Forms/New Clients/ Claims
Forklift
Terminology
OSHA
Policies and Procedures
Final Jeopardy - Safety
100
This is completed after an incident to prevent future incidents.
What is an accident investigation?
100
Place where a stored copy of forklift certification documentation is kept
What is Personnel file at the branch or onsite location?
100
First Report of Injury
What is FROI?
100
Fine for late reporting or failure to report a reportable injury to OSHA within the required time limit
What is $5,000?
In California, we have 8 hours from the time of notification to report to CalOSHA.
100
Injured worker on mod duty is told that they are not permitted to be on their cell phone. The Injured Worker responds "I don't care, i'm going to keep doing it until you fire me".
Injured worker is Face Timing someone while on the clock out side of their scheduled break. Branch personnel tells them to stop talking on the phone and they continue to Face Time.
What is insubordination?
100
Exposure to Infectious Materials
Documented Training
Hepatitis B Inoculation
Declination Form
What is Blood Bourne Pathogen?
200
Amwins, New Client Form, Client Provided Job Description or Signed Analysis Form, Worksite Evaluation, Credit Application, and Staffing Agreement
What are basic required forms for New Client Approval?
We should also ask for the documented training. If forklift positions we need to provide the clients forklift training materials.
200
Risk level worksite evaluation(WSE), copy of client's forklift safety program, and approval from the carrier via Newclients@lyneer.com.
What are the requirements to staff Forklift Positions?
200
This rating is calculated based on premium paid to the insurance carrier and 3 years of prior claims experience excluding the most recent year.
What is exMod?
High exMod's above 1.2 are scrutinized by the insurance carrier out of concern for claims experience at that particular work-site.
200
Amputation, over night hospitalization, death
(in CA, also included disfigurement)
What are OSHA reportable injuries?
200
Injured worker is completing mod duty assignment at the branch. But they don't call or show up to the branch this morning.
What is an Attendance infraction?
You should call the injured worker to check on them and also to find out why they are not at work.
You should reach out to HR@lyneer.com and safety@lyneer.com to discuss the write up. Utilize the Attendance Counseling form that is on the J Drive for documentation.
200
What is no harness, no lanyard, pallet is not an authorize working/walking surface?
300
Wording on a client job description or title that the insurer will not accept
What is "other duties as assigned", "various duties to be assigned by supervisor", "may include but not limited to" or General Laborer?
Lyneer staff employees cannot modify a job description provided by the client as this creates a liability for Lyneer in the event of a serious accident that becomes litigated.
300
Operator name, types of equipment, Expiration date, physical location of client where training is conducted, Name and signature of trainer and date of issue
What is: Information that must be included on the operator forklift certification card?
300
This document is used to identify the components of a chemical including flammability, combustibility, danger to person exposed to it and how the physician needs to treat someone exposed to it.
What is SDS (MSDS) or Safety Data Sheet or Material Safety Data Sheet?
300
Document that host employer (client) is required to complete for OSHA with information that Lyneer must provide to the host employer related to a recordable injury
What is the OSHA 300 log?
300
Required deadline in NY, PA, FL, NC, and NJ for providing the Mod duty letter to the Injured Worker.
What is 5 calendar days?
We must offer Mod duty within 5 days of Lyneer getting a work status with Restrictions. Sending the letter Certified Mail with Return Receipt keeps us in compliance.
In Delaware we have 3 days to do this.
400
Minimum information required in order for claim to be reported to the WC insurance carrier.
What is an entirely completed first page of the FROI?
This form needs to be completed and submitted immediately upon notice of the incident by the onsite. If there isn't an onsite then it is the branch's responsibility to provide the documentation. Additionally, Onsites and Branches should work together to get all forms filled out completely and to Safety@lyneer.com.
400
This device is used to move product around the warehouse but does not require PIT certification.
What is a manual pallet jack?
400
Legal process whereby an insurer seeks recovery for claim payments against another party who is responsible for causing the damage/injury
What is subrogation?
400
Documented training for job positions with exposure to blood and/or other potentially infectious bodily fluids. Additionally, offering Hep B inoculations to exposed workers
What is mandatory OSHA Bloodborne Pathogen training?
There are other site specific, mandated training and/or controls that will include but are not limited to: Lock Out / Tag Out, HazCom, PPE Assessments
400
This service is used to transport the injured Temp associate to our approved medical provider in the event of a work-site incident that does not require an ambulance.
What is UBER?
Some clinics will send an UBER or LYFT at no cost to Lyneer. In instances where they do not, you can contact your regional manager, risk or support services for assistance.
Under NO circumstances should Lyneer employees transport other employees for medical treatment.
500
This Entity is responsible for providing documented site specific, OSHA compliant training.
What is the host employer?
Lyneer cannot prepare the client's documented training. Lyneer does not have professional liability insurance coverage for this exposure. Risk can provide the client with links to resources and programs but we cannot prepare the documentation/training.
500
Identify five safety requirements for Powered Industrial Truck (PIT) operators.
What are:
Free from being under the influence of alcohol or drugs, seat belt, horn, fall protection, pre-shift inspection, PPE protection when changing propane tanks, site certification, eye wash station near battery charger, travel with forks at 6" above the ground, don't enter a trailer without illumination, dock plate is sufficiently capable of loaded weight
500
This is used by the insurance carrier to determine the rate. If not classified right, it may impact the experience mod rating(ex-mod).
What is Class Code?
500
In the following video clip, identify what OSHA requirement was not adhered to?
JT Video
What is Machine Guarding?
500
Temp is unconscious, bleeding uncontrollably, having a seizure, head trauma, amputation, severe burn, venomous bite/sting, chemical inhalation/burn, heart attack, and/or apparent over dose.
What is grounds for calling 911?
For other non-emergency related injuries employees should be dispatched to the authorized medical provider. If its not during regular business hours, have them report to the medical provider first thing in the morning when the clinic opens.