2580.2 AGENCY RESPONSIBILITY
(Revised 03/02)
Agencies shall:
Establish, implement and maintain written policies for an injury prevention program in accordance with Chapter 1369, Statutes of 1989, and for returning injured employees to work as soon as it is medically feasible in accordance with Executive Order D4885 and guidelines for the Injured State Workers' Assistance Program. Copies of these policies shall be forwarded to the State Workers' Compensation and Safety Program. Department of Personnel Administration, 151 S Street, North Building, Suite 400, Sacramento, California, 95814, Telephone (916) 3274021, CALNET 4674021.
Allocate funds, time and other resources needed to achieve agency injury prevention goals.
Maintain an occupational health and safety program which includes training in general safe and healthy work practices for all employees and specific instruction on hazards specific to each employee's job in accordance with Chapter 1369, Statutes of 1989.
Inform new State employees of their right to receive Workers' Compensation Benefits.
Appoint Safety and Return-to-Work Coordinator(s).
Encourage and recognize employees who develop safety devices and safe practices in the area in which they work.
Establish procedures to officially recognize employees who have an outstanding record of accident and injury free work performances.
Cooperate with Worker's Compensation and Safety Program reviews conduced by the State Workers' Compensation and Safety Program.
Establish a prompt reporting system for job-related injuries or illnesses.
Provide an injured worker with an Employee's Claim for Workers' Compensation Benefits, SCIF 3301, within one working day of knowledge of injury.
Establish procedures to advise injured employees (or their dependents in event of a death) generally of the benefits to which they may be entitled within 5 working days of a notice of injury or death.
Institute procedures which call for follow-up by supervisors with disabled employees to assure that proper treatment is provided, to assist employees in obtaining a doctor's release to return to temporary limited duty as soon as it is medically feasible and to see that rehabilitation services are furnished when necessary.
Require cooperation at all levels of management in returning disabled employees to work.
Provide for establishment and supervision of an Injured State Worker Assistance Program at appropriate levels to coordinate the rehabilitative/return-to-work process.
Compile and submit to the State Workers' Compensation and Safety Program figures representing the number of hours worked and number of deaths on a semi-annual basis. Annually, agencies will be requested to send a photocopy of the Log and Summary of Occupational Injury and Illness, CAL/OSHA Form 200. This information is used to prepare statistical reports for the Administration, agency secretaries, and department heads.
Compile and submit the Summary Report of State Driver Accidents, Office of Insurance and Risk Management Form INS68. This annual report must be submitted by February 1 for the preceding calendar year. See SAM Section 0750 et seq., for information, forms, and instructions, contact the Defensive Driver Training Program, Office of Insurance and Risk Management, Department of General Services, 707 Third Street, First Floor, West Sacramento, CA 95605, Telephone (916) 376-5309.
Include all performance appraisals an evaluation of the supervisor's and manager's efforts in injury prevention, loss control, and returning disabled employees to work.
The subsequent sections of the Manual establish the applicable policies, procedures, and forms necessary to give uniformity among agencies. Payroll information, including supplementation procedures, is in SAM Sections 85388538.61. Each agency must use these procedures and forms; however, different procedures and equivalent forms may be used if approved by the State Workers' Compensation and Safety Program.
