D.C. Mun. Regs. tit. 7, § 105
105.1 In accordance with Section 2320 of the Act, the immediate supervisor, shall report by telephone or electronic mail to the Program any injury which results in an employee’s death or probable disability. Claims shall be reported to the Program by calling the phone number or sending an electronic mail to the address for this purpose that is published on ORM’s website.
105.2 The immediate supervisor shall make an initial report of injury to ORM by telephone or electronic mail within twenty-four (24) hours of the incident, injury, death, or notice by employee, whichever occurs earlier.
105.3 No later than three (3) days after receipt of Form 1 from the employee, the immediate supervisor shall complete Form 2 and return it to the Program by electronic mail with the employee’s Form 1.
105.4 The immediate supervisor shall supply all information requested by the Program.
105.5 Form 2, the Employing Agency’s Report of Injury / Response to COP Request, shall contain the following information:
(l) The identity of any witnesses to the events;
(m) Whether medical treatment was sought or provided;
(o) Whether the immediate supervisor or anyone witnessed or was present during the incident;
(p) Whether the employee reported the incident or injury, and to whom;
(q) Whether an incident report was prepared in connection with the injury or death;
(r) The nature of the injuries the employee complained of;
(s) The period of time the employee has been absent from work;
(t) Whether the employee was in the performance of duty at the time of injury or death;
(u) A description of the events which resulted in the death, injury, or disease;
(v) A copy of the employee's official position description and all incident reports; and
(w) Whether the employing agency controverts the employee's request for continuation of pay pursuant to § 110 of this chapter.
105.6
The immediate supervisor shall complete and submit supplemental reports to the Program as requested. The supplemental reports shall contain, but not be limited to:
(a) Statements from witnesses confirming or refuting the employee's allegations concerning the accident or injury;
(b) Statements, when requested, to give additional details of the accident or incident;
(c) Statements regarding whether the employee, to the immediate supervisor's knowledge, had a similar injury or incident prior to the alleged injury, and if so, full details of the prior injury or incident and associated medical reports; and
(d) Statements of other injuries or incidents of a similar character and the full details.
105.7 The immediate supervisor shall complete and return to the Program Form CA-3, Employing Agency Report of Return to Work on day fourteen (14) and the last day of COP, as provided at Section 2318(b)(2) of the Act.
SOURCE: Final Rulemaking published at 28 DCR 2307 (May 22, 1981); as amended by Emergency and Proposed Rulemaking published at 57 DCR 9540 (October 8, 2010)[EXPIRED]; as amended by a Final Rulemaking published at 57 DCR 12224, 12227 (December 24, 2010); as amended by Final Rulemaking published at 59 DCR 8766, 8769 (July 27, 2012); as amended by Final Rulemaking published at 64 DCR 6325 (July 7, 2017).