Accident Details Tab
Use this tab to enter detailed information about the nature of the accident or illness.
Update this tab whenever an employee has been injured in a work-related accident, or reports an illness caused by working conditions.
Location
Field | Description |
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Accident Occurred on Employer's Premises |
Select this check box if the accident or illness occurred on the employer's premises. |
Accident Occurred on State Property |
Select check box if the accident or illness occurred on state property. |
Street Address of Accident |
Enter the street address or other location where the accident occurred. You can enter a maximum of 40 characters in this optional field. |
City |
Use this drop-down list to select whether the accident or illness occurred in a City or a Country. In the unlabeled field to the right, enter a maximum of 30 alphanumeric characters for the name of the city or country. |
Reported To |
Enter, or use
|
Witness Employee |
Enter, or use
|
Injury/Illness Information
Field | Description |
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Machine, Tool, or Object Causing Injury or Illness |
Enter a description of the machine, tool, or object that caused the employee's injury or illness. This is a required field. |
Machine Part, Tool Part, etc. |
Enter a description of the specific part of a machine, tool, and so on, that contributed to this employee's injury or illness. This is an optional field. |
Safeguards Provided |
Select this check box if safeguards were provided to reasonably protect against injury or illness. |
Safeguards Utilized |
Select this check box if safety equipment was being used or safeguards were being used or followed at the time of the accident or the onset of the illness. |
Describe How Injury or Illness Occurred |
Enter a description of how the injury or illness occurred. This is a required field. |
Describe Nature of Injury or Illness |
Enter a description of the injury or illness. Include the parts of the body that were affected and any machinery, tools, or objects involved. This is a required field. |
Time
Field | Description |
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Date of Injury/Onset of Illness |
Enter the date, in MM/DD/YYYY format, on which the injury or illness occurred. This is a required field. |
Time of Event |
Enter the time, in HHMM format, at which the injury or illness occurred. For example, if an accident occurred at 11:02 a.m., enter "1102AM." Costpoint automatically inserts the colon between the 11 and the 02. This is a required field. |
Date Reported |
Enter the date, in MM/DD/YYYY format, on which the injury or illness was reported to the employer. This is a required field. |
Date of Incapacity |
Enter the date, in MM/DD/YYYY format, on which the employee became unable to work because of this injury or illness. This is an optional field. |
Time of Incapacity |
Enter the time, in HHMM format, at which the employee became unable to work because of this injury or illness. For example, if an accident occurred at 11:02 a.m., enter "1102AM." Costpoint automatically inserts the colon between the 11 and the 02. This is an optional field. |
Date of Death |
If this injury or illness resulted in the employee's death, enter the date in MM/DD/YYYY format. This is an optional field. |
Probable Length of Disability |
Enter the amount of time this employee is expected to be disabled. Use the drop-down list to the right of this optional field to determine whether this amount represents days, months, or years. |
Outcome Information
Use the options in this group box to enter data regarding the accident or illness.
Field | Description |
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Employee Paid for Day of Injury |
Select this check box if the employee was paid for the day on which the accident or illness occurred. |
Employee Paid for Day Incapacitated |
Select this check box if the employee was paid for the day on which he became unable to work. |
Employee Has Returned to Work |
Select this check box if the employee has returned to work. |
Date Returned |
If the employee has returned to work, enter the date of return in MM/DD/YYYY format. If the employee has not returned to work, leave this field blank. |
Wage Upon Return |
If the employee has returned to work, enter the hourly rate that the employee was paid upon returning. If the employee has not returned to work, leave this field blank. |