CLAIM CODE CHEAT SHEET

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					                               CLAIM CODE CHEAT SHEET
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First Report on Injury - Injury Description Instructions:

Begin every Injury Description with;
* “What” - listed below in bold,
“How” – Narrative of incident

* Fall, Same Level – Indoor, Trooper in PT (Red Man) slipped and fell during training landing
on and injuring right knee.

* Exposure: (This is for exposures to BBP, meth labs, scabies, TB, human bites, needle
sticks, spit, etc). (Include; “during arrest” if applicable)

* Fall, Same Level – Outdoor: (This is for injuries that occur on flat surfaces outside,
including parking lots, curbs, wet walkway/surfaces) (Include; “during arrest” if applicable)

* Fall, Same Level – Indoor: (This is for injuries that occur on floor and flat surfaces inside,
gymnasium floors, wet floors/surfaces). (Include; “during arrest” if applicable)

* Fall – on Stairs – Indoor/Outdoor: (his is for injuries that occur while on stairs either
inside or outside. Identify address if possible). (Include; “during arrest” if applicable)

* Fall on Ice or Snow: (This is for injuries that occur as a result ice and/snow, Slips and falls
on stairs that are snow covered, near slip and falls on walkways/stairs that are ice and snow
covered). (Include; “during arrest” if applicable)

* Struck-by Suspect: (This is for injuries caused by a suspect including but not limited to
restraining suspect, injury resulting from searching suspect, pat searches, etc.). (Include;
“during arrest” if applicable)

* Struck by Object: (This is for injuries that occur when struck by machinery, tool, etc.
Must clarify if object was Moving or Stationary). (Include; “during arrest” if applicable)

* Struck by Motor Vehicle: (This is for injuries that occur when a motor vehicle strikes an
employee. (Include; “during arrest” if applicable)

* Motor Vehicle Collision: (This is for injuries that occur as a result of motor vehicles
colliding with each other). (Include; “during arrest” if applicable)

* Motor Vehicle Collision with Fixed Object: (This is for injuries that occur when a motor
vehicle hits a wall, building, tree, etc). (Include; “during arrest” if applicable)

* Mental Stress: (This is for stressful incidents where there are no physical injuries)

				
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