Injury and Accident Reporting

Timely reporting of employee injuries and accidents is vital to maintaining the health and safety of our employees. As such, we would like to remind everyone that injuries/accidents must be reported immediately.

MOTOR VEHICLE ACCIDENTS & REPORTING:

An accident is defined as one that involves a state-owned vehicle (or a non-state owned vehicle operated by a state employee on state business) where there is damage caused to another person or property.

An incident involves only a state-owned vehicle where the damage, regardless of the amount, is limited just to the state vehicle which was stationary at the time the damage occurred. Incidents should not be reported to the Office of Risk Management.

An Accident Identification STD 269 card, should be carried in the glove compartment of all state vehicles. The card should be completed and the tear-off portion given to the other party. The card provides a convenient place to write down pertinent information while still at the accident scene. This information should be transferred to STD 270.

State employees should not discuss the accident with anyone other than the police, their supervisors, Risk Management Claims officials, or the independent claims adjusting company under contract with CSUN. If contacted by the other party, their attorney, or insurance company, the state employee should refer the party or correspondence to the Office of Insurance and Risk Management. Under no circumstances should the state employee driver give either a written or recorded statement to the other party or their representatives.

SUPERVISOR'S REVIEW & POLICE REPORTS:

The supervisor of an employee involved in an accident must investigate that accident. This investigation will enable the supervisor to co-sign STD 270. The supervisor is also responsible to ensure that STD 270 is completed and promptly forwarded to the Office of Insurance & Risk Management.

The supervisor is also responsible for preparing the Review of State Driver (Supervisor's) form, STD 274 , take any appropriate corrective action, and forward STD 274 to both the Office of Insurance & Risk Management, and the agency's Safety Coordinator.

If a California Highway Patrol (CHP) or other police authority accident report is needed to allow the supervisor to do the above, he or she may obtain these reports as an "interested party" and at no cost.

FOR FURTHER INFORMATION, PLEASE CONTACT KARI DOM AT EXT. 3351.

FORMS:

Accident Report (non-motor vehicle) STD 268

Acknowledgement & Verification for University and Private Vehicles

Vehicle Accident Report STD 270

State Driver Accident Review STD 274

Worker's Compensation Claim Form DWC1

Worker's Compensation Claim Procedure

Worker's Compensation Claim Procedure Modifications

Please contact the Risk Manager at (818-677-2079) for a quote or additional information.