Field Definitions: HR Accidents Form

The following is a list of field descriptions for the HR Accidents form. Many of the descriptions include links to other topics that provide additional information about or related to the topic.

Accident #

Enter a unique number (or code), up to 10 characters, that represents this accident.

Accident Date

Enter the date on which the accident occurred.

Accident Time

Enter the time (24-hour format) at which the accident occurred. Entry in this field prints in the 'Time of Event' field (#13) on the HR OSHA Form 301 (Injury and Illness Incident) report.

Accident Location

Enter the location of the accident, up to 30 characters. This field is typically used to describe the exact location of the accident on the employer’s premises or on the job site.It will print in Column E of the HR OSHA Form 300 report.

Reported By

Specify the name of the individual, up to 30 characters, who reported this accident.

Date Reported

Enter the date this accident was reported. Although typical, this is not necessarily the same date the accident occurred. Entry in this field prints in the 'Date of injury or illness field' (#11) on the HR OSHA Form 301 (Injury and Illness Incident) report.

Time Reported

Indicate at what time this accident was reported.

Closed Date

Specify on what date the all claims related to this accident were closed and all involved resources have been fully released to work.

On Employer's Premises

Check this box if the accident occurred on the employer’s premises (place of business).

Leave this box unchecked if the accident occurred at a location other than the employer’s premises.

Accident Occurred on Job Site

Check this box if the accident occurred on a job site.

Leave this box unchecked if the accident did not occur on a job site.

JC Co#

Enabled only if the Accident Occurred on Job Site option is Y (checked).

Enter the JC company of the job at which the accident occurred.

Job

Enabled only if the Accident Occurred on Job Site option is Y (checked).

Enter the job (from JC Jobs) where this accident occurred.

Phase

Enabled only if the ‘Accident Occurred on Job Site’ option is Y (checked).

Enter the phase of work involved with this accident. Must be a valid phase set up in JC Phases or JC Job Phases (if a locked job).

MSHA ID#

Use only if accident occurred at a mine.

Enter the identification number assigned by MSHA. Must be a valid MSHA identification number set up in HR Mine. This ID#, along with other information defined for the MSHA ID# will be used on the HR MSHA 7000-1 (Mine Accident, Injury Illness Report) report.

Note: If you are unsure of your number assignment, contact the nearest MSHA Mine Safety and Health District or Subdistrict Office.

Corrective Action

Use this tab to describe the corrective action that was taken, if any, as a result of the accident. The space allowance in this box is virtually unlimited.

Add a Standard Note

Standard notes allow you to insert frequently used text into some fields in the application. This text is created and maintained using the HQ Standard Note form.

To insert a standard note into the field, right click the mouse while focus is in the field and select Standard Notes from the shortcut menu, which opens the Standard Note Copy window. Then enter the standard note to copy (or select from F4 lookup) and click OK. The system inserts the selected note into the field.

Spelling Check

Click the Spelling icon on the toolbar or select Tools > Spelling to spell check the text in this field.

Seq

Enter N, New, or + to add a new witness sequence. The system will auto-assign the next available sequential number.

Type

Indicate the witness type.

  • C=Contact. Select this option if the witness is set up as a claim contact (in HR Accident Claim Contacts).

  • R=Resource. Select this option if the witness is an employee (set up in HR Resources).

  • O=Other. Select this option if the witness is an individual other than an employee or accident claim contact.

Name

Enabled only for witnesses flagged as type ‘Other’.

Enter the full name of the witness, up to 30 characters.

Address

Enabled only for witnesses flagged as type ‘Other’.

Enter the address for this witness, up to 30 characters.

City

Enabled only for witnesses flagged as type ‘Other’.

Enter the city for this witness, up to 30 characters.

State

Enabled only for witnesses flagged as type ‘Other’.

Enter a valid state (as defined in HQ States) for this witness. The system validates the state based on the Default Country specified in HQ Company Parameters for the active company. If not valid, an error displays, but entry is allowed. You must then enter a valid country for this state in the Country field.

Zip Code

Enabled only for witnesses flagged as type ‘Other’.

Enter the zip code of this witness, up to 12 characters.

