EFFECTIVE DATE: 7/06/2001
DURATION: Effective until superseded or removed / 32
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FSH 6709.12 - safety and health program
Chapter 30 - accident investigation and reporting
/ Forest Service Handbook
Mt. Hood National Forest (hq)
sandy, oregon
fsH 6709.12 – safety and health program
chapteR 30 – accident investigation and reporting
Mt.Hood Supplement No. 6709.12-2001-1
Effective Date: July 6, 2001
Duration: This supplement is effective until superseded or removed.
Approved: Christine arredondofor Forest Supervisor / Date Approved: 07/06/2001
Posting Instructions: Supplements are numbered consecutively by Handbook number and calendar year. Post by document; remove the entire document and replace it with this supplement. Retain this transmittal as the first page(s) of this document. The last supplement was Mt. Hood Supplement No.3 September 1997.
New Document / 32 thru 37.3 and Exhibits I thru III / 18 PagesSuperseded Document(s)Mt. Hood Supplement No. 3 September 1997 / 32 thru 37.3--13 / 8 Pages
Digest: Updates requirements for accident investigations.
32 – accident notification.
32.1 – Notification Criteria and Process. Required notifications, based on event severity, are set forth in EXHIBIT I. A flow chart showing the steps of the accident notification, investigation, and reporting processes is in section 37.3.
33 – ACCIDENT REPORTING.
33.02 –Objective. The primary objective of this supplement is to update the accident investigation, reporting and review processes and procedures to be utilized on the Mt. Hood National Forest.
33.1 – Types of Reports. Documentation requirements vary depending on the severity of the accident and implications for potential claims. Reporting requirements are set forth in EXHIBIT I. The Accident Report Checklist is to be used to ensure all forms are included in the accident packet before submittal to Forest Headquarters. See EXHIBIT II.
34 – ACCIDENT INVESTIGATIONS. Every accident, chargeable or non-chargeable, will be investigated to the extent necessary to determine the facts, conditions, and background factors present and to determine appropriate preventative measures for future implementation.
A Chargeable Traumatic Injury Accident is one that:
a. causes disability for work beyond the day or shift when it occurred;
-OR-
b. appears likely to result in prolonged treatment or in permanent disability or serious
disfigurement of the head, face, or neck;
-OR-
c. has resulted, or is likely to result, in a charge for medical or other related expenses.
A Chargeable Motor Vehicle Accident is any occurrence involving the use of a government-owned, leased, or rented automobile, truck or bus that results in illness, injury, or death -OR- total combined damage costs of $350 or more, regardless of whose property was damaged or who was injured. This definition also applies to private vehicles when used on official duty. Exceptions are as follows:
accidents to properly and legally parked, Government-owned, leased or rented motor vehicles, and accidents caused by natural events with no human intervention such as earthquakes or volcanic eruptions. These are reportable as propertydamage accidents; and,
Vehicle accidents in which it is clear that the Forest Service is not at fault, such as when the other driver is cited for a violation and the Forest Service driver is not. These are reportable as propertydamage accidents.
35 –INVESTIGATION PROCEDURES.
35.2 – Initial Procedures. The subunit on which an accident occurs initiates the investigation process the District Rangers and/or the Forest Staff Officer will ensure a thorough accident investigation. The Line/Staff Officer will determine the level of investigation required and will assign specific members to the incident review team depending upon the type and severity of the incident.
See FSM 5720 for aircraft accident investigation requirements and EXHIBIT I for fatality and hazmat incidents. Also follow guidance for accidents in the Health and Safety article of the FS/NFFE Master Agreement. Notify Forest Dispatcher immediately for any incident involving a hazardous materials spill, an aircraft accident, or a fatality.
Whenever an accident involves a private party or damage to private property, a Forest LawEnforcement Officer must be involved in the investigation. This is required even in cases where there appears to be no injuries, only minor injuries, or minimal property damage.
35.3 – Forest-level Investigations.
Accidents identified for Forest-level investigations will be investigated by a team consisting of the Safety and Health Manager or designee, an FLT member who is not in the supervisory chain of the accident, a trained accident investigator, the President of NFFE local or a designee when the accident involves a bargaining unit member, and, any other member deemed necessary. The District Ranger or Forest Staff Officer in the supervisory chain will work with the accident investigation team on a consultant and/or advisory basis.
37 - REVIEW AND ANALYSIS. Intensity of review will vary depending on the result or potential result of the accident. As a minimum:
-- the Line or Forest Staff Officer will review each accident to determine cause and any other contributing factors as well as management responsibility. The list in EXHIBIT III is provided to facilitate investigation of possible causes. It is not intended to be all inclusive nor is it intended to imply all would be applicable to a specific incident. The resultinginformation will be documented for ALL CHARGEABLE ACCIDENTS.
