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S Montana. Division 
363.1l75of Uorkers* 
W20bLc Compensation. Loss 
19a7 Control Section 
Basic loss 
£?-( control manual for 
Montana employers 




DIVISION OF 

WORKERS' 

COMPENSATION 




BASIC LOSS CONTROL MANUAL 

FOR 
MONTANA EMPLOYERS 



> 



Developed by: 



Division of Workers' Compensation 
Safety Bureau 
Loss Control Section 
Helena, Montana 



PLEASE RETURN 






: 



DWC-MIS PAM 10 (New 12/87) 



GS8/M 



SEP 2 9 1993 



MONTANA STATE LIBRARY 

S363.1175W20bLc1987c.1 

Basic loss control manual for Montana em 



3 0864 00060577 7 




> 



151y E. 6f! 

HELENA, MONTANA 59620 



* 



TABLE OF CONTENTS 



TITLE PAGE 



Introduction 



Loss Control Program Outline 

Section I : Management Commitment 1-1 

Section II: Hiring Practices II-l 

Section III: Safe Operating Procedures III-l 

Section IV: Training IV-1 

Section V: Equipment Provision & Maintenance V-l 

Section VI: Hazard Identification & Elimination VI-1 

Section VII: Accident Reporting & Investigation VII-1 

Section VIII: Emergency Preparedness* VIII-1 

Section IX: Recordkeeping IX-1 

Section X: Other Loss Control Activities X-l 

FORMS AND INSTRUCTIONS 

Sample Statement of Policy 1-3 

Sample Job Application Form II-3 

Reference Checking Instructions & Form II-4 

Job Safety Analysis Instructions & Forms III-2 

New Employee Checklist IV-4 

Safety Meeting Form IV-5 

Job Safety Observation Instructions & Forms VI-3 

Accident Investigation Instructions & Forms VII-3 

Accident and Illness Summary Form IX-3 

Incident Rate Calculation Instructions IX-4 



> 



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Digitized by the Internet Archive 

in 2011 with funding from C 

Montana State Library 



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http://www.archive.org/details/onsiteconsul2001mont 



INTRODUCTION 



Purpose : This manual is designed to provide a basic blueprint 
of a sound loss control program for Montana employers. The 
primary goal of such a program is to reduce occupational 
injuries and illnesses and their associated costs. The 
policies, procedures and activities described herein will 
allow you to reduce losses if practiced consistently in your 
daily operations. The manual is essentially generic in nature 
so that it can be utilized by employers in a wide variety of 
industries. Each individual firm must tailor the program to 
their particular type of operation. 

Organization : The manual is divided into 10 chapters. The 
chapter titles and page numbers are shown in the Table of 
Contents. Each chapter begins with a rationale section 
explaining the reasons for the particular policies, procedures 
or activities in that chapter. Next, are the Core 
Requirements. These are the items which are essential to a 
good program and if you are participating in the Safety 
Discount Program, must be implemented for certification. 
Following the Core Requirements section is an Optional 
Considerations section. These are additional elements which 
will further enhance a loss control program as the program 
becomes more sophisticated. Finally, in many of the chapters, 
instructional materials and examples of forms or documents 
have been included to help you implement the core requirements 
in that chapter. In attempting to keep the manual from being 
overly lengthy, instructions and example forms or documents 
were not included for every core requirement. 



11 



Should you desire additional information on a core requirement 
or an optional item, please feel free to request it from your 
Loss Control Consultant or the Safety Bureau Office directly. 
Also, any portion of the manual may be reproduced for use in 
your operation. 

Summary : Research has shown that a business has a greatly 
improved chance of being successful if a business plan is 
developed and followed. A loss control program is nothing 
more than a part of management's overall plan of doing 
business in terms of containing costs and maximizing 
resources. But for a plan to work, it must be implemented and 
followed. This takes perserverance, determination and a 
considerable amount of time. The benefits are real and we 
hope this manual will assist you in attaining them. 



111 



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) 



) 






( 



LOSS CONTROL PROGRAM OUTLINE 



I . Top Management Commitment to Safety 
Core Requirements : 

1. Develop or adopt a written loss control plan. 

2. Include a written policy statement from management, 

3. Implement the plan and insure adherence to it. 

a. Allocate adequate resources. 

b. Assign proper authority, responsibility and 
accountability. 

c. Set a good example by participating in safety 
efforts . 

d. Insure compliance with applicable safety and 
health regulations. 



> 



> 



II . Hiring Practices 

Core Requirements: 

1. Use written application form. 

2. Consult with previous employers. 

Optional Considerations: 

1. Have applicant take a preemployment physical 
examination. 

2. Incorporate probationary period of employment for 
new hires. 

3. Conduct personal interviews with all applicants 
prior to hiring. 

4. Utilize your local Job Service for applicant 
referrals . 



IV 



Ill . Establish Safe Operating Procedures 
Core Requirements : 

1. Perform job analysis to develop safe operating 
procedures . 

2. Review procedures periodically. 

3. Outline general safety rules and regulations. 

IV. Provide Training 

Core Requirements: 

1. Management training on plan implementation. 

2. Newly hired or transferred employee training. 

a. Orientation on safety plan contents and safe 
operating procedures. 

b. Employee acknowledgement form. 

c. On-the-job training. 

3. Ongoing employee training. 

a. Safety meetings held regularly. 

b. First aid, CPR trained personnel. 

c. Other mandated training. 

Optional Considerations : 

1. Provide formal classroom or seminar training 
sessions . 

V. Equipment Provision and Maintenance 

Core Requirements: 

1. Provide necessary and adequate production and 
protective equipment. 



( 



o 



2. Maintain equipment to manufacturers specifications 
and applicable regulations. 

3. Keep maintenance and inspection logs when required 
by regulations. 

Optional Considerations: 

1. Develop a scheduled preventive maintenance program. 

2. Keep maintenance records even when not required by 
regulations . 

VI . Hazard Identification and Elimination 

Core Requirements: 

1. Routine daily hazard identification and elimination. 

2. Documented periodic self -inspections of the 
workplace. 

3. Documented periodic job safety observations. 

4. Noise and air contaminant monitoring. 

5. Chemical hazard identification and labeling. 

6. Disciplinary policy for rule enforcement. 



Optional Considerations: 

1. Documented daily hazard reports 

2. Inspections by outside entities 



VI 



VII . Accident Reporting and Investigation 
Core Requirements: 

1. Insure prompt accident reporting to management. 

2. Prompt written accident investigation by supervision, 

3. Insure the prompt submission of claim forms to the 
Division of Workers' Compensation when applicable. 

4. Review and communicate investigation results to 
prevent future accidents. 

Optional Considerations: 

1. Investigate non-injury accidents. 

VIII. Emergency Preparedness 
Core Requirements: 

1. Establish emergency procedures. 

2. Provide necessary first aid equipment. 

Optional Considerations: 

1. Notify emergency medical service of remote job site 
locations . 

IX. Recordkeeping 

Core Requirements: 

1. Establish a loss control filing system. 

a. Written company loss control plan. 

b. Accident records. 

i. Accident investigation reports, 

ii. Workers' compensation claim forms, 

iii. Accident summary log. 

iv. Man hour totals or number of employees. 