Country

This field is accessible only for witnesses flagged as type ‘Other’.

Enter the 2-character country code. Entry in this field is required when the address exists outside the Default Country specified in HQ Company Parameters for the active company. Country must be valid for the specified state (e.g. state, province, territory, etc.) as defined in HQ States.

Phone

Enabled only for witnesses flagged as type ‘Other’.

Enter the contact phone number for this witness.

Email

Enabled only for witnesses flagged as type ‘Other’.

Enter the email address for this witness (if applicable).

Contact

Enabled only for witnesses flagged as type ‘Contact’.

Specify the claims contact that witnessed this accident. Must be a valid contact set up in HR Accident Claim Contacts.

Contact Name

For witnesses flagged as type ‘Contact’ only.

Display only, the name of the accident claim contact specified in the previous field.

Resource #

Enabled only for witnesses flagged as type ‘Resource’.

Specify the resource that witnessed this accident. Must be a valid resource set up in HR Resources.

Resource Name

For witnesses flagged as type ‘Other’ only.

Display only, the name of the resource specified in the previous field.

Notes

Enter any notes or information about this witness in regards to this accident. The space allowance in this box is virtually unlimited.

Add a Standard Note

Standard notes allow you to insert frequently used text into some fields in the application. This text is created and maintained using the HQ Standard Note form.

To insert a standard note into the field, right click the mouse while focus is in the field and select Standard Notes from the shortcut menu, which opens the Standard Note Copy window. Then enter the standard note to copy (or select from F4 lookup) and click OK. The system inserts the selected note into the field.

Spelling Check

Click the Spelling icon on the toolbar or select Tools > Spelling to spell check the text in this field.

Seq #

Enter a sequence number for this accident (1-9999) or enter N, New, or + to have the system auto-assign the next available sequential number.

This number is used to identify each of the resources, equipment, and/or third-party individuals involved in the accident. Each individual, piece of equipment, and third-party involved should be set up as a separate sequence. For example, if two employees, one piece of equipment, and two third-party individuals were involved, you should have a total of five sequences set up for the accident.

Accident Type

  • Resource - Select this option if this sequence identifies a resource that was involved in this accident.

  • Equipment - Select this option if this sequence identifies a piece of equipment that was involved in this accident.

  • Third-Party - Select this option if this sequence identifies a third-party individual (non-employee) that was involved in this accident.

Resource #

Displays when Accident Type is 'Resource'.

Enter the resource (from HR Resources) that was involved in this accident.

Worker's Comp Filed

Displays when Accident Type is 'Resource'.

Check this box if a Worker’s Comp claim was completed and filed.

Leave this box unchecked if a Worker’s Comp claim has not yet been filed for this accident or if no Worker’s Comp claim is required for this accident.

Claim #

Displays when Accident Type is 'Resource'.

Enter the worker’s comp claim number, up to 20 characters.

EM Company #

Displays when Accident Type is 'Equipment'.

Enter the EM company for this accident. This will be the company to which the equipment involved in this accident is assigned.

Equipment

Displays when Accident Type is 'Equipment'.

Enter the equipment (from EM Equipment) that was involved in this accident

Name

Displays when Accident Type is 'Third-Party.

Enter the name of the third-party (non-employee) individual involved in this accident, up to 20 characters.

Address

Displays when Accident Type is 'Third-Party.

Enter the address of the third-party individual, up to 60 characters.

Note: If you have Internet access, you can click the Map button for direct access to the default map site for your login (as defined in User Options, Main Menu). Map will default the approximate location of the specified country and address. If a country is not specified, attempts to locate address based on Default Country specified in HQ Company Setup.

City

Displays when Accident Type is 'Third-Party.

Enter the city for the third-party individual, up to 30 characters.

Note: If you have Internet access, you can click the Map button for direct access to the default map site for your login (as defined in User Options, Main Menu). Map will default the approximate location of the specified country and address. If a country is not specified, attempts to locate address based on Default Country specified in HQ Company Setup.

State

Displays when Accident Type is 'Third-Party.

Enter a valid state (as defined in HQ States) for this third-party individual. The system validates the state based on the Default Country specified in HQ Company Setup for the active company. If not valid, an error displays, but entry is allowed. You must then enter a valid country for this state in the Country field.