--the supervisor will discuss, with the employee(s) involved in any accident, the contributing factors to that accident and suggest areas that need improvement to prevent similar incidents in the future. This discussion will be documented for ALL CHARGEABLE ACCIDENTS.
--Reports of any accidents which involve private parties will also be forwarded to Financial Management (Headquarters) in case of potential claims against the government.
The Forest Leadership Team will have safety on the agenda at each regularly scheduled meeting. Included will be a review of chargeable accidents which have occurred since the last meeting. The FLT member whose unit had the accident will briefly discuss the circumstances of the accident, the primary contributing factor(s), any management actions or inactions that were contributing factors, and recommendations to prevent similar accidents in the future. The full FLT will discuss the factors, recommendations, and any other available information, and determine what can be done to mitigate any identified issues or problems. Additionally, the FLT will determine whether a pattern of certain types of accidents is developing; and, if so, what additional action needs to be taken.
37.2 – Conduct of Formal Accident Review. Incidents which require a review by the Forest Board of Review are identified in EXHIBIT I. In general, all accidents will be reviewed with emphasis on chargeable accidents which have occurred during the previous quarter. The staff work necessary for assembling and supporting the Board shall be performed by the Forest Safety and Health Manager and the OWCP Assistant.
All available information regarding chargeable accidents will be reviewed:
--for completeness and adequacy of the investigation report;
-- to ensure recommended mitigation measures and actions
are being implemented or are planned;
-- to identify and communicate any additional recommendations that may assist
in mitigation of future accidents; and,
-- to determine the amount of liability, if any, of the involved employee (s)
regarding costs associated with the accident.
The Board of review will also consider trends represented by accidents that have occurred on the Forest and make recommendations to management on preventative programs. This should be accomplished with representatives of the Forest Safety, Health and Wellness Steering Committee if possible.
The board will meet quarterly or on an “as needed” basis and will consist of the Deputy Forest Supervisor, the Forest Administrative Officer, the Forest Safety and Health Manager, the OWCP Assistant, the Property Management Officer, and, an FLT member who would be selected for a 1 or 2 year period. NFFE will be offered the opportunity to participate. As needed, the Board may also include the FLT member whose unit had an accident and other personnel to facilitate a full and complete discussion (i.e. claims officer, property management officer, fleet manager, or a personnel specialist.) The group will be convened and facilitated by the Forest Health and Safety Manager.
37.3 – Flow Chart for Accident Investigation and Review.
The chart on the next page demonstrates the steps in an accident investigation and review.
MT. HOOD NATIONAL FOREST
Summary of Procedures For
Incident Investigation, Review and Reporting
May 2001Revision
In 1997, the Mt. Hood published a supplement to FSH 6709.12, Safety and Health Program Handbook, updating the procedures for reviewing and reporting various types of incidents (motor vehicle collisions or employee injuries) that occur on the Forest.
The majority of the information in this supplement is still valid, although some revision is necessary. The following is a brief summary of the current procedures to follow when investigating, reviewing, and reporting incidents.
Investigation/Review/Reporting Procedures:
- Allincidents will bereported immediately, or as soon as feasible. Notification must occur within the first 24 hours to the immediate supervisor and to the unit line/staff officer.
- A Forest Law Enforcement Officer must be contacted if an incident involves a private party, an employee injury, or significant damage to government or private property. Contact with the State Police may also be required, depending upon location and/or specifics of the incident.
- All incidents will be investigated to the extent necessary to determine the facts surrounding the incident and to identify the contributing cause(s). The goal is to initiate appropriate preventative measures to avoid future incidents. Employees are also encouraged to informally report situations involving “close calls” which will serve to increase safety awareness for others.
- The unit on which an incident occurs will initiate the investigation process. The Line/Staff Officer will determine the level of investigation required and will assign specific members to the incident review team, depending upon the type and severity of the incident. A collision that results in personal injury to an employee; or, a traumatic injury incident requiring medical treatment may be reviewed at the Forest level.
- Appropriate contacts will be initiated by the unit manager including, but not limited to, the Forest Supervisor or Deputy, the Forest Safety Manager, Forest Law Enforcement, the Forest Accountant, the Information Officer, the Forest Fleet Manager, the Property Office, and the injury compensation specialist.
