The following actions will be taken/followed on all accidents/injuries being submitted as a Workers' Compensation claim. a. Injured employees must report all accidents/injuries to their supervisor immediately (within 72 hours), who in turn will notify other appropriate company officials, such as the safety manager or claims manager. All accidents/incidents will be investigated by the safety manager, supervisor, or the claims manager to determine the facts and take corrective action to prevent recurrence. b. Employees, within ten (10) days after notification to the employer, must complete the Worker Information section only of the Workers' Safety and Compensation Report of Occupational Injury or Disease forms package. c. The supervisor or claims manager will complete the Employer's Information section of the same report within ten days of the notification. d. The claims manager will ensure that the proper local, state or federal Workers' Safety and Compensation Division is notified as appropriate by filing the above report within ten days of the notification. e. The accident investigation must confirm that the injury was job related for the resultant claim to be valid. |

| H E A L T H A N D S A F E T Y P R O G R A M |


| WORKERS' COMPENSATION CLAIMS MANAGEMENT |
| Houston KACO, Inc. 7107 Peerless Street Houston, TX 77021 (713) 203-2505 |