Note: If you have Internet access, you can click the Map button for direct access to the default map site for your login (as defined in User Options, Main Menu). Map will default the approximate location of the specified country and address. If a country is not specified, attempts to locate address based on Default Country specified in HQ Company Setup.

Zip Code

Displays when Accident Type is 'Third-Party.

Enter the zip code for this third-party individual, up to 12 digits.

Note: If you have Internet access, you can click the Map button for direct access to the default map site for your login (as defined in User Options, Main Menu). Map will default the approximate location of the specified country and address. If a country is not specified, attempts to locate address based on Default Country specified in HQ Company Setup.

Country

This field displays when Accident Type is 'Third-Party.

Enter the 2-character country code for this third-party individual. Entry in this field is required when the address exists outside the Default Country specified in HQ Company Setup for the active company. Country must be valid for the specified state (e.g. state, province, territory, etc.) as defined in HQ States.

Note: If you have Internet access, you can click the Map button for direct access to the default map site for your login (as defined in User Options, Main Menu). Map will default the approximate location of the specified country and address. If a country is not specified, attempts to locate address based on Default Country specified in HQ Company Setup.

Phone

Displays when Accident Type is 'Third-Party.

Enter the phone number at which the third party can be reached, up to 20 characters.

Closed Date

Enter the date the claim for this sequence (individual, piece of equipment, or third-party) was closed, and the individual was fully released to work or no further claims regarding this accident are expected to be filed.

Accident Code

Enter the accident code (defined in HR Codes, Type A) that indicates the type or category of this accident.

Supervisor/Superintendent

Enter the name of the supervisor or superintendent who was on duty at the time of this accident, up to 20 characters.

Project Manager

If this accident occurred on a job site, enter the name of the project manager who was in charge at the time of the accident. Up to 20 characters allowed.

Hospitalized

Disabled if Accident Type is ‘Equipment’.

Check this box if the individual specified for this accident sequence was hospitalized as a result of the accident.

Leave this box unchecked if this individual did not require hospitalization.

Hospital/Treatment Center

Disabled if Accident Type is ‘Equipment’.

If the individual was hospitalized or received emergency treatment, specify the name of the hospital or treatment center, up to 20 characters. If you do not enter a valid hospital (set up in HR Hospital Information), you will receive a warning, but the entry will be accepted.

Entry in this field prints in the 'Facility' field (#7) on the HR OSHA Form 301 (Injury and Illness Incident) report. The address will be pulled from HR Hospital Information.

Hospitalized Overnight?

Disabled if Accident Type is ‘Equipment’.

Check this box if this individual required overnight hospitalization. If checked, a checkmark will print in the 'Yes' box (Field #9) on the HR OSHA Form 301 (Injury and Illness Incident) report.

Leave this box unchecked if this individual did not require overnight hospitalization. If unchecked, a checkmark will print in the 'No' box (Field #9) on the HR OSHA Form 301 (Injury and Illness Incident) report.

Treated in Emergency Room

Disabled if Accident Type is ‘Equipment’.

Check this box if this individual was treated in an emergency room (specified above). If checked, a checkmark will print in the 'Yes' box (Field #8) on the HR OSHA Form 301 (Injury and Illness Incident) report.

Leave this box unchecked if box if this individual did not require emergency room treatment. If unchecked, prints a checkmark in the 'No' box (Field #8) on the HR OSHA Form 301 (Injury and Illness Incident) report.

Attending Physician

Disabled if Accident Type is ‘Equipment’.

Specify who the attending physician (from HR Claim Contacts) was for the person receiving first aid or medical attention.Entry in this field prints in the 'Name of physician or other healthcare professional’ field (#6) on the HR OSHA Form 301 (Injury and Illness Incident) report.

Claim Estimate

Enter the estimated amount of this accident claim, up to 10 digits before and 2 digits after the decimal (not including commas).

Preventable

Check this box if this accident could have been prevented.

Leave this box unchecked if this accident could not have been prevented.

Type

Select the correct accident type:

  • OSHA - Select this option if this accident will be reported to OSHA (Occupation Safety & Health Administration) and if a workman’s comp claim will be filed.

