255City Of Anaheim Administrative Regulation
CHAPTER 2 - EMPLOYMENT PROCEDURES
Subject: Reporting on the Job Accidents/ A.R. 255
Grant of Industrial Accident Leave Issue Date: Aug. 1, 1984
Revised:
Page (1) of (2)
Purpose:
The purpose of this regulation is to establish procedures for the reporting of on-the-job
injuries and the granting of industrial accident leave.
It is the policy of the City that all on-the-job injuries will be reported promptly and that
industrial accident leave will be granted only in accordance with prescribed procedures.
Procedures:
All on-the-job injuries shall be reported by the employee as soon as possible on the day
of the injury to his/her supervisor and the employee shall complete Form RISK/M-60,
Report of Employee Injury. If the injury prevents reporting by the involved employee, it
will be the responsibility of the employee's direct supervisor to insure the accident is
reported properly and timely.
If medical attention beyond first aid is required, the employee shall be issued a Medical
Service Order, RISK/M-67, and referred to one of the City's primary care facilities by his
supervisor.
If medical attention beyond first aid is required, the department/division/control center
shall complete Form RISK/M-100, Employer's Report of Occupational Injury or Illness,
and forward along with RISK/M-60 to Risk Management. A copy of both forms should
be retained by the department. (Serious injuries requiring hospitalization, or death,
should be reported immediately to Risk Management by phone.)
If an employee is absent from work because of a work incurred injury or illness and such
absence is supported by a physician's certification, and industrial accident leave request
shall be phone to Risk Management for proper code numbering for all newly reported
injuries illness.
City of Anaheim Administrative Regulation 255
Page (2) of (2)
Responsibility:
It is the responsibility of each department/division/control center to report all on-the-job
injuries to Risk Management within three (3) working days and to review with Risk
Management before granting industrial accident time to an employee.
It is the responsibility of Risk Management to coordinate the reporting of industrial
injuries and to administer and monitor the granting of industrial accident leave.
Attachments: None