VI 1 



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i ) c. Hazard Identification and Elimination Records 

i. Formal self inspection reports, 
ii. Job safety observation reports, 
d. Training records 

i. Safety meeting documentation. 

2. Establish personnel files. 

a. Employment applications and previous employer 
check forms. 

b. Employee acknowledgement forms. 

Optional Considerations: 

1. Maintain non-core requirement records. 



> 



X. Other Loss Control Activities 
Core Requirements: 

1. Periodic contact with injured workers who are off 
work . 

2. Periodic review of the loss control program to 
insure continued effectiveness. 

Optional Considerations: 

1. Monetary or other rewards for attaining and 
maintaining safety performance goals. 

2. Initiate a "back to work" policy. 

3. Promote Off -Job Safety. 



vm 



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( 







SECTION I 



MANAGEMENT COMMITMENT 



Rationale : The commitment of top management to an effective 
loss control plan has to be the first step in implementing 
such a plan. Also, it is the most important element of the 
plan as the remaining elements will not be implemented and 
maintained unless management is strongly committed to do so. 

The commitment must be properly communicated to employees and 
management must be involved in safety and health activities to 
demonstrate their concern. 

Core Requirements : 

1. Management must adopt or develop a written loss 
control plan which contains all of the core 
requirements as outlined in the remainder of this 
packet. Employee participation is encouraged. 

2. The plan must contain a written policy statement 
expressing management's commitment and goals. The 
example on page 1-3 can be adopted or develop your 
own. 

a. The policy statement must be signed by the chief 
executive officer. 



1-1 



3 . Management must implement the plan and insure that 
it is followed. 

a. Allocate adequate resources to allow the plan to 
be implemented and maintained. 

b. Assign proper authority, responsibility and 
accountability for safety and health. 

c. Set an example of safety by adhering to the 
rules and participating in safety activities. 

d. Insure compliance with applicable safety and 
health regulations. 



1-2 



SAMPLE 



LOSS CONTROL PROGRAM STATEMENT OF POLICY 

In recognition of the responsibility of the management of 

(Company Name) to establish procedures 

for the prevention of employee accidents, this Loss Control 
Program has been developed. 

Our objectives are to provide to the best of our ability: 

1. An accident and injury free work environment. 

2. Protection of the general public. 

3. Reduction of costs associated with accidental losses. 

The achievement of these objectives is based upon good planning 
and making sure safety is an integral part of day to day 
operations and work procedures. This can only be accomplished 
if all personnel take an active interest and participate in the 
Loss Control Program and abide by the applicable Federal, State, 
Local and Company rules and regulations. 

The success of our program can be measured directly by its 
ability to control unnecessary loss. An accident resulting in 
personal injury, property damage or equipment loss represents 
needless waste. It is imperative that all employees recognize 
their responsibility to control these losses and that they take 
all necessary actions to do so. Their performance in this regard 
will be measured along with their overall performance. 

It is my earnest request that all employees of (Company Name) 

devote their serious attention toward making this program an 
integral part of day to day business operations. 



PRESIDENT/OWNER DATE 



GENERAL MANAGER DATE 



1-3 



<> 



J ) SECTION II 



HIRING PRACTICES 

Rationale : Good hiring practices are the employers' only 
means for being selective in obtaining a new employee. 
Through a formal screening process, you are making your best 
attempt at hiring an employee who will work safely and 
productively in your business. 

Core Requirements ; 

1. The employer must utilize a written job application 
form for all job applicants. An example of such a 
form is shown on the next page. This form has been 
reviewed and deemed not to contain any unlawful 
questions . 

2. The employer must do an employment history check 
with at least two (2) of the applicants' previous 
employers listed on the job application. A brief 
outline on conducting reference checks and an 
example of a reference check form are included. 
When reference checks cannot be made, it should be 
so noted in the personnel file. 

Optional Considerations : 

1. For physically demanding jobs, the applicant should 
take a preemployment physical examination. Provide 
the examining physician with a job description and 
have the exam results reported directly to you. 

2. Incorporate a probationary period for newly hired 
employees . 



II-l 



3. Conduct a personal interview with prospective 
employees to gain further knowledge about their 
background, experience, etc. Be sure to keep all 
questions job related. 

4. Utilize your local Job Service Office for applicant 
referrals. 



( 



II-2 



PLEASEPRINT NOTICE : This is an application for work onjj 



SAMPLE 



1-3. Name - First, 


Middle, Last 


8. Circle highest 
school year 
completed 
12 3 4 5 6 7 

8 9 10 11 12 13 

14 15 16 17 18 

19+ Yr. Grad. 


9. Highest Degree 
None 

HS or GED 

_ Associate 
Bachelor 
Master 
Ph. D. 


10. 


Driver's License 
Operator 1 s 
Chauffeur's 


11. Vocational, trade 
or technical 
school attended 







Months of training 
completed 


4. Address 


Date Completed 


5. City, State, Z 


p Code 
7. Msg. Phone 






"1 


Courses Taken 


6. Phone 





IMPORTANT CIVILIAN AND MILITARY EXPERIENCE 
Describe your longest and most important jobs - Begin with your most recent job 



12. Name of Firm or Branch of Service 


16. Name job and describe exactly what you did and how you did it. 


13. Address 




14. Employer's Type of Business 




15. Length of Job Date Ended Pay 


Reason for Leaving 






17. Name of Firm or Branch of Service 


21. Name job and describe exactly what you did and how you did it. 


18. Address 




19. Employer's Type of Business 
) 




20. Length of Job Date Ended Pay 


Reason for Leavinq 






22. Name of Firm or Branch of Service 


26. Name job and describe exactly what you did and how you did it. 


23. Address 




24. Employer's Type of Business 




25. Length of Job Date Ended Pay 


Reason for Leaving 




27. Name of Firm or Branch of Service 


31. Name job and describe exactly what you did and how you did it. 


28. Address 




£9. Employer's Type of Business 




30. Length of Job Date Ended Pay 


Reason for Leaving 


32. Summary of Other Work Experience: 


3° vVolunteer Work: 



Do you have any physical or mental handicap which will limit your ability to perform the job for which you are applying? 