  • MSHA - Select this option if this accident will be reported to MSHA (Mine Safety & Health Administration).

  • First Aid – Select this option if first aid was sufficient enough to handle the injury caused by this accident, and no medical treatment or hospitalization was required.

  • None - Select this option if no reporting is required for this accident. Typically, this type will be for liability-only accidents that are equipment-related or involve a third-party.

OSHA

Enabled only when you select OSHA from the Type field.

  • Illness - Select this option if this accident resulted in an illness.

  • Injury - Select this option if this accident resulted in an injury.

Illness Type

Enabled only when you have selected OSHA in the Type field and you select the Illness option from the OSHA section of the form..

For accidents resulting in illness, specify which illness type applies to this individual. Illnesses specified here correspond to those shown on the OSHA report.

  • 2 - Skin Disorder

  • 3 - Respiratory Conditions

  • 4 - Poisoning

  • 5 - Hearing Loss

  • 6 - All Other Illness

Note: Type '1' is not available for Illness-type claims as it is reserved for, and identifies, an Injury-type claim.

Fatality

Displays when Type is 'OSHA'.

Check this box if this accident resulted in the individual’s death.

Leave this box unchecked if no fatality occurred.

Date of Death

Displays when Type is 'OSHA'.

If this was a fatal accident, specify the date this individual died.

Entry in this field prints in the 'If the employee died, when did death occur?' field (#18) on the HR OSHA Form 301 (Injury and Illness Incident) report.

OSHA Establishment/Site

Displays when Type is 'OSHA'.

Enter the establishment for this incident. Up to 20 characters allowed.

When running the HR OSHA Form 300 report, this is the establishment that should be entered in the 'OSHA Establishment' input of the report parameters.The establishment will then be used to restrict the information pulled into the HR OSHA Form 300 report.

Experience in This Job Title: Years/Weeks

Displays when Type is 'MSHA'.

Enter the number of years and/or weeks (0-255) experience this individual has had in his/her current job title. Entry here will print in the corresponding field (Field #25) of the HR MSHA 7000-1 (Mine Accident, Injury Illness Report) report.

Experience at This Mine: Years/Weeks

Displays when Type is 'MSHA'.

Enter the number of years and/or weeks (0-255) experience this individual has had at this mine. Entry here will print in the corresponding field (Field #26) of the HR MSHA 7000-1 (Mine Accident, Injury Illness Report) report.

Total Mining Experience: Years/Weeks

Displays when Type is 'MSHA'.

Enter the total number of years and/or weeks (0-255) mining experience this individual has had. Entry here will print in the corresponding field (Field #27) of the HR MSHA 7000-1 (Mine Accident, Injury Illness Report) report.

Hazardous Material Involved

Check this box if any hazardous materials were involved in this accident. If a hazardous material is involved, you will need to indicate (below) whether the material requires a Material Safety Data Sheet (MSDS).

Leave this box unchecked if no hazardous materials were involved.

MSDS

Disabled if the Hazardous Material Involved option is ‘No’ (unchecked).

Check this box if the accident involved a hazardous material and the material requires a MSDS (Material Safety Data Sheet) sheet.

Leave this box unchecked if the hazardous material involved with this accident does not require a MSDS sheet.

MSDS#/Desc

Disabled if the Hazardous Material Involved option is ‘No’ (unchecked).

If the accident involved a hazardous material requiring a MSDS sheet, enter the MSDS (Material Safety Data Sheet) number and/or description, up to 30 characters.

DOT Reportable

Check this box if this accident will be reported to DOT (Department of Transportation).

Leave this box unchecked if this accident does not need to be reported to DOT.

Time Employee Started Work

Enter the time (24-hour format) the employee started work. Entry in this field prints in the 'Time employee began work' field (#123) on the HR OSHA Form 301 (Injury and Illness Incident) report.

Object/Substance Cause

If the accident was caused by an object or substance, enter a description of the object or substance here, up to 60 characters. Entry in this field prints in the 'What object or substance directly harmed the employee?' field (#17) on the HR OSHA Form 301 (Injury and Illness Incident) report.

