Injury and Illness Recordkeeping

1. PURPOSE 

a) To establish a uniform method for injury and illness reporting and recordkeeping. 

2. SCOPE 

a) This policy covers all ESCO Group employees, ESCO locations and customer locations. ESCO employees on company business are also included regardless of location (i.e. an automobile accident on a public road or business travel).  This policy applies to all incidents noted below: 

i. Employee work-related injuries and illnesses

ii. First aid cases

b) Guests and visitors involved in any incident listed above are also covered under this procedure. However, ESCO Worker’s Compensation does not cover guests or visitors. 

3. POLICY 

a) All fatalities, injuries, and illnesses (no matter how slight), shall be reported immediately by all ESCO employees to their supervisor. Contractors, vendors and guests shall report injuries and illnesses to their ESCO Representative.  Immediately is defined as within the shift or no later than by the end of the day. The supervisor or the ESCO representative shall notify ESCO Safety of the incident immediately. 

b) It is ESCO Group’s policy to investigate all incidents which result in injury or potential for OSHA Recordable Injury.  These injuries include, but are not limited to: loss of consciousness, laceration requiring sutures, work duty restrictions (reduced work capacity), musculoskeletal strains, recommended physical therapy, prescribe medication by a medical professional, and loss of work time or loss of life.   First Aid incidents which do not meet the criteria of an OSHA Recordable Incident will be logged and analyzed for trends. 

c) All investigations are strictly fact finding events to encourage safe behavior going forward and to prevent reoccurrence of similar injuries or illness. All evidence collected and documented will be maintained and preserved in the injury report file.

d) Incident reporting and investigation activities are directed at discovering the root cause of the occurrence and to prevent re-occurrence of the events that caused the incident. 

e) All employees will be informed of incident lessons learned during weekly safety meeting process. 

f) ESCO GROUP EMPLOYEE’S WORK INJURY REPORT will be completed by the employee and supervisor to document the incident/injury occurrence.  All injuries, illnesses and fatalities shall be recorded on the work injury report form and when completed the form must be forwarded to the ESCO Safety Department. 

g) ESCO Group’s Supervisor’s Investigation Report will be completed by the Supervisor. The Supervisor must notify the Safety Department immediately of all incidents. Acceptable methods of communicating the incident include email, text message, phone call or leaving a message. 

4. POST ACCIDENT TESTING 

a) An employee will be required to submit to a urinalysis or blood test if he or she is involved in an incident when a personal injury occurs requiring the injured person to report to a medical facility and receive treatment. A property damage incident in excess of $1,000 will also require the person to submit to a post-accident test. If an individual is involved in an incident that does not require medical treatment or a property damage incident less than $1,000, the customer may request that the individual submit to a post-accident test. 

i. Safety Director 

1. Shall review the report immediately upon receipt and conduct additional investigation if required.

2. Enter any additional measures needed for completion of the report. 

3. Meet OSHA recording requirements. 

4. Notify ESCO Group management team of any incidents requiring review. 

5. Report all incidents as required to appropriate Customer Representatives.

6. Use investigation reports to inform employees of safety events (near miss, 1st aid case, medical aid, property damage, etc) to prevent reoccurrence of safety event. 

7. Follow-up with the employee’s medical provider to monitor recovery and treatment options. 

8. Coordinate return-to-work activities as required 

9. Follow-up with employees, supervisors and Department Manager for implementation of return-to-work restrictions, work hardening, etc. 

10. Participate in development of records and case information if the claim escalates into the Worker Compensation hearing stages.

11. Complete all necessary Workers’ Compensation First Report of Injury Form and forward to the Insurance Company 

ii. Claims Administrator

1. Compile all claim forms for worker’s compensation insurance provider. 

2. Copy and distribute reports to HR Representative for Case Management. 

3. Responsible for training all personnel on their responsibilities for incident investigation. 

4. Maintain all documentation from investigations and training. 

5. All records will be maintained for a minimum of 5 years. 

iii. OSHA Reporting Requirements 

1. A death, hospitalization of three (3) employees from the same incident and an amputation must be reported within 8 hours to the Iowa Division of Labor.

2. OSHA 300 Log of all fatalities and OSHA Recordable Incidents must be completed within 7 calendar days from the date of the incident. 

3. OSHA 300A Summary of Incidents shall be completed and signed by a Company Officer prior to February 1st of the following year. 