Yes No If Yes, explain: 

. II-3 



R eference Checking 

{ ) Many of the problems of subjectivity which affect the interview are present in 
reference checking as well. Similarly, by using a systematic procedure, 
reference checking can be improved. 

The same guidelines for interview questions apply to questions asked of 
references. 

° Ask only for job-related information (based on job analysis) or for 
verification of information provided by the applicant. 

Write down in advance the questions or areas which will be explored. 

Cover the same areas for each applicant. 

Develop criteria against which to judge the reference giver's response, 
(what sort of responses would be qualifying? What kinds of responses would 
disqualify an applicant?) 

Contact only former supervisors or persons who have direct knowledge of the 
applicant's qualifications to perform the job. 

° Ask for factual information which can be documented. Stay away from 
subjective impressions of character, personality, etc. 

Don't ask the popular rehire question. Since nearly everyone answers "yes" 
the question is meaningless. 



II-4 



Applicants can request that they be notified before their current employer isr 
contacted. Determine if that is their desire before such a contact is 
made . 

The EEOC offers two broad guidelines which are useful reference checks. 

1. Will the answers to the question, if used in making a selection decision, 
have a disparate effect in screening out minorities and /or members of one 
sex, i.e., disqualifying a significantly larger percentage of members of a 
particular group than others? 

2. Is this information really needed to judge an applicant's competence or 
qualification for the job in question? 

Research seems to indicate that the reference check has more use as a verifica- 
tion of information provided by the applicant rather than as a predictor of job 
success. Until additional methods for checking references are developed, other 
applications are not generally recommended. 



i 



( 
II-5 



SAMPLE 



Name of Applicant 



I ) REFERENCE CHECK 

FORM 



Name Title 



Agency/Business Telephone 

Questions: 

1. Verify employment? 



2. Verify duties? 



3. Supervisory relationship to applicant? 



4. Meets timeframes/deadl ines/objectives? 



5. Works as member of team; gets along with other workers; can gain cooperation? 



6. Accuracy of work; number of errors; need for review? 



7. Represents organization; professional demeanor; verbal skills? 



8. Rule compliance; does applicant comply with organizational rules; attendance, 
leave, punctuality. 



Signature (person checking reference) Date 

II-6 



i ) 



{ ) SECTION III 



» 



SAFE OPERATING PROCEDURES 



Rationale: Development of written job-specific safe operating 
procedures and their subsequent use in training employees has 
been proven to shorten the length of time required to bring a 
newly hired or transferred employee up to full production 
potential. In addition, it is done safely. These procedures 
are also used to perform job safety observations on regular 
employees as discussed in Section VI. 

General rules are also necessary to cover company wide 
policies on accident reporting, absenteeism, and topics of a 
broad nature. 



Core Requirements ; 

1. Perform a written job safety analysis (JSA) for 
those positions deemed hazardous using the 
instructions and forms on the following pages or an 
equivalent. 

2. Review the written safe operating procedures from 
the job analysis periodically to insure completeness, 

3. Develop a set of written rules covering general 
topics. (Note: Sections VI, VII, and VIII require 
written policies and procedures regarding hazard 
reporting, accident reporting and emergency 
procedures. These can be incorporated into the 
general rules or addressed separately). 



III-l 



JOB SAFETY ANALYSIS (JSA) 

Job Safety Analysis (JSA) is a procedure that identifies the hazards in each 
step of a job and involves the development of safe job procedures to control or 
eliminate each hazard. The basic steps in making a JSA are: 

• Break the job down into successive steps. 

• Identify hazards in each step. 

• Eliminate or guard against potential hazards. 

• Develop safe job procedures for each job step. 

A job safety analysis worksheet is on the following page. In the left column, 
the basic steps of the job should be listed in the order in which they are 
performed . The middle column should describe how to perform each successive 
job step. The right column should indicate the safe job procedures that should 
be followed to eliminate or guard against potential hazards. 

Priority of Jobs to be Analyzed 

The priority of jobs to be analyzed should be determined by the following 
factors: 

• Frequency of accidents. 

t Severity of accidents or injuries, 

t A high severity potential. 

• Repetition of the job. 

• New jobs or changed job procedures. 

A job that has a history of many accidents should be analyzed immediately. Any 
job that has produced disabling injuries or has the potential for a serious 
accident or injury should have a JSA developed. Persons working on repetitive 
jobs have a high rate of exposure to hazards. If new jobs are created by 
changes in equipment or operating procedures, it is important that a JSA be 
developed for the jobs immediately because the safe operating procedures are 
not always clear. 

Those are the five factors that should be used for determining the 
priority of jobs to be analyzed. After job priorities have been 
established they should be listed on a form similar to the one on 
Page III-7 and scheduled for analysis. 



III-2 



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III-3 



Breaking the Job Down Into Steps 

The steps in a job should describe exactly what is done in the order each step 
is performed. The following is an example of this procedure: 

Job: Pre-start of a Front-End-Loader 

t. Check for the presence of safety shields. 

2. Check for loose parts. 

3. Check for small cracks on safety equipment. 

4. Check tires for proper air pressure. 

5. Check crank case oil level. 

6. Check coolant level. 

7. Check air cleaner condition. 

8. Test control levers for free movement. 

9. Check yourself for personal safety equipment and unsafe 
clothing. 

10. Place transmission lever in neutral. 

11. Install safety belt. 

Additional factors that should be considered when performing a JSA are: 

• Select the right person to observe. 

• Brief the person on the purpose of the JSA. 

• Personally observe the job being performed. 

• Record each step on the worksheet. 

• Check the job steps with the persons when the JSA is done 
to get their input. 



III-4 



) Identify Hazards 



J 



After the steps in the job are listed on the worksheet, each step should be 
analyzed to identify hazards or potential accident causes. Each should be 
recorded on the worksheet in the center column. Keep the hazards in line with 
the steps recorded. 

Developing Solutions and Safe Operating Procedures 

When the hazards and potential accident causes have been identified, the next 
step is to develop solutions and procedures to eliminate or guard against the 
problems you have identified. Solutions and procedures may include some or all 
of the following: 

• A different method of performing the job. 

t A change in physical conditions or environment. 

