Incident/Accident Reporting and Investigation Training
 
Purpose
 
Outline
Definitions
 
 
·         Accident: an unplanned event that caused personal injury or property damage. Even “minor” injuries (cuts or sprains) are considered accidents.
 
 
·         Incident: an unplanned, or “near-miss”, event that could have caused personal injury or property damage.
 
 
·         Serious Illness or Injury: a condition requiring immediate medical assessment or treatment.
 
 
·         Minor Illness or Injury: a condition that does not require immediate medical assessment or treatment.
 
What Should Be Reported
Any:
 
Reporting Responsibilities
        Shall immediately notify their Supervisor/Instructor of any incident/accident.
        Supervisors/PIs and Instructors:
        Ultimately responsible for reporting employee or student incidents/accidents to University Police.
        Complete and submit the necessary reporting forms within 24 hours.
        Note for serious illness or injury, contact 911 for medical attention.
  
·         Shall respond to all reported serious incidents or accidents.
·         Shall notify Environmental Health and Safety of all incidents/accidents.
 
 
 Reporting Forms
 
1.       The Incident/Accident Investigation Form (DA 2000 form) - used to report incidents/accidents involving LSUHSC employees. To view form, click here.
 
2.       The Employer Report of Injury/Illness (DA 1973-E1) - used when an accident involves an injury that results in employee and/or student medical expenses or workers’ compensation related loss. To view form, click here.
Please Note: In addition to the above forms, a DA 2041 form must be filled out for reporting vehicle accidents to ORM within 48 hours of the accident. Click here to view form.
 
When Should an Incident/Accident Report (DA 2000) be filled out
Who Should fill out the DA 2000 Reporting Form?
 
 
 
How to fill out an Acceptable DA 2000 form
 
When Should a DA 1973-E1 Employer Report of Injury/Illness Form Be Filled Out?
 
 
Who Should Fill Out the DA 1973-E1 Form?
 
 
How to fill out an Adequate DA 1973 form
 
 
Incident/Accident Notification Procedures
 
1.       For an EMPLOYEE:
·         Employees must report any incident/accident to their supervisor/principal investigator IMMEDIATELY.
·         The Employee’s supervisor or principal investigator must immediately report every incident/accident to University police (568-8999).
·         Supervisor’s or Principal Investigators must complete the First page of the Employee Incident/Accident reporting form DA 2000 and forward to EH&S and HRM within 24 hours of the occurrence.
·         If an accident or injury results in medical expenses or workers’ compensation related loss, the Supervisor or Principal Investigator must fill out the DA 1973 -E1 form and forward to HRM within 5 days of the occurrence.
·         HRM will notify ORM of the potential claim within 10 calendar days of the injury, enter the DA 1973-E1 data into the STARS Reporting System and People Soft, and send a copy of the DA 1973-E1 to EH&S.
 
2.       For a STUDENT:
·         Students must report any incident/accident to their instructor IMMEDIATELY.
·         The students Instructor must notify University police (568-8999).
·         The students Instructor must fill out the DA 1973-E1 form within 5 days and forward to HRM.
·         HRM will maintain the DA 1973-E1 on file and submit a copy to EH&S.
·         EH&S will complete the DA 3000 form to document student incident/accidents.
 
3.       For a VISITOR, CLIENT or CONTRACTOR:
·         Ensure the visitor, client or contractor notifies the University Police immediately (568-8999).
·         University police will respond to all incidents/accidents, conduct initial investigation, and notify EH&S.
·         EH&S will fill out a DA 3000 form to document any visitor, client or contractor incident/accident at LSUHSC-NO.
 
Incident/Accident Reporting Summary
 
 
Time Limits for Reporting
 
  1.  Employee Accident/Investigation form (DA 2000) form
  2. Employer Report of Injury/Illness form (DA 1973-E1) form


Any Questions?

450A South Claiborne

Sister Stanislaus Memorial Bld.      

Room 206                                        

New Orleans, La 70112                  

Phone: (504) 568-6585

Labor Relations Section              

RCB

6th floor (Suite 603)                                      

New Orleans, La 70112              

Phone: (504) 568-3916

425 S. Roman St.                      
Room 301                          
New Orleans, La. 70012    
Phone: (504) 568-8999