4. OSHA 300A summary must be posted in a noticeable place on the jobsite or in the office from February 1st through April 30th of the following year. 

iv. Customer Reporting Requirements

1. Incidents on customer’s property will be reported to the customer in the manner and time frame in which the customer requests. 

2. Injuries on a customer site may be documented on the customers incident form.  If necessary, the ESCO forms will be used to verify all incident information is included.

5. RETURN TO WORK 

a) The employee is required to report to the superintendent or safety director following medical treatment whether the injury was job related or of a non-job related nature, regardless of duration. 

b) Any employee suffering from a non-job related injury will not be allowed back to work until given a full release by the attending physician. 

c) Any employee suffering from a job-related injury with a recommendation of light duty by the attending physician shall be put to such light duty work ONLY if available. 

d) All medical bills, information and physician releases should be forwarded to the main office:

ESCO Group
Attn: Safety Department
3450 3rd St.
P.O. Box 708
Marion, IA. 52302  

 

6. MODIFIED DUTY RETURN TO WORK PROGRAM 

In fulfilling the company’s commitment to providing a safe and healthy working environment, ESCO Group has a Return to Work Program for those employees who have experienced a workplace injury or illness. All non-work related injuries are excluded from this program.

ESCO Group is committed to providing employment opportunities when possible for employees that are injured on the job. If the injured employee is not physically capable of returning to full duty right away, the program may provide opportunities for the employee to perform his or her regular job duties with modifications or to perform alternate temporary work that meets his or her physical capabilities. These job duties may include: tasks at current project, tasks at the corporate office, other tasks within the company, tasks within the community, or a non-profit organization assignment.

We will make every reasonable effort to facilitate the successful return to work of every employee who is injured on the job.

a) Program Benefits

i. ESCO Group has a written policy in place supported by management and consistent across the board for all employees injured on the job. Both employee and employer benefit greatly from an injured employee maintaining an active work status. Employers retain a valuable trained employee. Employees continue to work and avoid lost wages as a result of a work injury. 

b) ESCO Group Benefits:

i. Reduces financial impact (e.g. may save indemnity expenses).

ii. Employee maintains billable status on projects.

iii. Decreases recovery time.

iv. Keeps experienced employee on the job.

v. Promotes better communication between employee, employer, and medical providers.

c) Employee Benefits:

i. Maintains the employee’s earnings. 

ii. Promotes better morale, not only for the injured, but for all employees.

iii. Faster recovery by keeping the employee mentally and physically conditioned.

iv. Maintains social contact with their fellow employees and therefore enhances recovery and encourages a faster return to normal job functions.

v. Provides the employee with a sense of security and stability. 

vi. Promotes better communication between employee, employer, and medical providers.

d) Responsibilities

i. ESCO Group:

1. If medical attention is needed, authorize it immediately and be sure that all necessary forms are completed.

2. Handle the injury timely and properly.

3. Investigate the reported injury and record all data.

4. Determine the preventative measures or actions that are needed to prevent the circumstance from reoccurring, and make all corrections immediately.

5. Explain in detail the modified job duties that have been assigned to the injured employee, and point out any safety precautions that may exist.

6. Ensure the employer and employee understand and follow the medical restrictions assigned by the attending physician at all times until the employee has been released to full duty.

7. To maintain the program’s effectiveness the employer must stay involved with the current treatment plan, employee’s recovery status (when possible), and how the employee perceives the quality medical attention that they are receiving. Quality medical attention is directly related to how fast the employee is returned to full duty and aids in preventing reoccurrence of the injury. 

ii. Employee:

1. If seeking medical attention for a work related injury, inform the attending physician that the employer has a modified duty/return to work program.

2. Understand and follow the medical restrictions that the physician has prescribed at all times.

3. Do not attempt any task that exceeds the restrictions. If an employee is in question about the restrictions provided, talk to the physician. If there is a change in restrictions, the changes must be in writing and submitted to the employer.

4. When reporting to work while on modified duties the employee must be on time and ready to work. Not reporting to work may be considered a work rule violation.

5. An employee who engages in any activity that is not consistent with the work restrictions may be subject to disciplinary action. 

iii. Coordinator:

1. Oversee the entire program and make changes as needed.

2. Serve as the primary contact for the program and be the coordinator between the employee, employer, and attending physician.