• A changed job procedure. 

• A change in the frequency of how often the job is performed. 

For each hazard or potential accident cause listed on the worksheet, ask "what 
can be done differently and how should it be done?" Answers and solutions must 
be very specific to be of value. Solutions which state "Be more aware" or "Be 
careful" are of no value in determining safe operating procedures. The 
solutions should state exactly what must be done to perform the job safely. 

Benefits of JSA 

For the supervisor, the JSA will enable him/her to clearly understand the safe 
way of performing all jobs in their area of responsibility. In addition to 
providing the supervisor with a basic training guide, the JSA will provide a 
tool for: 

• Making safety contacts with all employees. 

t Determining whether safe work procedures are taught in training and 
followed on the job. 

• Issuing uniform safety instructions. 

• Analyzing jobs for possible methods of improved operating procedures. 

• Assisting training personnel in updating safe operating procedures 
relative to program content. 

• Reviewing job procedures after accidents occur. 



III-5 



The JSA allows the supervisors and employees to work together in developing 
effective safe operating procedures which can be used as OJT training guides. 
The JSA is an excellent tool for eliminating non-applicable content in job 
skills training. If the JSA's are not used as training guides, a lot of time 
and effort will have been wasted presenting ineffective training. 



III-6 






HIGH RISK JOB LIST WORKSHEET 



Department 


Department Supervisor 


Occupations and Jobs 


Priority 


Remarks (notes) 


Occupation: 






Jobs: 1. 






2. 






3. 






4. 






5. 






6. 






7. 






Occupation: 






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2. 






3. 






4. 






5. 






6. 






7. 






Occupation: 






Jobs: 1. 






2. 






3. 






4. 






5. 






6. 






7. 







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SECTION IV 



TRAINING 



Rationale ; There are a number of benefits to be derived from 
relevant training. In the implementation of new procedures, 
new processes and for new employees, you are asking personnel 
to make a transition and learn a particular new role. 
Providing training will help gain acceptance and make the 
transition safer and faster. Also, existing safe work 
procedures and operational procedures must be regularly 
reviewed and reinforced to prevent complacency. This can be 
accomplished through periodic refresher training. 

Core Requ i rements : 

1. Management must receive training on how the plan 
will be implemented and operated. Topics include 
forms to be completed, areas of responsibility, 
accountability, etc. 

2. Newly hired or transferred employee training 
procedures must comply with the following 
criteria : 

a. Prior to actually starting work, the employee 
must become familiar with the safe operating 
procedures (SOP's) applicable to that position 
and the general safety rules as developed under 
Section III. 



IV-1 



b. The employee must sign an acknowledgement form 
such as the one shown on page IV-4 or an 
equivalent indicating that this has been 
performed . 

c. Once the employee begins work, an on-the-job 
training period must be provided where job 
procedures are demonstrated by a trained person 
and then the new employee is observed to insure 
proper work practices are being followed. 

3. Ongoing training must be provided for all employees 
meeting the following requirements: 

a. A minimum of one (1) safety meeting every two 
(2) weeks where job hazards, accident 
investigations, current safety goals or records 
and other pertinent information are discussed. 
These meetings must be documented using the form 
shown on page IV-5 or an equivalent. For mobile 
worksites such as construction, a safety meeting 
must be held prior to the start-up of each 
project and at least bi-weekly thereafter. 

b. There must be an adequate number of first 
aid/CPR trained persons so that at least one ( 1 ) 
such person is available on each shift or job 
site. Documentation of such training must be 
maintained. 

Note: Periodic job safety observations and retraining 
are outlined in Section VI, Hazard 
Identification and Elimination. 






IV-2 



( 



) 



c. Training required by Federal or State 

regulations, such as annual hearing conservation 
training, must be provided and documented. This 
may be accomplished through the required Safety 
Meetings if appropriate. 

Optional Considerations : 

1. Allow management and employees to attend formal 
safety and health seminars, classes, etc. if 
feasible. 



Note: Training assistance can be provided by your Loss 
Control Consultant and/or the Safety Bureau, 
however, this will be on a limited basis. 



IV-3 



NEW EMPLOYEE CHECK LIST 



) 



Company Name: 



Employee Name: 



Employee Position: 



Date : 

Started Date 

_of Training: 

Completed Date 

_of Training: 



Date of Completion 



1. Provide employee with a copy of the Loss 
Control Plan to read. 

2. Review general Company regulations. 

3. Review emergency medical plan and procedures, 

4. Your immediate supervisor is 

He reports to 



5. Explain fire fighting equipment procedures and 
evacuation plan. 

6. Review job safety analysis. 

7. Review personal protective equipment required. 

8. Review Company disciplinary procedures. 



I do hereby acknowledge that the above items were discussed on 



(Date) 
Employee Signature 



Date 



Supervisor's Signature 






(Continual observations should be performed so to insure employee competency.) 
To be filled in by the Supervisor or person responsible for training. 
(See Job Training Section.) 



First Observation_ 

Needs Training 

Observation 



(Date/Comments) 



Completed Training_ 



Keep as a permanent personnel record. 



IV-4 









SAFETY MEETINGS 



Date: 



Company Conducted 
Name: By: 



Items Discussed: 



Follow-up Need: 



Signature of Employees: 



IV-5 



I 



> 



SECTION V 



EQUIPMENT PROVISION AND MAINTENANCE 



Rationale ; The right tools for the right job is a basic 
safety and production rule. The right tools include both 
production and protection equipment. For these tools to be 
used properly, they must be maintained. 

Core Requirements ; 

1. The employer must insure that adequate production 
and personal protective equipment is available so 
that tasks can be performed safely. 

2. All equipment must be maintained in accordance with 
manufacturers specifications and applicable 
regulations. 

3. Where required by specific regulations, equipment 
maintenance and inspection logs must be kept. 

Optional Considerations ; 

1. Develop a scheduled preventive maintenance program 
for equipment. 

2. Document maintenance activities in areas even when 
not required by regulations. 



V-l 



( 






! 



> 



SECTION VI 



HAZARD IDENTIFICATION AND ELIMINATION 



Rationale ; There are essentially two (2) major types of 
hazards in the workplace. The unsafe condition and the unsafe 
act. Both of these types of hazards must be identified and 
corrected for a program to be successful. This is 
accomplished through daily routine observation and scheduled 
formal observations by management and employees. A policy 
must also be available to deal with continuous disregard for 
safety rules by personnel. 



