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United States Department of Agriculture

Agricultural Research Service

Safety: Accident/Incident Reporting
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Accident/Incident Reporting, Investigation and Analysis

(adapted from Manual 230 - updated: 12/05/2005)


The Federal Employees Compensation Action (FECA) provides compensation and medical care to Federal employees for disabilities due to injuries and illnesses sustained in the performance of their official duties.  FECA is also applicable to Federal employees while serving as Federal petit or grand jurors and certain other groups.  The benefits outlined in the act constitute the exclusive remedy for work-related injuries and deaths. 

By law, an employee (or their designated representative in cases where the employee is incapacitated by an accident or illness) and their immediate supervisor are responsible for completing all reports necessary to protect an injured employee's rights.  Penalties are provided by law for failure to make required reports and for filing false reports. 



While the facilities linked to the Madison ARS Location strive to maintain a safe and accident-free workplace environment, there may times where an incident/accident occurs.   In these instances, it is important that the incident/accident be reported and that corrective measures be taken to avoid future recurrence. 

When is an incident/accident "reportable"?  If the incident/accident has an impact on USDA-owned property, equipment, facility, program or personnel, OR involves external safety personnel (UW safety, UW or local police/fire/hazmat/etc.) are involved, then a report must be completed.  Ask yourself, "Can a lesson be learned?" If the answer is yes, then a report should be filed.  For example, if there were a spill in a lab that was contained and caused no injury, damage or release to the environment, it should still be reported so that causes could be analyzed in order to prevent similar spills in the future.  If unsure, contact the Location Administrative Office at 608/890-0101 for clarification.  It is important that the report be filed within 24 hours of the incident/accident.  

If an injury is involved, a CA-1 form for Worker's Compensation reporting will need to be completed as well as additional paperwork depending upon the injury.  Please contact the Location Administrative Officer (LAO) immediately if an incident/accident involves injury at 608/890-0044.

Additionally, major accidents must be reported to Facilities Division, Safety, Health, and Environmental Management Branch (FD SHEMB) within 24 hours of occurrence. The first notification should be made by telephone. Major accidents are defined as "a job-related fatality, the hospitalization of two or more persons, or property damage in excess of $100,000". The Area should coordinate all actions/information with location personnel. 

All media inquiries should be forwarded to the Location Administrative Officer at 608/890-0044.

Who files the report?  It is the responsibility of the person directly involved in the incident/accident to file the report.  In the event that the person is not able to complete the report due to injury, then the supervisor, witness or other delegated person may complete the employee portion of the report. 

Where are the reports located?  The reports are available at each SHEM location, in the individual labs, at the Management Unit's Administrative Office, through the Location Administrative Office and available at the Location's Safety Website.

What does the report involve?   The Incident/Accident Report (IR) is a double-sided, two-part stapled form that contains a set of instructions and both the Employee Report (IR-E) and the Supervisor’s Report (IR-S).  The IR-E is completed by the individual reporting the incident, a copy is faxed to the Location's Administrative Office at 608/890-0048 and the report is given to the supervisor for completion.  Once the supervisor completes the IR-S portion, the entire packet is returned to the Location Administrative Office at 1925 Linden Drive, Madison, WI  53706.  The expected time to complete the report is less than 15 minutes.

How is the information used from these reports?   The information supplied in these reports will assist the Location’s SHEM Committee to identify opportunities where safety may be improved resulting in a safer and healthier workplace environment.


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Last Modified: 11/30/2009
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