3. Ensure that all parties that are involved in the case understand their roles and responsibilities.

4. Monitor and ensure that the modified duty/work restrictions are being followed.

5. Monitor and ensure that the recovery process is progressing as planned.

6. Keep management informed of the modified work duty case.

7. Provide the medical providers with modified duty job descriptions.

e) List of Modified Job Duties

i. Make wire labels and tags.

ii. Assist the Safety Department. 

iii. Complete program reviews.

iv. Review job drawings and plans.

v. Estimate upcoming projects.

vi. Conduct a chemical inventory.

vii. Draft and review weekly safety meetings. 

viii. Review employee training records. 

ix. Enter data for employee safety training.

x. Complete continuing education coursework (OSHA 10, OSHA 30, etc.)

xi. Deliver material and equipment. 

xii. Inventory and enter data regarding Arc rated clothing.

xiii. Other job duties deemed reasonable.

7. ELECTRICIAN JOB DESCRIPTION

Division: ESCO Electric
Location: To Be Determined
Reports to: To Be Determined
Exempt or Non-Exempt: Non-Exempt
Status: Full-Time, Part-Time, Regular, Temporary
Typical Working Hours: Contract Hours
May be required to work extended hours including holidays and weekends due to the 24 hours, 7 days a week, 365 days a year type of service ESCO provides its clients.

a) Synopsis:

i. An Electrician is a skilled labor level position within the technical delivery structure of ESCO Electric.  This position is best described as a key labor resource for external customer project delivery for complex applications.  The position may require several levels of experience (truck driver, helper, construction worker, unindentured, apprentice, journeyman, foreman, general foreman, superintendent, and project manager).  This position requires acquisition and understanding of electrical construction methods (residential, commercial, and industrial), customer needs, and safe work practices associated with electrical construction and maintenance.  Technical leadership and mentorship of others may be required of this role.

b) Background and Work Experience:

i. To be considered, candidates should have:

1. Current electrical license for state in which work will be performed.

2. Approved license or authorization from the applicable JATC or IBEW Union hall as follows:

a. Master Electrician’s license; or

b. Journeyman Electrician’s license; or

c. Apprentice Electrician’s license; or

d. Approved work classification (i.e. CW, CE, Truck Driver, Helper, or Unindentured classifications).

ii. Preferred:

1. Experience in industrial, commercial, and residential electrical construction.

2. Knowledge and familiarity of control systems.

3. Knowledge and familiarity of automated programming and troubleshooting

4. Experience in technical maintenance and troubleshooting.

c) Responsibilities and Duties:

i. The Electrician will be responsible for, but not limited to:

1. Install, maintain, modify, and repair all electrical systems and associated electrical equipment.

2. Inspect and test electrical system components including transformers, transfer switches, switch gears, etc.

3. Complete work orders and record material used on jobs.

4. Use blueprints, wiring diagrams, manufacturer’s installation manuals, and other technical documents to complete assigned projects.

5. Survey electrical systems, circuits, and plans.

6. Work with clients to understand project needs and operating methods in order to best meet their requirements.

7. Comply with all state and federal applicable installation codes.

8. Complete job briefing prior to the start of all tasks.

9. Adhere to job classification and follow the IBEW chain of command.

10. Attend and participate in weekly safety meetings.

11. Attend appropriate skills or safety training prior to performing specific tasks.

12. Provide guidance and training to others with less experience through mentoring and project leadership.

13. Maintain professional client relationships.

14. Arrive to work on time and ready to begin work at the scheduled start time.

15. Report all unsafe conditions and acts to ESCO Group management for documentation and correction.

16. Report all work related injuries immediately to supervision for proper recording.

17. Report to work fit for duty no under the influence of substance (legal or illegal).

18. Wear appropriate attire for working at assigned facility.  Many facilities are governed by good manufacturing practices that require personal hygiene to be monitored.

19. Strictly adhere to scheduled breaks.

20. Report any absenteeism to supervisor. Unaccounted for absenteeism will not be tolerated.  “No Call, No Show” is grounds for immediate dismissal.

21. Utilize, support, and enhance ESCO’s standards and best practices.

22. Understand and follow all safety, conduct, and policy requirements established by ESCO and clients.

23. Other duties and responsibilities as assigned or deemed necessary by management.

d) Interpersonal Skills/Characteristics:

i. Self-starter that exhibits a high level of initiative and resourcefulness.

ii. Excellent organizational and time management skills.

iii. Willingness to take on and complete multiple project assignments quickly and efficiently.

iv. Develops meaningful relationships to build trust.

v. Strong written and verbal communication skills.

vi. Adapts behavior to changing circumstances.

vii. Work produced demonstrates excellent attention to detail and accuracy.

viii. Excellent customer service and teamwork skills.

ix. Able to effectively communicate and train others in areas of expertise.

e) Physical Demands:

i. The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is frequently required to stand; walk; sit; use hands to finger, handle, or feel; reach with hands and arms; climb or balance; stoop, kneel, crouch or crawl; and talk or hear.