Cause of Accident

Use this section to enter the details of the accident. The space allowance in this box is virtually unlimited. Entry in this field prints in the 'What happened?' field (#15) on the HR OSHA Form 301 (Injury and Illness Incident) report. (Note: Due to space limitations on the report, you may want to limit entry to less than 640 characters.)

Add a Standard Note

Standard notes allow you to insert frequently used text into some fields in the application. This text is created and maintained using the HQ Standard Note form.

To insert a standard note into the field, right click the mouse while focus is in the field and select Standard Notes from the shortcut menu, which opens the Standard Note Copy window. Then enter the standard note to copy (or select from F4 lookup) and click OK. The system inserts the selected note into the field.

Spelling Check

Click the Spelling icon on the toolbar or select Tools > Spelling to spell check the text in this field.

Injury/Illness Description

Use this section to describe the injury or illness that resulted from the accident. The space allowance in this box is virtually unlimited. Entry in this field prints in the 'What was the injury or illness?' field (#16) on the HR OSHA Form 301 (Injury and Illness Incident) report. (Note: Due to space limitations on the report, you may want to limit entry to less than 640 characters.)

Add a Standard Note

Standard notes allow you to insert frequently used text into some fields in the application. This text is created and maintained using the HQ Standard Note form.

To insert a standard note into the field, right click the mouse while focus is in the field and select Standard Notes from the shortcut menu, which opens the Standard Note Copy window. Then enter the standard note to copy (or select from F4 lookup) and click OK. The system inserts the selected note into the field.

Spelling Check

Click the Spelling icon on the toolbar or select Tools > Spelling to spell check the text in this field.

First Aid Administered

Use this section to enter the details of the first aid that was administered to the employee after the accident occurred. The space allowance in this box is virtually unlimited.

Add a Standard Note

Standard notes allow you to insert frequently used text into some fields in the application. This text is created and maintained using the HQ Standard Note form.

To insert a standard note into the field, right click the mouse while focus is in the field and select Standard Notes from the shortcut menu, which opens the Standard Note Copy window. Then enter the standard note to copy (or select from F4 lookup) and click OK. The system inserts the selected note into the field.

Spelling Check

Click the Spelling icon on the toolbar or select Tools > Spelling to spell check the text in this field.

Activity When Injured

Indicate what this employee was doing at the time the accident occurred. The space allowance in this box is virtually unlimited. Entry in this field prints in the 'What was the employee doing just before the incident occurred?' field (#14) on the HR OSHA Form 301 (Injury and Illness Incident) report. (Note: Due to space limitations on the report, you may want to limit entry to less than 750 characters.)

Add Standard Notes

To add standard notes (set up in HQ Standard Note), make sure focus is in the Notes box and click the right mouse button. From the shortcut menu, select the Standard Notes option, which brings up the Std Note Copy window. Enter the standard note to copy and click OK to add the note. Note will be appended to the end of existing note text (if applicable).

Spelling Check

A spell check can be run for any notes entered in this window. Click the Spelling button in the toolbar () or select the Spelling option from the Tools or shortcut menu.

Tip: To use the Tab feature (such as to indent the first line of a paragraph or create columns), you will need to press Ctrl + Tab for each tab increment.

Claim Seq

Display only, the sequential number assigned to this claim entry.

Claim Date

Enter the date that the claim was received.

Claim Contact

Specify who the claim contact was for this accident. Must be a valid contact set up in HR Accident Claim Contacts. The name of the claim contact displays to the right of this field.

Claims: Name

Display only, the claim contact’s name.

Claims: Notes

Use this field to enter pertinent information about this claim. The space allowance in this box is virtually unlimited.

Add a Standard Note

Standard notes allow you to insert frequently used text into some fields in the application. This text is created and maintained using the HQ Standard Note form.

To insert a standard note into the field, right click the mouse while focus is in the field and select Standard Notes from the shortcut menu, which opens the Standard Note Copy window. Then enter the standard note to copy (or select from F4 lookup) and click OK. The system inserts the selected note into the field.

Spelling Check

Click the Spelling icon on the toolbar or select Tools > Spelling to spell check the text in this field.

