Accident/Near-Miss Event Investigation

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State Fund is California's largest provider of workers' compensation insurance and a vital asset to California businesses. State Fund supports California's entrepreneurial spirit and plays a stabilizing role in the economy by providing fairly priced workers' compensation insurance making California workplaces safe, and restoring injured workers.



Accident/Near-Miss Event Investigation

Accidents are unplanned and unexpected events that cause injury, property damage, and/or financial loss in the workplace. Incidents or “near misses” don’t result in loss or a claim report, but are just as important to investigate.

Here are some more tips:

Six steps to a thorough investigation

Always report workplace injury accidents to your carrier right away, and then immediately begin your investigation.

  1. Start your investigation by reviewing our investigation overview to for tips on contributing factors to consider, interviewing witnesses, assessing physical conditions, and checklist, and more.  You can record your findings on State Fund’s Accident/Near-Miss Event Investigation checklist. This form does not replace the Employers First Report of Occupational Injury or Disease (DWC-1) claim report.
  2. Secure the scene, placing equipment out of service if necessary, and take photos. 
  3. Interview victims and witnesses.
  4. Collect evidence and records, and document your observations on the form.
  5. Find the contributing factors to determine the accident’s root cause.
  6. Document the recommended corrective actions, the people assigned to complete them, and a due date for completion.

Then just print out the form and you’ve got an investigation report for your records.

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