Form Attachment A Attachment A Telephone Questionnaire

Attachment A

Introduction

Thank you for agreeing to participate in our study of workplace injury and illness recordkeeping. We are talking with people about how companies gather, record, and use information about workplace injuries and illnesses. We will start out by discussing your company’s general recordkeeping practices, and then ask some questions specifically about recordkeeping during the 2013 calendar year and the 2013 BLS Survey of Occupational Injuries and Illnesses (SOII). We will use the information you provide us to improve the BLS survey. The information you provide us today is very important.

Everything we discuss today is strictly confidential and your participation is voluntary. The Bureau of Labor Statistics, its employees, agents, and partner statistical agencies, will use the information you provide for statistical purposes only and will hold the information in confidence to the full extent permitted by law. In accordance with the Confidential Information Protection and Statistical Efficiency Act of 2002 (Title 5 of Public Law 107-347) and other applicable Federal laws, your responses will not be disclosed in identifiable form without your informed consent.

This survey is being conducted under OMB Control Number 1220-0045. We estimate it will take an average of 20 minutes to complete this study.

If at any point you don’t understand a question, feel free to ask for clarification. Do you have any questions for me before we get started?

Our records show that you are the person that completed the 2013 BLS Survey. Could you confirm with me your job title and department so we can verify our records?

• Job title: _______________

• Department: ______________

Background and Company Demographics

First, I have a few questions on your company location, employees, and workplace injury compensation practices.

1. The location we selected for this survey is (sample unit description/address). We show the 2013 annual average employment at this location is ____. Does that sound correct?

   • Yes

   • No, specify: __________

   • DK

(Probe to see if they have a clear understanding of the unit we are asking about.)

2. Are all the (# ABOVE) employees at (Sampled Unit Description/Address) or does this number also include employees at other locations?

   • Sampled Unit Description/Address

   • Other/Multiple locations

   • DK

(Probe for what other locations are and how different they are from location selected.)

3. Do you have other locations in (state name of sampled unit)?

   • Yes

   • No

   • DK

4. Do you have locations in other states?

   • Yes

   • No

   • DK

5. Does your company have part-time employees at this location?

   • Yes

   • No

   • DK

a. (If yes), How many/what proportion of workers were part-time?

#__________

%_________

6. Are any employees covered by a union or collective bargaining agreement at this location?

   • Yes

   • No

   • DK

7. Does your company use temporary workers hired through a temp help or staffing agency at this location?

• Yes

• No

• Not now, but has in past

• DK

8. Can you tell me who completes or assists with WC claims for your company at (sample unit description/address)? (CHECK ALL THAT APPLY)

   • You (respondent)

   • Other company employees

   • WC insurer

   • TPA

   • Other, specify: ____________

   • DK

(Probe for whether there is a “primary” person for this.)

(Definition: TPA is an individual or firm hired by an employer to handle insurance claims processing)

Recordkeeping and Recordkeepers

Great, thank you. Next I have some questions on workplace injury and illness tracking and recordkeeping in your company.

9. Injury and illness recordkeeping sometimes involves use of the Occupational Safety and Health Administration Log of Work-Related Injuries and Illnesses, Form 300. In 2013, did your company use, maintain, or have the capacity to electronically generate the OSHA 300 log?

• Yes (go to 10)

• No (go to 9a)

• DK (go to 9a)

(Definition: The OSHA 300 log is a form that includes information on the employee name and job title, type, date and location of injury, and whether the employee lost days of work or was assigned different work tasks due to the injury).

a. (If no or DK) Does your company (keep records/keep track of information/record any information) about your employees’ workplace injuries and illnesses?

• Yes (go to 10)

• No (go to 11)

• DK (go to 11)

10.) Can you tell me more about how your company keeps track of workplace injuries and illnesses? How is the information tracked/recorded? Does your company use… [CHECK ALL THAT APPLY]

a. A specialized injury software program?

• Yes

• No (Go to 10b)

i. (If yes) Do you know the name of the software?

• Yes

• No (Go to 10b)

ii. (If yes) What is the name of the software? Name: ______________

b. Do you use paper forms?

• Yes

• No

(Probe: Sometimes companies use individual files on employees, state forms, WC forms, or injury report forms, do you use any of those?)

(Probe: Are any of these forms supplied by OSHA?)

c. Do you use any electronic forms or spreadsheets?

• Yes

• No

(Probe: Do you have your own system using Excel or other electronic spreadsheets?)

(Probe: Are the electronic forms or spreadsheets supplied by OSHA?)

