U.S. Department of Transportation
Federal Highway Administration
June 15, 1977
(1) FHWA employees notify their supervisors promptly of any accident in which they are involved in connection with their work, regardless of the degree of severity,
(2) FHWA supervisors investigate and prepare the required reports within 24 hours of each accident involving their employees, or visitors to locations under their supervision, and
(3) in the event of a major accident, a board of investigation is appointed according to procedures outlined in paragraph 5 of this Order.
(1) accident reports are complete and accurate, and that Appropriate Data Processing (ADP) codes are entered,
(2) original copies of accident reports are forwarded to the Occupational Safety Staff, HMS-4, within five working days,
(3) corrective action is implemented to ensure the elimination of the possibility of further occurrences,
(4) logs are maintained of Federal Occupational Injuries and Reports (OSHA Form 100) and coordinated with the Injury Compensation Officer to ensure that accident reports are received for claims submitted on CA series personnel forms and that actual length of disability and final disposition are known,
(5) quarterly reports (OSHA 102F/FF) are completed and forwarded to the Occupational Safety Staff, HMS-4, no later than 15 days after each calendar quarter ends, and
(6) direct construction accidents are processed according to paragraph 6 of this Order, and forwarded to the Occupational Safety Staff, HMS-4, within five working days.
(1) the date, time place of accident,
(2) in the event of loss of life, the name, age and address of victim and time of death, and
(3) a brief description of the circumstances surrounding the accident.
After the initial message following the accident, a board of investigation composed of no fewer than three individuals will be appointed by the Associate Administrator, Staff Office Director, Regional Administrator or Regional Engineer, as appropriate. The board will complete a narrative report of the accident, concluding with recommendations to prevent the occurrence or similar accidents. The report will be forwarded in duplicate through the Regional Federal Highway Administrator to the Headquarters Occupational Safety Staff, HMS-4. The Associate Administrator, Staff Office Director, Regional Federal Highway Administrator or Regional Engineer will state on the forwarding endorsement what corrective action has been taken.
(1) State, county, or municipal authorities, as required by law,
(2) the employee's supervisor, who will then fill out GSA Standard Form 91 and GSA Standard Form 94 if applicable, or
(3) the chief of the motor pool assigning the vehicle. When the operator is injured and cannot comply with the above requirements, the agency to which the vehicle is assigned shall arrange to notify the above parties.
Reports. Reporting of accidents involving contractors' personnel and equipment engaged in direct construction contracts is prescribed in the special provisions of the contract, subsection 107.20, Construction Safety and Health Standards. It is intended that these reports be utilized by the FHWA engineers, in cooperation with the Regional Safety Program Manager, to locate hazardous conditions or work practices which do not meet contract safety requirements, in order that appropriate corrective action can be initiated. Accidents involving contractor operations at direct construction sites or facilities under FHWA control which result in death, occupational disease, disabling injury, or damage to property of $1,000 or more will be investigated by the Contracting Officer and reported on Form DOT 3902.1, Accident Report, with the appropriate supplemental forms (with attachments and exhibits, if necessary). These forms, DOT F3902.1 and supplements, will be supplied to the contractors by the project engineer. All reports shall be reviewed by the appropriate levels of management, who shall direct or recommend corrective action based on causative factors. The original copy of the accident investigation report shall be forwarded through channels to the FHWA Occupational Safety Staff for final action within 5 working days.
(1) DOT F3902.1, Accident Report.
(2) DOT F3902.2 (Revised 7-73), Injury Report, Supplement 1.
(3) DOT F3902.3, Motor Vehicle Report, Supplement M.
(4) DOT F3902.4, Property Damage Report, Supplement P.
(5) DOT F3902.5, Fire or Explosion Report, Supplement F.
(6) OSHA Form 100F, Log of Federal Occupational Injuries and Illnesses.
(7) OSHA Form 102F/102FF, Federal Occupational Injuries and Illnesses Survey.
(8) GSA Standard Form 91.
(9) GSA Standard Form 94.
William M. Cox
Federal Highway Administrator