2581.3 RESPONSIBILITY OF REVIEWING OFFICER
(Revised 12/99)
Reviewing officer shall:
Go to the scene of the accident and collect data to reconstruct the circumstance of the accident, if appropriate.
Question witnesses and others who have knowledge of the injury.
Review the Supervisors Section of SCIF 3067 (STATE), to:
Assure adequate information has been recorded for injury prevention.
Make initial determination if injury is work-related or not.
Identify responsibilities for training-instructions and supervisory follow-up.
Reconcile questions and problems raised by either the supervisor or the employee.
Initiate injury prevention changes that will minimize the potential of recurrence of a similar accident. Process the form in accordance with agency safety plan.
Review SCIF 3067 (STATE) for completeness of data.
Submit SCIF 3067 (STATE) and SCIF 3301 as soon as possible, but no later than five (5) days after notification of employees work injury or death. If there is a question or doubt about the injury or illness being job-related, the supervisor shall attach a memorandum to SCIF 3067 (STATE) outlining the facts as they are known and request further investigation by State Compensation Insurance Fund.