[If yes to any of 10a, 10b, 10c, skip to 12]

11.) The OSHA 300 log includes information on the employee name and job title, type, date and location of injury, and whether the employee lost days of work or was assigned different work tasks due to the injury. Did your company maintain records or information during 2013 that could be used to complete the OSHA 300 log?

• Yes

• No

• DK

12.) Thank you. Now I have a few questions on company recordkeepers. Some companies have one and others have multiple persons to help with workplace injuries and illnesses reporting. From the following list, can you tell me who typically completes or assists with the (OSHA 300 log / injury and illness) recordkeeping at (sample unit description/address)? (CHECK ALL THAT APPLY)

• You (respondent)

• Other company employees, specify: __________

• WC insurer

• TPA

• Someone else, specify: ____________

• No one (Go to 14)

• DK (Go to 14)

a. (If more than 1 in Question 12) Can you tell me who has primary responsibility for the (OSHA 300 log / injury and illness) recordkeeping at this location? (CHECK ONE)

• Respondent

• Other company employees

• WC insurer

• TPA

• Someone else

• DK (Go to 14)

b. How long have (you/other person) been (an OSHA recordkeeper/kept track of workplace injuries and illnesses)?

_______Years

13.) (If yes to 9) Have/has (you/person with primary responsibility) received formal training on OSHA recordkeeping, such as classes, seminars, or online courses?

• Yes (Go to 13a)

• No (Go to 14)

• DK (Go to 14)

a. (If yes to question 13) Do you recall when (you/person with primary responsibility) last received formal OSHA recordkeeping training? (CHECK ONE)

• Within the past 12 months

• 1-5 years ago

• 6-10 years ago

• 10+ years ago

• DK

14.) Also focusing on recordkeepers, the 2013 BLS Survey of Occupational Injuries and Illnesses was completed for this location in (month, 2014). Can you tell me who completed or assisted with submitting the BLS survey? (CHECK ALL THAT APPLY)

• You (respondent)

• Other company employees, specify: __________

• WC Insurer

• TPA

• Other, specify: ____________

• Don’t know or recall (Go to 15)

a. (If more than 1 in question 14) Can you tell me who had primary responsibility

for completing the BLS survey? (CHECK ONE)

• Respondent

• Other company employees

• WC Insurer

• TPA

• Other, specify: __________

• DK

2. (If yes to Q3 or Q4) Are (you/other person in 14) responsible for completing the BLS Survey for any other company locations?

   • Yes

   • No

3. Was 2013 the first time (you’ve personally/other person in 14) completed the BLS Survey at (sampled unit description/address)?

   • Yes

   • No

   • DK

   • Other, specify: _______________

d. What information sources were used to complete the 2013 BLS Survey?

• OSHA 300 Log

• WC Data

• Company injury and illness records

• Other, specify: _______________

(If yes to Q11): Now we have some general questions about OSHA 300 Log recordkeeping, or your records that can be used to maintain, generate, or complete the OSHA 300 Log. [Ask all questions in this section about the OSHA 300 Log].

(If no to Q11): Now we have some general questions about your experiences completing the 2013 BLS Survey. You completed this survey on (DATE).

[Ask all questions in this section about the 2013 BLS Survey]

15. (Only ask if yes to 9) In general, how long after an injury or illness is reported to your company does it get recorded on the OSHA 300 log?

• Within 1 week

• Within 1 month

• End of year

• Other, specify: __________________

15. Where does your company usually get the number of days away from work for the (OSHA 300 log / BLS Survey)? (CHECK ALL THAT APPLY)

• Doctor’s report/note

• Payroll data

• Attendance records/timekeeping

• WC Time loss data

• TPA

• From employee

• Supervisor

• Other, specify: __________________

(Probe: What about for DJTR? Do you get that the same way?)

15. Does the number of days away from work (for the OSHA log / on the BLS Survey) include all calendar days, or only days in which the employee was scheduled to work?

• Calendar days

• Scheduled days/shifts

• DK

• Other, specify: __________________

15. Does your company add or update cases on the previous year’s (OSHA 300 log / BLS Survey)?

• Yes

• No

• DK

Now I have some general questions about recordkeeping practices for the BLS Survey (SOII) at your company.

Since the BLS survey covers one calendar year, and your company receives and returns the survey early the following year, there are a number of common reasons the survey may miss some injury and illness cases. For example, sometimes injuries and illnesses happen late in the calendar year when information on them is not complete, cases maybe be pending in the workers’ compensation system, employees may delay in reporting injuries and illnesses, or an injury may change and become more serious over time.

15. Do you recall whether any of these types of timing issues have occurred at your company that could have resulted in the BLS survey missing injury or illness cases?

