Lost-time injury/disease Outcome of injury/disease Additional questions to be answered for cases Questions 20 are about information that is not –24 which result in a fatality or permanent disability, or available at the time of the report of injury or disease. where there was time lost from work of one or questions should be answered as soon as the more days/shifts. These questions should be information becomes available. For some completed as soon as possible after the injury or occurrences, such as where there was no time lost, disease is reported. some of these questions will not be relevant. 15. Employee’s 20. Rehabilitation: preferred language Date of commencement of rehabilitation program 16. Type of employment: Day Month Year Type of employee: 17. 21. Was the injury or disease: 22. Preventive action proposed or taken: (Tick one or more as appropriate) 18. Worker’s experience in task being carried out when injury or disease occurred 19. Proportion of worked: 23. Date of resumption of work on: (Enter each date when applicable) 24. number of working days lost (Should be completed only when the worker has resumed permanent duties)
Lost-time injury/disease Additional questions to be answered for cases which result in a fatality or permanent disability, or where there was time lost from work of one or more days/shifts. These questions should be completed as soon as possible after the injury or disease is reported. 15. Employee’s preferred language 16. Type of employment: 17. Type of employee: 18. Worker’s experience in task being carried out when injury or disease occurred 19. Proportion of worked: Outcome of injury/disease Questions 20 –24 are about information that is not available at the time of the report of injury or disease. questions should be answered as soon as the information becomes available. For some occurrences, such as where there was no time lost, some of these questions will not be relevant. 20. Rehabilitation: Date of commencement of rehabilitation program Day Month Year 21. Was the injury or disease: 22. Preventive action proposed or taken: (Tick one or more as appropriate) 23. Date of resumption of work on: (Enter each date when applicable) 24. number of working days lost (Should be completed only when the worker has resumed permanent duties)
Cert%20IV%20WHS%20Student%20Workbook%20ONLINE%20v11.5.docx