Tools
Motivate's Claims Site can be found here. A step-by-step tutorial on how to fill out the form can be found at the bottom of this article.
Any incidents involving a loss of limb, overnight hospital stay, or death must also be emailed to the safety department immediately upon notification.
Introduction
Filing Injury reports is one of the most important jobs of an AOM. Injury reports should be submitted as close to the time of incident as possible but must be submitted no later than the end of the employee’s regular shift. Documenting injuries is an essential part of MTV complying with workplace safety laws, ensuring employees get proper treatment/support, and allowing our team to focus on reducing incidents in the future.
The priority should be ensuring staff safety. Any injury/emergency event that requires immediate medical attention should be referred to 911. All injuries should be documented through the nurse triage process. This ensures that the proper medical documentation is started. For further information on the Nurse Triage program, please see this article elsewhere in the PHD.
Documenting Injuries
Once the employee has been referred to medical attention and/or contacted the Nurse Triage, AOMs should start documenting the incident that led to the injury. The MTV Injury form can be found on Ops Source or through this direct URL.
AOMs should aim to accurately answer every part of the form. However, if there is any portion of the form that the information is not readily available, AOMs should fill out all the information that they can, add in dummy data for any field that information is not available, and notate it to the manager and safety officer. This will ensure that the claims process is not delayed.
OSHA Forms
In addition to submitting reports in Claims, the AOMs must complete the OSHA 301 paperwork. After submitting the information to Claims, the Safety team will email the 301 form to fill out. Please complete the 301 within 24 hours of completion and return it to the safety team. This ensures that MTV is compliant with OSHA rules.
Reports
Documenting vehicle incidents helps ensure that MTV is able to protect the company from spurious vehicle claims and hold drivers accountable for at fault accidents. Vehicle incidents should be completed by the end of the shift they occur.
AOMs are responsible for ensuring there is an exchange of information between the MTV employee and the other vehicle. This can be conducted remotely unless there is serious injury or a severe incident and is requested to the scene by authorities.
The MTV Incident form can be found on Ops Source or through this direct URL.
Investigation Guidelines
Investigating Incidents and Injuries is essential to ensuring they do not happen again. After ensuring that the injured employee has been given proper medical attention and that no one else can be injured, an Incident investigation will need to be conducted. A general guideline for the investigation is as follows:
Incident Scene
Unless unsafe to do so, the Incident scene should be secured, and the physical evidence should be undisturbed until the investigation of the scene is complete. When examining the Incident scene, the person investigating the Incident should note the condition of the equipment and any surrounding areas; note the materials that were being used and how they were being used; and take pictures, diagrams, and notes of all other observations.
Witnesses
The person investigating the Incident should identify and record the names of all individuals and contact information who witnessed the Incident; those involved in the Incident; those who were in the area immediately before or after the Incident; and those who have knowledge of the process, system, or equipment involved in the Incident. Each witness should be asked to provide a written statement identifying their account of the Incident.
Gathering Information and Data
The person investigating the Incident should collect information on all contributing factors to the Incident such as weather conditions, lighting, noise, machine condition, etc. Be as detailed as possible when describing what the employee was doing when the Incident occurred. They should also find out the exact location of the incident including information such as the facility, department, building, room, or location. Other questions the
investigator will need to note are when the Incident occurred, including the date and time of the Incident. In addition, he/she will want to review any documentation that could be involved such as training records, procedures, policies, or instructions, etc.
Non-Injury or Incident Report
Non-incident reporting is crucial to providing valuable data to help ensure what almost happened or could happen doesn’t happen. If you see something report it so we can correct it and help, ensure we reduce our risk to all those who are on Motivate property.
Safety Hazard Form
If an employee comes across an immediate safety hazard, they may use the safety hazard form on MTV Claims
Near Miss
If there is a near miss that occurred it is the employee's obligation to report this through the MTV Claims process
How to Submit Claims