                          SUBMITTED BY
                            KEN SOBEL
                      SAFETY ADMINISTRATOR
                       CITY OF LOS ANGELES
                         (213) 485-4691

_________________________________________________________________
The following chapter from the City of Los Angeles Safety Manual is
a draft.  It has been submitted so that others may utilize the
information in helping to meet the requirements of the Written
Injury and Illness Prevention Program required by Senate Bill 198
and the expanded General Industry Safety Order 3203.
_________________________________________________________________
                                                        Chapter 7




      (EMPLOYER'S REPORT OF OCCUPATIONAL INJURY OR ILLNESS)


RESPONSIBILITY

It is the responsibility of the employee's immediate supervisor to
provide for medical attention or transportation to a medical
facility, if required, for an on-the-job occupational injury or
illness.

When a work-related injury or illness is reported, the supervisor
must immediately telephone the Workers' Compensation Division at
(213) 485-5683 to report the injury and receive instructions for
obtaining medical treatment.  Detailed instructions on what to do
in the event of an occupational injury or illness are provided on
a poster in every work area.  Included in the instructions are
telephone numbers for ambulance service, how to locate the nearest
medical facility, and procedures to follow if the injury or illness
occurs during off hours, weekends or holidays.  The poster, 
TREATMENT AND REPORTING OF ON-DUTY INJURIES TO CIVILIAN EMPLOYEES,
must be posted in all City work areas.  The poster is available
from the Personnel Department, Workers' Compensation Division at
485-4691.  Police and Fire Department personnel should follow the
instructions on their poster concerning treatment and reporting
procedures.

The California Code of Regulations requires that every employer
shall file with the Division of Labor and Statistics, a complete
report of every injury and illness, arising out of or in the course
of employment.  The City of Los Angeles utilizes Form Gen. 166 (R
4-83) for this purpose.  The State requires that the report be
forwarded to them on their Form 5020.  This is done through the
Workers' Compensation computer which transfers the information from
our Form Gen. 166 to the State's Form 5020.

The Form Gen. 166 is obtainable from the Department of General
Services, General Stores.  The Form has seven copies which are to
be distributed to the locations printed on the top of the form. 
Individual copy locations are also printed in red on the bottom
right corner of each copy.  Copy numbers 4, 6, and 7 are retained
by the department originating the form.  Copy number 7 should be
filed with each recordable Cal/OSHA Form 200 entry (see Chapter 8)
and maintained for five years.  The Form Gen. 166 shall be
completed and distributed within five days after the injury or
illness.


SUPERVISOR'S INVESTIGATION 

Supervisor's observations and conclusions should be recorded,
including an opinion regarding the accuracy and completeness of the
employee's statement.  Any contributing factors not accurately
included in the employee's description of the accident should be
added.  Use additional sheets if necessary.  Attach additional
sheets to each distribution copy.  If, at the time the Form Gen.
166 is due for distribution and the investigation is incomplete,
enter the statement:  Supplemental report follows.  When additional
sheets and/or supplemental reports are used, be sure to include the
employee's name and Workers' Compensation number.

The investigation should be thorough and should determine the
nature and cause of the accident and what remedial action or
immediate steps have to be taken to prevent additional injuries
from the same condition or work procedure.  State, if possible, any
unsafe work procedure or act and/or unsafe condition that may have
contributed to the injury.


HELPFUL HINTS

Note (1): If an investigation demonstrates that the injury did not
          occur on duty after this report has been distributed, the
          supervisor should complete a follow-up report and state
          the facts in the investigation block.  The follow-up
          report will be the supplemental report.

Note (2): If the injured employee is not placed on restricted or
          light duty at the time the report is distributed, this
          should be indicated. 

Block 17: If the injured employee is available, the employee should
          describe the accident using the first person singular. 
          (Example:  "I was lifting...")

          NOTE:     If injuries resulted from a vehicle collision
                    involving a third party, i.e. collision with a
                    vehicle driven by a person who is not a City
                    employee, enter:

                    Third party vehicular collision.  See the City
Attorney.

                    In third party accidents, line-through the
                    following blocks:

                    a)   16.  What was employee doing when injured?
                    b)   List witnesses present
                    c)   18.  Object or substance that directly
                         injured employee.

          When available, provide, along with the Form Gen. 166, a
          copy of the Police Report to the Occupational Safety
          Office, Mail Stop 517.

Block 24: A "No" means the employee reported to work on all days
          following the date of the accident.

See Chapter 6, FORM GEN. 66, EMPLOYER'S REPORT OF OCCUPATIONAL
INJURY OR ILLNESS.