2. The employee must regularly lift and/or move up to 25 pounds, frequently lift and/or move up to 50 pounds, and occasionally lift and/or move up to 75 pounds.

3. Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, depth perception, and ability to adjust focus.

4. Physical activity such as climbing up and down stairs (may be several flights) and/or ladders, and walking long distances while carrying equipment.

5. Overhead work (arms above head) will be done on a regular basis; installation of electrical conduit and pulling cable.

6. Extended periods of walking to and from work areas will be required.

7. Physical activity such as pulling cable into conduit will be required.

f) Work Environment:

i. The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

1. While performing the duties of this job, the employee is frequently exposed to moving mechanical parts, risk of electrical shock, and vibration.

2. The employee is occasionally exposed to wet and/or humid conditions; high, precarious places; fumes or airborne particles; toxic or caustic chemicals; outside weather conditions; extreme cold; and extreme heat.

3. The noise level in the work environment is usually moderate, but may be exposed to very loud areas.

**All necessary personal protective equipment is provided to meet and in some instances exceed OSHA Regulations.
The above statements describe the general nature and level of work being performed by people assigned to this job.  They are not intended to be an exhaustive list of all responsibilities, duties, and skills required of personnel so classified.  Difference in job requirements may very between locations and facilities.

I can, with or without accommodations, perform the essential functions of this position outlined above.

🔲 Yes                               🔲 No

Signature of Employee:________________________________________________Date:_________________

Print Name:_____________________________________________________________________________________

HR Signature:____________________________________________________________Date:_________________

Print Name:______________________________________________________________________________________

 



INSTRUCTION FOR INJURED EMPLOYEE 

“What do I do if I have a work related injury or illness?” 

Take the workers’ compensation authorization form (page 1) of this packet to the designated physician/facility with you.  This will assist in your care and the billing process for you medical expense. 

Have someone call the designated physician/facility to alert staff of your injury, and your approximate arrival time. 

“Who pays for the medical treatment?” 

All medical bills relating to this claim should be sent to your workers’ compensation coordinator within 48 hours of your work related injury. 

Do not use your health membership card if this injury/illness was sustained while working or acting in an official capacity for this 
company. 

“Who completes the employee’s work injury report?” 

You are responsible for answering all questions on the employee’s work injury report accurately, and in detail.  This will make processing of your claim both accurate and timely.  This report should be given to the workers’ compensation coordinator within 24 
hours of your work related injury or 6 hours if 3 or more employees were injured.  Call IMMEDIATELY if we have a death of an 
employee. 

“What do I do with the Supervisor’s Instructions and Supervisor’s Investigation Report?"

You should give both documents to your supervisor immediately and relate to him/her the details of your work related injury/illness. 

“What should I do if I have further questions or concerns?” 

Be sure to contact your workers’ compensation coordinator. 




SUPERVISOR’S INSTRUCTIONS

ASSISTING THE INJURED EMPLOYEE 

The following steps should be taken in order to better assist the employee after he/she has been injured or becomes ill. 

1. Remind the injured employee to go to the designated physician or treatment center.

2. Emphasize that only injuries/illnesses that are serious or need treatment after regular clinic hours should be treated at a
hospital emergency center.

3. Call the designated physician or medical treatment center prior to the employee’s arrival.  Alert the staff of the
injury/illness and approximate time of arrival.


THE INVESTIGATION REPORT 

The purpose of this form is to determine what actions are needed to eliminate or control the hazards that have caused the accident. The information gathered will guide your staff in developing safety consciousness and knowledge of safe conditions and safe work methods.  If you are not aware of the circumstances surrounding the injury, you should consult with the employee in order to 
complete the investigation report accurately. 
The statements made in this report are very important and should not contain certain phrases such as “Employee should be more careful”.  As the supervisor, you should make the appropriate corrective recommendations for each accident, such as, “Notified the appropriate employee to place caution sign in area when floors are wet”. 
After you complete the investigation report, return it to the workers’ compensation coordinator within 48 hours of the employee’s work related injury. 

If you have questions or concerns, call the workers’ compensation coordinator.