Core Requirements ; 



Management must encourage the reporting of hazards on a 
daily basis and insure correction. A written statement 
of this policy must be contained in the loss control plan 
such as in the safe operating procedures or the general 
rules. Instructions on hazard reporting systems are 
available. 

2. Formal, planned self -inspections must be performed 
at least monthly. The use of an inspection 
checklist is suggested. Example checklists can be 
provided by the Loss Control Section. The 
correction of hazards noted during the 
self-inspection must also be documented. 

3. At least annually, planned job safety observations 
of employees must be performed using the safe 
operating procedures developed under Section III as 
a guide. Job observation instructions begin on page 
VI-3. 



VI-1 



4. A policy for rule enforcement must be established. 

The policy should be applied fairly and consistently 
to all employees including management. Additional 
informational material on disciplinary procedures is 
available. 

Optional Considerations ; 

1. Develop a hazard report form for use in daily 
observations to further insure correction of 
reported hazards. Use of small pocket cards or 
slips is an effective way to allow daily hazard 
reporting. 

2. Periodically request inspections or program audits 
by outside organizations. 



I 



VI-2 



E 



JOB SAFETY OBSERVATION (JSO) 

Detecting unsafe practices promptly is one of the best ways to prevent acci- 
dents. Why do employees do what they do? Generally because they have been 
taught to do it and because they receive satisfaction from doing, it. Employees 
do things that are foolish, dangerous, or illegal for the same reasons that 
they do smart, safe, and legal things. . .because their actions are reinforced by 
someone or something. For example, an employee does silly things because other 
employees laugh. 

Often, we feel there is no need to reinforce safe performance. An employee 
"ought" to want to work safely or wear eye protection for his or her own good. 
"You oughta wanna do it for your own good" is not a potent motivator; it is one 
of the weakest techniques known for influencing anyone to do something. What 
reinforces safe performance depends on the individual to some degree, but there 
are some generally applicable reinforcers. Two of the most potent reinforcers 
known are praise and recognition. They are universally available to the super- 
visor. By timely use of praise and recognition, the supervisor can provide 
effective feedback and incentive for employees to perform safely. Such a posi- 
tive performance feedback and evaluation system may be accomplished through a 
program of job safety observation (JSO). The basic idea of job safety observa- 
tion is simple. It is essentially nothing more than observing employees doing 
their jobs to find out if they are working safely. 

There are three types of job safety observations. They are listed below along 
with a brief narrative pertinent to each. 

1. Incidental Safety Observation 

Part of a supervisor's job is keeping his/her eyes and ears open for unsafe 
actions and conditions. You probably do it every day whether you realize it or 
not. The key to effective incidental safety observations is to look around 
with safety on your mind. If you don't do this already, remind yourself to 
look for unsafe practices while conducting daily work place inspections. 

2. Deliberate Safety Observation 

This is one step beyond the incidental observation. The supervisor pauses in 
what he/she is doing and deliberately watches how an employee handles some part 
of the job. He/she observes from a safety standpoint. . .Is the employee doing 
the job safely? Why a deliberate safety observation? The employee may be new, 
or performing a particularly hazardous job. The employee may also have a repu- 
tation for being unsafe. Whatever the reason, the supervisor stops and 
observes the employee deliberately. This observation should be more than a 
casual glance in his/her direction, although it might start out that way. 



VI-3 



3. Planned Safety Observation 

In this instance, the safety observation is planned in advance and, if possi- 
ble, in conjunction with an established JSA of a particular job. It is best to 
plan safety observations for all employees under your supervision. Sinqling 
out individuals leads to a "picking on me" response by some. But definitely 
some employees need more frequent safety observation than others. 

If results of a safety observation show that employees are not working safely, 
the following may be some of the reasons for the unsafe behavior. 

a. They do not know how to work safely: If the problem is a lack of 
skill, you train. It is a major responsibility of every supervisor and 
instructor to see that employees are trained to do their work safely 
and efficiently. The level of skill necessary to accomplish a work 
task can be assessed to some degree by question and discussion, but the 
final check is to watch the employee do the job. If necessary, rein- 
struct, arrange practice, or assign him to a more skilled employee for 
further on-the-job training. 

b. They are prevented from working safely: Sometimes employees would do 
their jobs safely, but they are prevented by someone or something in 
the work environment. Inspection of the work place will pick up such 
hazards as poorly maintained work equipment, but a well documented 
safety observation is necessary to isolate such equally hazardous con- 
ditions as insufficient time, poor work flow, no clear-cut chain of 
command, and inadequate supervision. 

c. They do not want to work safely: Some supervisors categorize all per- 
formance problems under the motivational incentive label - "They could 
do it if they wanted to." Although lack of incentive is often closely 
associated with the work environment, solutions to these problems 
differ from the solutions to environmental problems. In looking at 
motivational incentive problems, we need to define why employees per- 
form the way they do. In order to accomplish this goal, the personal 
safety observation should be integrated with a system of performance 
analysis and evaluation. 

A Job Safety Observation (JSO) provides supervisors and trainers with a proce- 
dure to determine if employees are following safe work procedures on the job 
after training. Following the procedures outlined below, supervisors and 
trainers are provided with an opportunity to check on the results of past 
training; revising content for future training; make immediate, on-the-spot 
corrections and improvements in work practices; and compliment and reinforce 
safe performance. 






VI-4 



Follow these steps when implementing a JSO Program: 

Worker Selection 

All employees should be observed performing the job. The following factors 
should determine which employees to observe first: 

• A new employee on the job. 

• Employee recently trained for a new job. 

• Below-average performers. 

t Employees consistently involved in accidents. 

• Risk takers. 

• Employees with special problems. 

Making the JSO 

With few exceptions, tell employees what will be taking place prior to the 
personal observation. Then simply observe the employee performing in his 
normal operation. Make any notes on the worksheet provided on the following 
page about work practices and procedures observed. Be sure not to interfere 
with the employee performing the job or distract him, in any way. 

Recording the Information 

Fill out the Job Safety Observation Worksheet describing any unsafe procedures 
or work practices observed. Examples of some basic types of unsafe work 
procedures and practices which will probably be observed are: 

• Failure to secure equipment or materials against unexpected movement. 

• Operating or working at an unsafe speed. 

• Using unsafe tools and equipment. 

• Using tools and equipment unsafely. 

• Failure to warn or signal as required. 

• Assuming an unsafe position. 

• Removing or making safety devices inoperable. 

