Workplace Injury Reporting Forms Quiz

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30 Questions

Which bodily fluids can transmit Bloodborne Pathogens?

Tears, saliva, and perspiration

What is the difference between Incidental Exposure and Significant Exposure?

The area of the body that comes into contact with the bodily fluid

What is the first step an employee should take in protecting themselves and the City after an on-duty injury or exposure?

Reporting the incident to a supervisor

According to the supervisor's manual, what should the supervisor do before an employee is taken for immediate treatment?

Notify the medical facility

What should the supervisor do if the source individual refuses to have their blood tested?

Notify the Administrative Secretary

What should the supervisor do if an employee has a recurrence injury that occurred less than 2 years from the original injury?

Use the initial injury packet

Who determines the specific course of treatment and follow-up diagnostic testing schedule for an employee's post-exposure follow-up?

WorkHealth's Infectious Disease Physician

Who completes the 'Treatment info.' section in the Physician's Report of Injury form?

The physician

When should an employee seek post-exposure testing for tuberculosis?

Within 5 days of initial exposure

What should an employee do if there is an exposure to a bloodborne pathogen during non-business hours?

Go to a specific Ohio Health Emergency Department

What can happen to an employee's workers' compensation benefits if an incident regarding exposure to an infectious disease is not properly documented?

The benefits will be negatively affected

What should supervisors do when an on-duty injury or exposure is reported?

Provide the employee with the appropriate reporting packet and assist the employee in completing the paperwork as needed

What should supervisors do when personnel receive billing or collection notices for medical treatment provided for incidents that occurred on-duty?

Direct personnel receiving billing or collection notices to the Administrative Secretary

How should communications between officers regarding exposures be handled?

In person or over the telephone

What is the responsibility of the employer when injuries are incurred while working special duty?

The employer contracting the special duty officer covers the injury

Bloodborne Pathogens can be transmitted by tears, saliva, and perspiration


Incidental Exposure occurs when another person's blood or bodily fluids come into contact with an employee's mucous membrane


All on-duty injuries and/or exposures should be reported to a supervisor


Employees should seek medical treatment immediately after an on-duty injury or exposure.


Both the employee and the physician must sign and date the Physician's Report of Injury form.


Supervisors are responsible for ensuring all incidents regarding employee exposure to infectious diseases are properly documented.


Personnel with scheduled duty hours between 8am and 5pm should call WorkHealth to schedule a post-exposure testing appointment for tuberculosis.


Should the supervisor ensure that the medical facility is notified before the employee arrives for immediate treatment?


Is the source individual legally obligated to have their blood tested if requested by the supervisor?


Should the completed Injury Packet be forwarded to the Administrative Secretary?


Is it the responsibility of the employee to respond as directed by WorkHealth's Infectious Disease Physician during post-exposure follow-up?


Supervisors should discourage employees from filing or reporting on-duty injuries or exposures.


The appropriate reporting packet for a recurrence of old on-duty injuries that occurred over 2 years ago is an Injury Packet.


Information about exposures should not be broadcasted over the radio to protect the privacy of the involved employee and the infected person.


Injuries incurred while working special duty must be caused by the actual performance of the duties of a police officer to be covered under the City of Grandview Heights’ Injury Leave Program/Workers’ Compensation.


Test your knowledge on the forms required for reporting a work-related injury with this quiz. Learn about the purpose and content of the Employer's First Report of Injury, the Injured Worker and Injury/Disease/Death Info form, and the Physician's Report of Work Ability. This quiz will help you understand the process of reporting a workplace injury and the necessary paperwork involved.

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