• Yes, specify: __________

• No

• DK

2013-specific questions

We are interested in learning about possible timing issues for the 2013 BLS Survey of Occupational Injuries and Illnesses. It may be useful to refer to your records for these questions, e.g., the OSHA 300 log or the BLS survey.

15. As mentioned earlier, sometimes timing issues prevent full reporting on an injury or illness. Here’s a list of some common examples. Do you recall if any of the following timing issues could have prevented your company from including one or more cases on the BLS survey?

	…in 2013?	...Has it ever happened in the past?
An injury or illness was reported or discovered after submitting the 2013 BLS Survey	□ Yes □ No	□ Yes □ No
An injury or illness occurring in November or December 2013 had incomplete information and was not included	□ Yes □ No	□ Yes □ No
An employee reported an injury or illness to you after separating from your company that was not included on the 2013 BLS survey.	□ Yes □ No	□ Yes □ No
An injury worsened and resulted in days away from work after submitting the 2013 BLS survey (probe for: CTS, hearing loss, soft tissue injuries, sprains/strains, cumulative trauma, recurring injuries)	□ Yes □ No	□ Yes □ No
A claim was pending WC at the time of submitting the 2013 BLS survey and was not included	□ Yes □ No	□ Yes □ No
An injured employee was still away from work at the time of submitting the 2013 BLS survey and was not included	□ Yes □ No	□ Yes □ No
The final days away from work was incomplete or unknown when you submitted the BLS Survey	□ Yes □ No	□ Yes □ No
Any other issues that might have prevented reporting of an injury or illness on the 2013 BLS survey? Specify: ______________________	□ Yes □ No	□ Yes □ No

(For the above, Probe on whether and how respondent could identify these types of cases in their record system, e.g., by memory, by comparison of 2013 BLS SOII with new records, update field that indicates a change in electronic system, etc.)

(Probe: How (did/would you) identify these types of cases in your records?)

1. (If uses the OSHA 300 Log), do you have or could you generate an updated OSHA 300 log that would include 2013 cases additions or updates?

   • Yes

   • No

   • DK

(Probe: What records would you consult?

Could you provide BLS with your additions/updates?

What would be the easiest way to provide BLS with the additions/updates?)

2. (If uses non-OSHA records/record-keeping system), if requested, could you provide BLS with additional or updated information on 2013 cases that are added or change?

   • Yes

   • No

   • DK

(Probe: What records would you consult?

Could you provide BLS with your additions/updates?

What would be the easiest way to provide BLS with the additions/updates?)

Recordkeeping vignettes

Now we have a few questions about different possible scenarios on recordkeeping practices that may be related to timekeeping issues. These questions are just meant to get your feedback regarding what recordkeeping decisions you think your company might make in the following situations.

15. (If yes to Q7) Would you ever include a temp agency worker on your BLS survey?

• Yes

• No

• DK

15. Let’s say an employee sprained his ankle at work on Friday. His doctor recommended he take 2 days off from work. He was not scheduled to work on the weekend, and he returned to work on Monday.

1. Would your company consider this an OSHA-recordable injury?

• Yes

• No

• DK

2. (If yes) would you record any days away from work?

   • Yes

   • No

   • DK

3. (if yes) How many? _____

15. Let’s say a worker was injured, and the doctor recommended 2 days away from work and 5 days of modified duties/DJTR. For the (OSHA 300 Log / BLS Survey), you are asked to classify either DAFW or DJTR as the most serious outcome of the case. Would your company classify this as a ‘days away from work’ case or ‘days of job transfer and restriction’ case on the (OSHA 300 Log / BLS Survey)?

• DAFW

• DJTR

• Software decides

• Other: _____________

• DK

(Probe to find out if they accommodate DJTR)

24.) Let’s say an injured employee was kept on salary instead of receiving WC wage replacement benefits. Would your company include this case (on the OSHA log / include on the BLS Survey)?

• Yes

• No

• Other: __________

• DK

Debriefing questions (for pretest only):

• Do you have any general thoughts or comments about this survey, the SOII, or injury and illness recordkeeping?

• Could we identify changes by comparing your BLS survey responses to your updated OSHA log?

• I have a question on the overlap between WC claims and cases that you record on the OSHA log. Are they one in the same or are they sometimes different? If different, do you have any examples?

• How could we collect information on cases that are added or are changed most efficiently from your company?

• Are these additions/changed cases more likely to happen in the first half of the year, second half, or anytime during the year?

• Would it have been easier if we asked for your OSHA 300 log prior to the interview?