"l • Repairing, servicing, or riding hazardous equipment. 



VI-5 



(< 



t 



PLANNED SAFETY OBSERVATION RECORD 



) 



Department 


Employee 


Position 




Job 


Date 


Supv. 


S 


R 


Comments 


1. 












2. 












3. 












4. 












5. 












6. 












7. 












8. 












9. 












10. 












11. 












12. 













S = Satisfactory Performance 
J= Reobserve 



VI-6 



(t 



Failure to wear required personal protective equipment. 

Wearing unsafe personal clothing. 

Violation of known safety rules and safe job procedures. 

Engaging in other unsafe practices (not violations). 

Indulging in horseplay, practical jokes, fighting, sleeping, creating 
distraction, and so on. 



Discussing the JSO with Employee 

After completing the JSO, review the results with the employee. Your feelings 
about the work habits and practices observed should be discussed informally and 
in a friendly manner. Do not let the discussion be one-way communication. 
Encourage the employee to talk and give his/her views about any problems or 
barriers they see in following the current operating procedures. 

The Follow-up 

Follow-up the JSO as needed. In some instances, the follow-up will be often. 
How often follow-up is needed depends on the employee, the results of the 
initial observation, and the job. 

Benefits of the Job Safety Observation 

The JSO is a feedback device. It provides excellent information of the effec- 
tiveness of training and on the adequacy of established safe job procedures. 
Through the JSO, unsafe practices can be identified and corrected before an 
accident happens. Additionally, any weaknesses taught in training relative to 
safe operating procedures can be revised and included in the OJT content. 

Since the firstline supervisors are responsible for making sure that safe 
operating procedures are followed on the job, they should be allowed to provide 
feedback to training personnel on how well training prepared employees to per- 
form their assigned jobs. 

Job safety observation provides an effective way of determining the accuracy of 
the job safety analysis. In addition, implementation of a Job Safety Observa- 
tion program is an excellent method of assuring supervisory involvement in all 
training efforts. 



vi-7 



t 



SECTION VII 



ACCIDENT REPORTING AND INVESTIGATION 



Rationale : The primary purpose of accident investigation is 
to determine how a reoccurrence can be prevented and thus 
improve the safety of your operation. Obviously, an accident 
must be reported before the investigation can be performed. 
Accident investigations must be done in a thorough and 
objective manner based on the facts and must not attempt to 
place blame on the individuals involved. In regard to the 
validity of a reported accident, a good accident investigation 
report can be a very important source of information in 
subsequent investigations or proceedings. 

Core Requirements : 

1. A written policy stating that accidents must be 
reported to management within a specified time 
period must be included in the written plan. 

2. All injury or illness incidents must be investigated 
as soon as possible after they are reported by 
management. Investigation findings must be 
documented. Procedures for conducting a proper 
accident investigation and example forms begin on 
the following page VII-3. 



VII-1 



I 



3. Insure that the appropriate workers' compensation 
claim forms are completed and sent to the State 
Compensation Insurance Fund (located within the 
Division of Workers' Compensation) as soon as 
possible after an accident or illness is reported 
involving medical treatment or lost time. 

4. Corrective actions taken as a result of accident 
investigations must be documented. 

Optional Considerations ; 

1. Investigate non-injury accidents to determine causes 
and preventative measures. 



VII-2 



) 



> 






ACCIDENT INVESTIGATION 

INTERVIEW TECHNIQUE AND SKILLS 

1. Keep the purpose of the investigation in mind. 

a. To determine WHO was injured? WHEN, WHERE, and 
HOW did it happen? WHAT materials or equipment 
were involved? WHY did it happen? 

b. To reveal causes so reoccurrence can be prevented. 

2. Approach the investigation with an open mind (it will 
be obvious if you have preconceptions about the 
individuals or the facts ) . 

a. Do not attempt to place blame; 

b. Stay away from conjecture. 

3. Promptness will reduce the possibility of: 

a. Destruction of physical evidence (changed work 
site ) ; 

b. Forgetf ulness of witnesses or victim; 

c. Interjection of opinion or conjecture by witnesses 
or victim after they evaluate the accident from 
their perspective; 

d. Witnesses and victim talking together and getting 
confused about what they know and what they've 
been told by others. 

4. Go the scene. (Just because you're familiar with 
the location or the victim's job, don't assume that 
things are always the same). 

5. Interview the people involved (victim, witnesses, 
people involved with the process, i.e., forklift 
driver, mechanic, so on). 

a. Attempt to do the interview at the site. 

Circumstances may not permit (noise, lack of 
privacy, congestion). If not possible, use: 
i. Combination (look, then go somewhere to talk); 
ii. Photos; 
iii. Blueprints; 
iv. Sketches. 



VII-3 



Put the person at ease: 

i. Explain the purpose and your role; 
ii. Sincerely express concern regarding the 
accident and desire to prevent a similar 
occurrence ; 
iii. Express to the individual that the infor- 
mation he gives is important; 
iv. Be friendly, understanding and open-minded ; 
v. Be calm and unhurried. 

Interviews should be private and in a neutral 
location . 

Let the individual talk: 

i. Ask background info; name, job, address; 
ii. Ask the witness to tell what happened: 
Don't ask leading questions; 
Don't interrupt; and 

Don't make expressions (facial, verbal) 
of approval or disapproval; 
iii. Then: Ask questions to clarify particular * 
areas or to ask "why" . Do not put the person on 
the defensive. Try to avoid "yes" and "no" 
questions . 
iv. Ask for their suggestions; 
v. Repeat the facts and sequence of events back 
to the person to avoid any misunderstandings; 
vi. Notes should be taken very carefully and as 
casually as possible. Let the individual 
read them if he desires; 
vii. Recordings should only be made with the know- 
ledge of the witness; (Some people may be 
very intimidated by a recorded interview and 
not speak as freely). 



VII -4 



) 



viii. Conclude the interview with a statement of 
appreciation for their contribution. Ask 
them to contact you if they think of any- 
thing else; 
ix. Do not hesitate to reinterview; and 
x. Avoid reenactment if at all possible. 



; 



VII-5 



SUPERVISOR'S ACCIDENT INVESTIGATION REPORT 



COMPANY/EMPLOYEE INFORMATION 



-^/1I 



PANY 



EMPLOYEE 



DATE OF INJURY 



DEPARTMENT 

AGE OCCUPATION 



LOCATION 



HOUR 



A.M._P.M._DATE REPORTED TO EMPLOYER 

ON THIS JOB SHIFT 



LENGTH OF EMPLOYMENT 

DESCRIPT ION 

1. Describe the accident. Include the machine, object, or substance involved and explain exactly what the 
injured worker was doing. 



