually over time.
Were there any eye witnesses to the accident or people who observed the injured employee perform this task just prior to the accident?
Find out exactly how the employee was injured. Consider information from the employee, witnesses, supervisor and the accident scene. Document the events leading up to the accident and what occurred just after the accident.
Find out if the employee had been properly trained to perform the task or operation that he/she was performing. Ask the supervisor, employee, safety officer and go back through the safety training documents to verify that training was or was not performed and when.
Review the definition of evidence
Ask participants how they would determine what evidence is important in the investigation.
Notes:
Changes can occur at accident scenes virtually overnight. Preserve important evidence in photographs.
