REPORTING OCCUPATIONAL INJURIES AND …

1 LOS ANGELES COMMUNITY COLLEGE DISTRICT _____ laccd EH&S _____ REPORTING OCCUPATIONAL INJURIES AND illnesses _____ RR-03 _____ Los Angeles Community College District REPORTING OCCUPATIONAL INJURIES and illnesses laccd EH&S RR-03 _____ LOS ANGELES COMMUNITY COLLEGE DISTRICT REPORTING OCCUPATIONAL INJURIES AND illnesses TABLE OF CONTENTS I. OBJECTIVES Page 02 II. DEFINITIONS Page 02 III. RESPONSIBILITIES Page 05 IV. REPORTING WORKPLACE INJURY OR ILLNESS Page 08 V. EMPLOYEE INFORMATION Page 16 VI.

2 RECORDKEEPING Page 18 APPENDICES A. Incident / Injury Report Page 20 B. Injury and Illness Incident Report (Cal/OSHA Form 301) Page 21 C. Supervisor s Report of OCCUPATIONAL Injury or Illness Page 22 D. Bloodborne Pathogens Exposure Incident Log Page 24 E. Employer s Report of OCCUPATIONAL Injury or Illness Page 25 F.

3 Employee Claim for Workers Compensation Benefits Page 26 G. Log of Work-Related INJURIES and illnesses (Cal/OSHA Form 300) and Page 29 Annual Summary of Work-Related INJURIES and illnesses (Form 300A) H. Referral for Treatment of OCCUPATIONAL Injury or Illness Page 31 I. Statement of Employee s Pre-Designated Physician and Employee Consent Page 33 J. College Sheriff Department Telephone List Page 35 K. Telephone Notification to Division of OCCUPATIONAL Safety and Health Page 36 Checklist L. Notice of Employee Death Page 38 M.

4 Workers Compensation Benefits Information Page 39 N. REPORTING INJURIES and illnesses Process Model Page 41 O. Developmental Resources Page 42 _____ Rev. 7 03/03 Page 1 of 42 Los Angeles Community College District REPORTING OCCUPATIONAL INJURIES and illnesses laccd EH&S RR-03 _____ LOS ANGELES COMMUNITY COLLEGE DISTRICT REPORTING OCCUPATIONAL INJURIES AND illnesses I. OBJECTIVES A. This procedure complies with Title 8, California Code of Regulations, Sections 9770 through 14000 et seq for REPORTING OCCUPATIONAL INJURIES and illnesses at each campus and at the Educational Services Center (ESC).

5 B. This procedure complies with Title 8, California Code of Regulations, Section 3203 for investigating reported OCCUPATIONAL INJURIES and illnesses . C. Each campus may develop and prescribe additional procedures and controls approved by the Vice President - Administration, or equivalent, to meet these objectives, as appropriate. II. DEFINITIONS A. Date of Injury means the date of the work accident which resulted in the employee s injury or the date upon which the employee first suffered disability from an OCCUPATIONAL disease or cumulative injury and either knew, or in the exercise of reasonable diligence should have known, that such disability was caused by the employee s present or prior employment.

6 B. Date of Knowledge of Injury means the date the District Workers Compensation Office, the employee s supervisor, or higher level of supervisor, manager, or administrator has knowledge of an employee s OCCUPATIONAL injury or illness. C. Date of Onset of Illness means the date of initial diagnosis of illness or, if absence from work occurred before diagnosis, the first day of the absence attributable to the illness that was later diagnosed or recognized. D. Emergency Treatment means that medical treatment reasonably required by an injured employee immediately following an OCCUPATIONAL injury or illness, which, if delayed could decrease the likelihood of maximum recovery.

7 _____ Rev. 7 03/03 Page 2 of 42 Los Angeles Community College District REPORTING OCCUPATIONAL INJURIES and illnesses laccd EH&S RR-03 _____ II. DEFINITIONS (Continued) E. Employee means an employee as defined in Section 3351 of the Labor Code. For the purpose of workers compensation benefits, eligible persons include the following classifications whose INJURIES or illnesses arise out of and during the course of employment with the District or other covered activities and services: 1. Full-time (regular) and part-time employees; 2. District Officers and Board Members; 3. Persons performing voluntary services for the District without pay upon adoption of a resolution by the Board of Trustees (Labor Code ); 4.

8 Student workers as defined by the most recent revision of the Los Angeles Community Colleges Personnel Guide B385; and 5. Students enrolled in certain applied technology programs such as: (i) Intern programs; (ii) Mentoring programs; (iii) Cal/Works programs; (iv) Workforce Investment Act programs; (v) State Chancellor s Office grants; (vi) Other federal and state grants requiring student workers compensation coverage as a condition of the grant; and / or (vii) Under the purview of any course curriculum or District election to provide workers compensation benefits. F. First Aid means any one-time treatment, and any follow-up visit for the purpose of observation of minor scratches, cuts, burns, splinters, etc.

9 , which do not ordinarily require medical care. Such one-time treatment and follow-up visit for the purpose of observation, is considered first aid, even though provided by a physician or registered professional personnel. _____ Rev. 7 03/03 Page 3 of 42 Los Angeles Community College District REPORTING OCCUPATIONAL INJURIES and illnesses laccd EH&S RR-03 _____ II. DEFINITIONS (Continued) G. Injury Inspection / Investigation means a formal workplace inspection and / or employee interview process. 1. An inspection may be performed in order to assess facility conditions that may have contributed to OCCUPATIONAL injury or illness.

10 2. An investigation may be performed in order to assess employee safe work practices, procedures, personal protective equipment, business operations, and/or other pertinent matters related to the OCCUPATIONAL injury or illness. H. Lost Time means absence from work for a full day or shift beyond the date of the injury or illness. I. OCCUPATIONAL Illness means any abnormal condition or disorder, other than one resulting from an OCCUPATIONAL injury, caused by exposure to environmental factors associated with employment. Such illness includes acute and chronic illnesses or diseases that may be caused by inhalation, absorption, ingestion, or direct contact.