2. What did each co-worker or witness say about the accident (if necessary, attach additional sheets), 



3. If pain gradually occurred, how does the employee relate this problem to work? 



4. Have other employees had injuries, accidents, or near misses at or near this job site? If so, when, where 
and how are they related to this accident? 



PPSULT 
F~ 
6. Has the worker sought medical treatment? 



Date 



6. What part(s) of the body were injured? (Be specific, e.g. left knee). 
CAUSE 

7. Identify the causes of this accident by checking the appropriate boxes below. Remember all causes should be 
identified so they can be eliminated. 



J 



ORGANIZATIONAL CAUSES 

L ] Inadequate job training procedures 

t ] Failure to enforce safe job procedures 

[ ] Inadequate standards for hiring, placement 

and upgrading 
L ] Lack of safe job procedures 
t J Lack of motivation or incentive to work safely 
[ J Lack of adequate supervisory training 
t J Management disinterest in accident prevention 
[ J Lack of competent safety staff services 
L ] Management unawareness of safety fundamentals 
[ J Failure to assess true accident costs 
[ ] Failure to conduct planned safety inspections 
I ] Failure to implement adequate preventative 

maintenance measures 
] Failure to incorporate safety standards in 

purchasing practices 



[ ] Failure to incorporate safety standards into 
the design of production facilities. 

t ] Rapid expansion of supervisor and employee 
work forces 

L ] Active antagonism between management and labor 

L ] Drastic up and down changes in production rates 



PERSONAL CONDITIONS 

[ ] Pre-existing medical conditions or impairment 

of worker or co-worker 
[ ] Worker's hobbies 
[ ] Worker's off job activities 
[ ] Worker's personal problems 



VII-6 



CAUSE (CON'T) 



UNSAFE CONDITIONS 



] Inadequately guarded 

] Defective tools, equipment or substance 

] Hazardous arrangement 

] Improper illumination 

] Improper ventilation 

] Unsafe clothing 

] Unsafe design or construction 

] Faulty equipment 



I ] Operating without authority 

[ ] Operating at unsafe speed 

[ ] Making safety devices inoperative 

[ ] Using unsafe equipment 

[ ] Using equipment unsafely 

[ ] Unsafe loading, placing or mixing 

[ ] Distraction, teasing, horseplay 

[ ] Failure to use personal protection devices 

[ ] Acts of another person not employed by your fii 

[ ] Short-cut to save time or effort 



i 



OTHER CAUSES 



I ] Explain: 



8. If an unsafe act(s) was a cause of this accident, why was the unsafe act committed? 



9. If an unsafe condition(s) was a cause of this accidnet, why did the condition exist? 



10. If an organizational cause(s) was a cause of this accident, why did the cause exist? 



PREVENTION 






11. Complete the following table: 



Corrective Action Proposed Responsible Person Target Date Action Taken 



Date Completed 



CLAIMS COST CONTROL 

12. Have all parts of faulty equipment, machinery, or other evidence associated with this accident been preserved 

13. If your employee is filing a workers' compensation claim, and you doubt the validity, specify reasons below. 
(Attach additional pages if necessary.) 

- 



Supervisor 



Date 



Reviewing Mgr. 



Date 



I 



J 



SUPERVISOR'S REPORT OF INDUSTRIAL INJURY 

ORIGINAL TO YOUR MAIN OFFICE FILE 



EMPLOYER . 



MAILING ADDRESS 
POLICY NO 



EXPIRATION DATE 



J L 



MO DA VR 



NAME OF INJURED- 
HOME ADDRESS _ 
JOB TITLE 



OEPT 



BIRTH DATE 



J L 



MO OA VR 



SOC SEC NO 



INJURY DATE. 



TIME. 



AM 
PM 



NATURE OF INJURY 



(SCRATCH. CUT, BRUISE. ETC I 



PART OF BODY INJURED . 



HEFT RING FINGER, RIGHT ANKLE. ETC I 



NAME OF DR OR HOSPITAL. 



WHERE DID ACCIDENT HAPPEN?. 



HOW DID ACCIDENT HAPPEN? (STATE SPECIFIC JOB BEING DONE AND WHAT 
WENT WRONG INCLUDE MACHINE/TOOL OR OBJECT CONNECTED WITH 
ACCIDENT ) 



IF ACCIDENT WAS CAUSED BY NON-COMPANY PERSON OR BY FAULTY EQUIP- 
MENT. GIVE NAME AND ADDRESS 



NAME OF WITNESSES 



WHAT HAVE YOU DONE OR WILL YOU DO TO PREVENT A SIMILAR TYPE OF 
ACCIDENT? 



EMPLOYEE S SIGNATURE 



DATE REPORTED 



SUPERVISOR S SIGNATURE 



REVIEWING MANAGER S SIGNATURE 



64 too .' mo Supervisor — Send this copy to YOUR main office 



This type of accident investigation form normally comes in triplicate bound 
in pocket size books. The original is sent to the main office, duplicate to 
the doctor with the injured person if possible, and the triplicate remains 
in the book for the supervisor. 



VII-8 



s 









1 



J 



I 



SECTION VIII 



EMERGENCY PREPAREDNESS 



Rationale: The ability to deal with an emergency situation in 
the workplace depends on the degree of planning and preparing 
that has been done prior to the actual emergency. When 
properly prepared, the impact of an emergency on personnel and 
property can be greatly reduced. 

Core Requirements: 

1. Emergency procedures must be established and 
emergency phone numbers posted. For remote job 
sites, either radio or telephone communications must 
be available. Supplemental materials are available 
on how to handle emergency situations in the 
workplace . 

2. Provide first aid materials necessary to allow those 
persons trained in first aid, as required in Section 
IV, to render prompt treatment. 

Optional Considerations: 

1. When the job site is located in a remote area, the 
location should be known to the emergency medical 
service for that area. 



J 



VIII-1 



) 






J 



G 



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) 



SECTION IX 



RECORDKEEPING 






Rationale : Just as production, sales, etc. must be accounted 
for, so must your loss control activities. Recordkeeping is 
often viewed as a "necessary evil", however, when properly 
planned and organized the burden can be minimized. The types 
of activities which must be documented and filed have been 
discussed in the preceding Sections and are summarized below. 

