Subchapter 5.7 SORM 703 – Incident/Accident Investigation Form

RMTSA Vol. III, Section Two, Chapter 5, Subchapter 5.7
Section Two – Employee Safety and Health Program
Chapter 5
Hazardand Accident Identification, Reporting, and Analysis
Subchapter 5.7
SORM – 703 Accident/Accident Investigation Form

  • Incident/Accident Investigation Instructions and SORM-703 Form (MS Word, Adobe PDF)

Incident and accident investigation should be an integral part of any loss control program. The unexpected actions of people, equipment, supplies, or surroundings cause most accidents. Accident investigations determine how and why these unexpected actions occur and are used to help prevent future accidents.

An incident is any unplanned event that does not result in loss due to personal injury or damage to property; however, given different  circumstances could have resulted in a loss. An accident is any unplanned event that does result in personal injury or damage to property. A detailed analysis of any accident/incident will normally reveal two causes of accidents: surface causes, and root causes. Surface causes are the hazardous conditions or unsafe work practices that directly or indirectly contributed to the accident. Root causes are the safety or loss control system weaknesses that allow the existence of hazardous conditions and unsafe work practices. Most accident investigations only identify the surface causes of accidents.

The SORM-703 Form may be used by state agencies in documenting both incidents and accidents.

As part of an effective risk management program, agencies should maintain internal documentation on incidents and accidents to assist in frequency analysis and to collect information helpful in developing mitigating strategies for loss exposures.

Accidents resulting in a Workers’ Compensation claim should always be investigated, documented and submitted to SORM in order to assist in determining eligibility for Workers’ Compensation benefits and to provide useful information to the claims adjuster in administering claims.

Agencies may use the SORM-703 Form or an equivalent for documenting incidents or reporting accident investigation information to SORM. Agencies should, however, assure that any form used collects the required information and that a standard investigative process is used.

*Information related to incidents is not required to be submitted to SORM*

SORM also offers training for state agencies to assist in conducting accident investigations. SORM’s Agency Outreach and Training section should be contacted for information concerning the accident investigations training classes.

Questions regarding implementation of an accident/incident investigation program or use do the SORM-703 form should be made with the assigned SORM risk management specialist for your agency.