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| Appendix D4 |
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| Workers' Compensation Accident/Incident Investigation |
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Identifying the cause of the accident allows the development of corrective action to prevent recurrence. Every accident deserves an investigation. Even "near miss" accidents that might have caused death, serious injury, or property damage are equally important and should be investigated.
Why Investigate?
• To discover the root cause of the accident
• To correct problems, conditions, or practices that lead to the accident or loss
• To establish the facts for future reference, records and to use in training
• To determine the accuracy of the employee statement or report of the accident
Steps to Follow
• Preserve the scene. Don't move key materials/elements involved in the accident until
the investigation has been completed.
• Conduct interviews with the injured, witnesses, and any other involved parties.
• Take notes and be specific (get details, photographs, etc).
• Do not editorialize or interpret remarks, JUST RECORD THE FACTS!
• Complete a written accident investigation report. (A sample form is included in
this section.)
• Keep key accident elements (i.e. broken tools and scaffold boards) as evidence.
Analyze the Data
• How could the accident have been prevented?
• What must be done to prevent recurrence?
• Is third-party subrogation possible?
• Share the results of the investigation with all supervisors.
Workers' Compensation Accident/Incident Investigation Report
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