Medical Facility

Enter the name of the medical facility (from HR Hospital Information) used for initial and/or on-going treatment for this claim contract.

Cost

Enter the total cost of this claim.

Deductible

Enter the deductible amount for this claim (i.e. the amount of the total cost that was applied to the deductible).

Paid

Enter the total non-deductible amount paid out for this claim.

Filed (Y/N)

Check this box if this claim has been filed with Worker’s Comp.

Leave this box unchecked if this claim has not yet been filed with Worker’s Comp or does not need to be filed with Worker's Comp.

Paid (Y/N)

Check this box if this claim has been fully paid.

Leave this box unchecked if this claim has not been fully paid.

Body Part

Specify the body part code (HR Codes, Type B) that identifies the part of the individual’s body that was injured or affected by the accident (e.g. arm, leg, hand, eye, etc.).

Injury Type

Specify the injury type code (HR Codes, Type I) that indicates what type of injury occurred to the specified body part (e.g. burn, fracture, contusion, etc.).

Restricted/Lost Days: Seq

Enter a sequence number (1-9999) for this restricted/lost day entry or enter N, New, or + to have the system auto-assign the next available sequential number.

Begin Date

Enter the date of the individual’s first restricted or lost work day. This date may not necessarily be the date of the accident.

End Date

Enter the date of the individual’s last restricted or lost work day. May be left blank if the end date is not yet known. Once this date is entered, the total number of restricted or lost work days is calculated and displayed to the right of this field.

# of Days

Defaults the total number of restricted or lost work days for this claim based on the Begin Date and End Date.

R or L

Indicate whether this was a restricted workday or lost workday.

R = Restricted

L = Lost

Restricted/Lost Days: Notes

Use this field to explain restrictions or enter pertinent information relating to this event. The space allowance in this box is virtually unlimited.

Add a Standard Note

Standard notes allow you to insert frequently used text into some fields in the application. This text is created and maintained using the HQ Standard Note form.

To insert a standard note into the field, right click the mouse while focus is in the field and select Standard Notes from the shortcut menu, which opens the Standard Note Copy window. Then enter the standard note to copy (or select from F4 lookup) and click OK. The system inserts the selected note into the field.

Spelling Check

Click the Spelling icon on the toolbar or select Tools > Spelling to spell check the text in this field.

Contact Seq

Display only, the sequential number assigned to this contact log entry.

Date

Enter the date the communication or conversation occurred.

Contact

Enter the contact (from HR Accident Claim Contacts) involved with this communication or conversation.

If you specify an non-valid contact, a warning displays, but the entry will be accepted. Be aware that since the Name field is display only, you will not be able to enter the name of the contact. If you want to enter the contact’s name, you will need to add the contact to HR Accident Claim Contacts.

Contacts Log: Name

Display only, the name of the contact entered in the previous field if a valid contact from HR Accident Claim Contacts. If not a valid contact, displays the message “Not a valid claim contact”.

Claim

Indicate the claim sequence (1-9999) to which this communication or conversation applies. This is a cross-reference to the claim entered on the Claims tab.

Type

Select the correct accident type:

  • OSHA - Select this option if this accident will be reported to OSHA (Occupation Safety & Health Administration) and if a workman’s comp claim will be filed.

  • MSHA - Select this option if this accident will be reported to MSHA (Mine Safety & Health Administration).

  • First Aid – Select this option if first aid was sufficient enough to handle the injury caused by this accident, and no medical treatment or hospitalization was required.

  • None - Select this option if no reporting is required for this accident. Typically, this type will be for liability-only accidents that are equipment-related or involve a third-party.

Contacts Log: Notes

Use this field to enter pertinent information about this contact. The space allowance in this box is virtually unlimited.

Add a Standard Note

Standard notes allow you to insert frequently used text into some fields in the application. This text is created and maintained using the HQ Standard Note form.

To insert a standard note into the field, right click the mouse while focus is in the field and select Standard Notes from the shortcut menu, which opens the Standard Note Copy window. Then enter the standard note to copy (or select from F4 lookup) and click OK. The system inserts the selected note into the field.

Spelling Check

Click the Spelling icon on the toolbar or select Tools > Spelling to spell check the text in this field.