Report an Incident or Accident

Only State Employees Submit State Incident/Accident Reports 

Prompt reporting of an incident is a critical component to a risk management program. Employees are directed to report all incidents and accidents as soon as possible to their supervisor (or his/her designee in the event of an absence) preferably by the end of the workday or within 24 hours. The supervisor is then responsible to work with the employee and the designated agency Risk Management or State Workers Compensation Contacts in filing an online incident report. If your incident/accident involves an injury to a state employee, visit Workers Compensation Program for State Employees or complete the Workers Compensation First Report of Injury (FROI) to file a Workers Compensation claim.

An incident is an unplanned occurrence that resulted or could have resulted in injury to people or damage to property. An incident may also be considered an accident or near miss. When an incident is reported promptly, injured persons receive timely medical care, unsafe conditions are quickly corrected, and evidence is preserved for administration of potential claims. Incidents should be reviewed to identify trends and assess the effectiveness of current safety programs so that a similar incidence does not reoccur.

All incidents as discussed above should be reported to the Risk Management Division within 24 hours of the incident or receiving the report of the incident. Please report incidents through Risk Management’s online Reporting System. The employee that has the most information or first-hand knowledge about the incident should complete the report. Incident reports should not be completed by non-state employees. For instructions on use of the online Reporting System, please refer to the Instructions to Online Incident Reporting or contact the Risk Management Division at 701.328.7584.

All incidents must be investigated thoroughly with factual and accurate information prepared and attached to the incident report. Properly investigated and analyzed incidents will assist in the administration of potential claims/lawsuits, and protecting property by locating causes of incidents so corrective action can be taken.

The Tort Claims Act NDCC 32-12.2 provides that Risk Management Fund records are privileged and exempt from the open records law. Therefore, to ensure that incidents are provided these protections, ensure that all incidents are documented by using the Risk Management Fund reporting forms.

To Report an Incident or Accident (state employees only)

Forms

  • SFN 50508 Risk Management Fund Incident Report (ONLY to be completed by state employees)
  • SFN 51301 Risk Management Fund Motor Vehicle Report (ONLY to be completed by state employees)
  • SFN 53601 Risk Management Medical Services Incident Report (ONLY to be completed by state employees)