- Complete documentation will be provided and a permanent file forwarded to the Forest personnel office. The Incident Report Checklist (attached) provides guidance for appropriate contacts, required forms, and time frames.
- All incidents will be reviewed by the unit line/staff officer/supervisors. The Safety Board will also review incident reports quarterly.
- In addition to the required contacts listed above, any incident involving hazardous materials or an aircraft accident should also be reported to Forest Dispatch.
Forest Incident Investigators
Current Listing as of May 2001
Forest Safety/Health Managers
Larry Reed, Clackamas River
Shelley Butler, Zig Zag
Clyde Shaver, Zig Zag
Aleris Kaufman, Hood River
Denise Hilkey, Hood River
Dennis Beechler, Barlow
Eden Lira, Barlow
Brian Bishop, Barlow
John Pierce, Barlow
Lisa Geren, Timber Lake Job Corps
The Regional Office maintains an Accident Investigation Team Resource Roster
to provide assistance and support to forests. Contact the Regional Safety Manager - (503) 808-2626
FLOW CHART FOR ACCIDENT INVESTIGATION AND REVIEW
Incident Occurs
Employee reports incident to first-line supervisor or acting. Immediate notification
is required if the incident involves a fatality, member of the public, injury which requires medical treatment, or property damage greater than $350.00. If otherwise, the incident must be reported within 24 hours. If a private party is involved, the Forest Law Enforcement Officer must be notified immediately through Mt. Hood Dispatch. Notify the Forest Safety and Health Manager or the OWCP Assistant atHeadquarters’ Office and the Line Officer or responsible Forest Staff Officerimmediately if the incident involves a member of the public, an injury which requiring medical treatment, or any amount of property damage. If otherwise, notify within 24 hours.
Investigation is initiated. Determination is made as to level of investigation required. With motor vehicle accidents, care should be taken to complete preliminary data collection before moving vehicles.
Depending upon type and severity of the incident, additional resources may be assigned to the investigation. (Such as the Forest Law Enforcement Officer)
Investigation completed and report submitted to Line Officer or responsible Forest Staff for review.
Investigation report submitted to OWCP Assistant for processing at Forest Headquarters. As needed, reports will be provided to the Financial Accounting Manager, the Safety and Health Officer, the Fleet Manager, or the Property Management Officer.
FLT discusses contributing factors and makes recommendations
If required, Forest Board of review reviews report, FLT recommendations and determines any further actions required including whether the employee will be held liable.
Recommendations forwarded to Forest Safety and Health Manager to coordinate implementation.
MH SupplemenT:EFFECTIVE DATE: 7/06/2001
DURATION: This supplement is effective until superseded or removed. / 32
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fsh 6709.12 – safety and health program
Chapter 30 – ACCIDENT INVESTIGATION AND REPORTING
EXHIBIT I - OCCUPATIONAL INJURY/ILLNESS
NotificationInvestigationReportingAccountabilityAdditional
IncidentRequirementsRequirementsRequirementsReviewReferences
Any injury to a1) IMMEDIATELY notifyA Forest law Enforcement1) Send MH-6700-4, Mt. HoodForest Board ofFSM 6730
private citizenthe Forest Agent or aOfficer will investigateInitial Report of Accident,Review may beFSH 6709.11
due to ForestLaw Enforcement Officer.and report to the Districtto OWCP Asst or Safety &convened at theFSH 6709.12
Service activityRanger or the Forest StaffHealth Manager by phone,discretion of the
2) The District Ranger orOfficer.e-mail, or fax. w/in 24 hrsresponsible Line
Forest Staff Officer.-AND-Officer or Forest
2) A full investigativeStaff Officer.
3) Notify the Forest Safetyreport, prepared by a Law
& Health Manager who willEnforcement Officer must
handle additionalbe submitted to the OWCP
notifications.asst within one week or as
arranged with Forest Supv.
Minor injury1) To District Ranger orFirst – line supervisor will1) CA–1, Notice ofForest Board of
or illnessForest Staff Officerinvestigate & report to theTraumatic Injury, completedReview may be
to an employeethrough work supervisorRanger or Forest Staffby employee & supervisorconvened at the
(NO lost timeWITHIN 24 hours.Officersubmitted within 10 days.discretion of the
and NO medical-OR-responsible Line
treatment2) If hazmat incident, seeRanger or Forest Staff2) CA-2, Notice ofOfficer or Forest
required)Hazardous MaterialsOfficer may request a fullOccupational Disease andStaff Officer.
Incident on last page ofinvestigative report ifClaim for Compensation,
this exhibit.negligence is possible orcompleted by the employee
if serious concerns exist.& supervisor & submitted
within 10 days.