Core Requirements : 

1. Establish and maintain an organized loss control 

filing system where the required records are kept as 
follows : 

a. A copy of your written loss control plan. 

b. Accident records (copies or originals); 

i. Accident investigation reports as required in 
Section VII. 

ii. Workers' compensation claim forms. 

iii. An accident summary log such as the OSHA 200 
shown on page IX-3 or an equivalent. 

iv. An accurate record of either total employee 

hours worked or the number of employees in any 
given quarter. The accident summary log and 
employee hours are used to calculate incident 
rates. See page IX-4. 



IX-1 



c. Hazard identification and elimination records I v 
(copies or originals). 

i. Formal self -inspection reports and written 

documentation of corrective action as required 
in Section VI. 

ii. Job safety observation reports as also 
required in Section VI. 

d. Training records. 

i. Documentation of safety meetings and other 
training must be maintained. This should 
include a brief description of the topics, who 
attended, and any correction actions taken. 

Establish and maintain an organized set of personnel 
files where the following records are kept: 

a. Job application forms and previous employment 
history check forms as required in Section II. 

b. The signed employee acknowledgement form 
indicating familiarity with the loss control plan 
rules and procedures as required in Section IV. 



Optional Considerations : 

1. Maintain any additional records that are related to 
the loss control plan but that are not core 
requirements . 



IX-2 



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IX-3 



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Incidence Rates for 
Safety Management 






Incidence rates can be used to show the relative level 
of injuries and illnesses among different industries, 
firms, or operations within a single firm. Because a 
common base and a specific period of time are involved, 
these rates can help determine both problem areas and 
progress in preventing work-related injuries and ill- 
nesses. 

How to compute incidence rates 

An incidence rate of occupational injuries and ill- 
nesses can be calculated quickly and easily. The formula 
requires: 

(a) The number of injuries and illnesses. Count the 
number of recordable cases from the Log and Summary 
of Occupational Injuries and Illnesses, osha No. 200 
(Appendix C), or refer to the TOTALS line for the year- 
ly total for fatalities, injuries and illnesses with lost 
workdays, and injuries and illnesses without lost 
workdays. 

(b) The number of hours all employees actually 
worked. Use payroll or other time records. "Hours 
worked" should not include any nonwork time, even 
though paid, such as vacation, sick leave, holidays, etc. 
(If actual hours worked are not available for employees 
paid on commission, by salary, or by the mile, etc., 
hours worked may be estimated on the basis of sched- 
uled hours or 8 hours per workday.) 

An incidence rate of injuries and illnesses may be 
computed from the following formula: 

(a) Number of injuries and illnesses X 200,000 = Incidence rate 
(b) Employee hours worked 



(The 200,000 hours in the formula represents the 
equivalent of 100 employees working 40 hours per week, 
50 weeks per year, and provides the standard base for 
the incidence rates.) 

NOTE: You can use the same formula to compute in- 
cidence rates for: 

(1) The number of lost workday injuries and illnesses; 

(2) The number of nonfatal injuries and illnesses 
without lost workdays; 

(3) Cases involving only injuries or only illnesses. 

Here is an example of how to compute an incidence 
rate: 

Jones Furniture Co. recorded 11 injuries and illnesses 
(from log and summary, osha No. 200). The total 
"hours worked by all employees were 130,000 (from 
payroll or other time records). 



1 1 x 200,000 



16.9 



130,000 
Therefore, Jones Furniture Co. experienced a rate of 
16.9 injuries and illnesses per 100 full-time employees. 
To compute an incidence rate for your own firm, 
enter the data in the appropriate spaces below and com- 
plete the formula. 



Number of injuries and 
illnesses in your firm 



X 200,000 



Incidence rale 
for your firm 



(Round to the 
nearest tenth) 



Hours worked by 
all your employees 

The incidence rate for your firm is the number of in- 
juries and illnesses per 100 full-time employees. 






IX~4 



c 



I 






c 



SECTION X 



OTHER LOSS CONTROL ACTIVITIES 






Rationale ; In addition to the essential elements of a loss 
control program already discussed, a number of other activities 
can be performed which will further enhance and broaden your 
program. Two of these activities are required, as shown below, 
while the remainder are optional. 

Core Requirements ; 

1. When an employee is injured and must be off work, 
regular contact with the worker should be maintained. 
Such contacts convey concern and can be used to assist 
workers in dealing with the compensation system. 
Assure the employee that you are not "prying or 
checking up", but that you are genuinely concerned 
about their progress and well being. 

2. Periodically the loss control plan must be reviewed to 
insure that it's scope, content and effectiveness is 
adequate. 






X-l 



Optional Considerations : 

1. Safety incentives, where employees are rewarded for 
attaining and maintaining safety goals, can produce 
increased safety awareness on the job. 

2. Develop a "back to work" policy where injured workers 
are encouraged to return to the job and can perform 
alternate duties until fully recovered. Of course, 
this must be cleared by the physician treating the 
worker, but, again this conveys your concern and 
keeps the employee in touch with the workplace. 

3. Promote off-the-job safety, such as seat belt use, 
through posters or handouts. Even though an 
off-the-job injury is not compensable, it may prevent 
that individual from working thus creating a hardship 
on the employer. 



X-2 






c 



1 



DIVISION OF WORKERS' COMPENSATION 

Margaret "Peg" Condon Building 

5 South Last Chance Gulch 

Helena, Montana 59601 



FOR RESPONSE TO QUESTIONS ABOUT: 



CALL 



1. State Fund claims or available benefits. 444-6500 

2. State Fund insurance coverage; i.e., enrollments, cancellations, endorsements, 
experience modification, volume discount, etc. 444-6440 

3. State Fund payroll audits. 444-3247 

4. State Fund premium billings. 444-6490 

5. Benefit claims of private insurance companies or self-insured employers. 444-6530 

6. Approval to operate as a self-insured employer or a private insurance company. 444-6530 

7. Silicosis & Occupational disease benefits. 444-6530 

8. Vocational Rehabilitation 444-6530 

9. Policy Services for employers with private insurance coverage. 444-6530 

10. Uninsured Employer's penalties. 444-6530 

11. Independent Contractor Applications. 444-6530 

12. Subsequent Injury Fund 444-6530 

13. Industrial safety, on-site consultations, boiler & mine safety, etc. 444-6401 

14. Message Center 1-800-332-6102 






6 



t 



500 copies of this public document were pub- 
lished at an estimated cost of $2.28 per copy, for 
a total cost of $1,142.50 which includes 
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