Minor injury orDistrict Ranger or ForestThe first – line supervisor1) MH-6700-4, InitialForest Board of
illness to anStaff Officer through thewill investigate & reportReport of AccidentReview may be
employeework supervisorto the Ranger or Forestwithin 24 hours toconvened at the
(lost timeStaff OfficerOWCP assistant.discretion of the
and/or medicalNotify OWCP asst WITHIN-AND-responsible Line
treatment24 HOURS.2) CA-1, Notice ofOfficer or Forest
required)Traumatic InjuryStaff Officer.
-AND-
(see definitions)If hazmat incident, seeLine or Forest Staff Officer3) CA-17, Duty Status
below.may request a full investigativeReport
report if negligence is possible-AND-
or if serious safety concerns4) FS-6100-16, Agency Provided
exist.Medical Care Authorization
-OR-
5) CA-16, Authorization for Examination
or Treatment
6) Line/Forest Staff Officer and immediate
supervisor analysis documentation.
**Submit all forms to OWCP assistant within 10 days
EXHIBIT I—CONTINUED
OCCUPATIONAL INJURY/ILLNESS
NotificationInvestigationReportingAccountabilityAdditional
IncidentRequirementsRequirementsRequirementsReviewReferences
Serious or life-Notify the Forest Safety &Forest level team will be1) MH-6700-4, InitialForest Board of
threatening Health Manager who willassigned.Report of Accident, toReview required.
injury to anhandle further notifications.OWCP Asst. within
employee24 hours.
(eg: major/If a hazmat or aircraft incident,
multiple the Forest Dispatcher must be2) CA-1, Notice of
lacerations; notified immediately. In thatTraumatic Injury;
multiplecase, the Dispatcher will coordinate-AND-
fractures;:all other required notifications.3) CA-17, Duty Status Report
serious head-AND-
injuries, orIn either case, notify the Ranger4) FS-6100-16, Agency Provided
hospitalization,or Forest Staff Officer throughMedical Care Authorization (for
etc)the work supervisor.hospitalization on first visit only.
-OR-
5) CA-16, Authorization for
Examination or Treatment.
6) Line/Forest Staff Officer and
immediate supervisor analysis
documentation.
7) If a hazmat incident is involved,
follow the “Hazardous Materials
Incident” guidance at the end of this
table as well.
** SUBMIT ALL FORMS TO OWCP
assistant within 10 days
EXHIBIT I –CONTINUED
OCCUPATIONAL INJURY/ILLNESS
NotificationInvestigationReportingAccountabilityAdditional
IncidentRequirementsRequirementsRequirementsReviewReferences
Occupational- ImmediateDistrict Ranger or Forest Staff1) MH-6700-4, InitialForest Board of ReviewFSH 6709.12
fatality (or notification of theOfficer will prepare for a WOReport of Accidentrequired, if incident isChapter 30\
death likely)-Chief’s Office throughor RO Investigation team, aswithin 24 hrsnot reviewed at a higher
to Forest Service-Forest Safety & Healthdetermined by the Chief’s Office.-AND-organizational level.
employee or Manager and Regional2) CA-1, Notice of
enrollee. Safety & Health ManagerTraumatic Injury
-AND-, if applicable-
-OR- Forest Law Enforcement
One or more Officer3) FS-6700-8, Report of
private citizensIncident to Other than
dies (or death likely).Employee.
as result of Forest-AND-
Service activity.4) Witness Statements,
(including name, address,
-OR-& signature), if available.
Five or more employees,Additional reporting will be
enrollees, and/orrequired. The Forest Safety
private citizens are& Health Manager and OWCP
hospitalized.asst will assist with their
completion.
** SUBMIT TO OWCP ASST WITHIN
10 days.
EXHIBIT I (CONTINUED) –MOTOR VEHICLE ACCIDENT
NotificationInvestigationReportingAccountabilityReferences
IncidentRequirementsRequirementsRequirementsReview
Total damage1) If a private party is District or Forest Staff1) MH-6700-4, Initial Report ofForest Board of Review
of less thaninvolved, IMMEDIATEInvestigation.Accident, WITHIN 24 HOURSmay be convened at the
$2,500 as a notification of the Forestto OWCP ASST.discretion of the responsible
result of a Law Enforcement Officer isTeam composition-AND-Line Officer or Forest Staff
motor vehiclerequired. This must beshould reflect the2) SF-91 Operator’s ReportOfficer.
accidentmet even when there is nocomplexity of theof MVA
involving aapparent damage to theincident.-AND-