NU-SAF-121 — INJURY & INCIDENT AFTERMATH

Tier 2/3/4 — Procedure + Field Card + Form · Rev DRAFT · Drafted August 2, 2026 · Owner: Adam Pelewski Legacy ID: NU-OPS-009 — same document, renumbered under the safety block. Nothing that already worked was rewritten; §3 (root cause) and §4 (OSHA tie-in) are the two additions since the last pass. Parent: NU-SAF-100 §5, element 17. Feeds: NU-SAF-122 — OSHA Recordkeeping (every incident here runs the recordability test there and lines up the 300 log). Companions: NU-FLD-200 (NU-OPS-002 — the first 10 minutes in full) · NU-GOV-001 (NU-OPS-005 — who speaks) · NU-PPL-403 (NU-OPS-008 — if rules were broken) · NU-FLT-315 (vehicle accidents hand off to this document for the people side) · NU-SAF-120 (post-incident drug/alcohol testing standard). Applies to: every injury, utility strike, vehicle accident, and near-miss — every site, every crew, no exceptions.

THE GATE

People before paper — care first, forms second. Facts only, in writing, same day — no fault admitted, no guessing, no "I think" (NU-GOV-001 rule). The Owner is called for every recordable injury, every strike with damage, and every vehicle accident — no exceptions, no "didn't want to bother you." And every incident, however small, gets a written root cause inside 48 hours and runs the OSHA recordability test under NU-SAF-122 — an incident with no cause and no OSHA call is just a story with no ending.

The Recipe Book (NU-FLD-200) covers the first ten minutes. This document covers minute ten through day thirty — the part that decides what the incident costs, and whether Nova is standing on solid paper the day OSHA or a carrier comes asking.

1. THE FIRST 10 MINUTES (recap — full detail lives in NU-FLD-200)

2. SAME DAY — BEFORE ANYONE GOES HOME

Never: admit fault to anyone (employee, client, utility, other driver) · promise "we'll cover everything" · let the injured employee drive themselves to treatment · negotiate side cash deals instead of a WC claim — a $200 clinic bill handled off-books becomes an uninsured $50K claim when it gets worse.

3. ROOT CAUSE — THE 48-HOUR RULE

Every incident on this document — injury, strike, vehicle accident, near-miss — gets a written root cause. A near-miss gets the same treatment, minus the claim. This is the step that turns "a guy got hurt" into "here's the one thing we changed so it doesn't happen again."

3.1 The method: 5 whys, checked against 3 factors

Ask "why" until the answer is something Nova can fix with a written change — a step added to a card, a piece of gear ordered, a training gap closed. Five is a target, not a rule: stop at three if you've hit a real cause, keep going past five if you haven't.

Every "why" gets checked against three buckets, so the chain doesn't stop at "he wasn't paying attention" — because that's never the real answer, and it fixes nothing:

"He should have been more careful" is never a stopping point — it's a sign there are two more whys to ask. Keep going until you land on a man/method/machine cause with a fix attached to it.

3.2 Who does it, and by when

A root cause with no fix attached isn't done. A fix with no root cause behind it is a guess.

4. OSHA RECORDABILITY & THE 300 LOG (NU-SAF-122)

Every incident on this document's list runs the OSHA recordability test before the file closes — not a supervisor's gut call, the actual three-part test in NU-SAF-122 §2 (work-related, new case, meets a recordability trigger). That test, not how bad it looked, decides whether an incident is a Band-Aid or a case.

• Recordable → the case's detail and 300-log line get filed within 7 calendar days on NU-SAF-122-F, straight off this same Incident Report. Nova does not run two separate reporting pipelines — one incident, one folder, one form that feeds the next.
• Not recordable (first aid only) → logged on the DFR, no OSHA paper, but the root cause in §3 still runs. First aid still teaches a lesson.
• Who makes the call when it's genuinely unclear: the Office, within the 7 days, per NU-SAF-122 §2 — Adam until that seat is filled (NU-GOV-005).

4.1 Reporting clocks — post this table in the office (print-and-post artifact):

Full mechanics of the recordability test, the first-aid line, the three forms, and the annual rhythm live in NU-SAF-122 — this table is the field version. [Adam: the 6-physician minimum is the confirmed O.C.G.A. § 34-9-201 baseline — not in question. What's still pending carrier/attorney confirmation per NU-SAF-122 §1 is the WC-1 filing mechanics and the posting requirements once the new carrier binds. That confirmation is tracked in §8 below and doesn't hold up the rest of this document.]

5. DAYS 2–30 — MANAGING THE CLAIM AND CLOSING THE LOOP

Done when: carrier notified on time · OSHA clocks met · recordability test run and, if recordable, the 300 log fed within 7 days (NU-SAF-122) · root cause written, reviewed, and the book updated · RTW offered in writing · one complete folder. That file is also what keeps our EMR — and therefore our bid eligibility with every prime — alive.

6. TIER-3 FIELD CARD — INCIDENT AFTERMATH (print, pocket-size, rides with the NU-FLD-200 cards)

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NOVA UNDERGROUND — INCIDENT AFTERMATH CARD (front)

1. PEOPLE FIRST. Injury beyond first aid → 911, don't move them unless unsafe, meet the ambulance at the road. 2. GAS OR ANY STRIKE → evacuate upwind, no ignition sources, 911 for gas. Never cover it. Photograph untouched. 3. VEHICLE ACCIDENT → check people, move to safety if drivable and safe, photos before anything moves. Full steps: NU-FLT-315. 4. ONE CALLER: Supervisor calls the Owner. Every time — recordable injury, strike with damage, or vehicle accident. No exceptions, no "didn't want to bother you." 5. SAY NOTHING about fault. Facts only, in writing, same day. No "I think."

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NOVA UNDERGROUND — INCIDENT AFTERMATH CARD (back)

□ Incident Report (NU-SAF-121-F) started before end of shift — facts, times, witnesses, photos □ Medical decision made: first-aid-only vs. treatment (panel physician if treatment) □ WC carrier called within 24 hrs — First Report of Injury □ Post-incident drug/alcohol test where impairment could plausibly have contributed (NU-SAF-120 §2.4/§3.2) — not automatic for every injury □ Scene preserved: photos filed, equipment red-tagged and held □ Client safety contact notified if their site (check the MSA) □ ROOT CAUSE — 5 whys / man-method-machine — written within 48 HOURS. Supervisor writes it, Owner signs it. □ RECORDABILITY TEST run within 7 DAYS (NU-SAF-122) — if recordable, 300 log entry filed. □ OSHA phone call if it hit: fatality (8 hrs) · hospitalization/amputation/lost eye (24 hrs) — 1-800-321-6742 □ RTW offer in writing within 1 week · weekly check-in call, logged

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7. TIER-4 FORM — NU-SAF-121-F: INCIDENT REPORT

Facts only. No fault, no opinions, no guesses. One page per incident — print pad.

Type: ☐ Injury ☐ Utility strike ☐ Vehicle accident ☐ Equipment damage ☐ Near-miss

Date: __ Time: __ WO # / Location: _______

People involved: ___________

Witnesses (name + phone): ______________

What happened (times, sequence, conditions — write like the reader wasn't there):

Injury detail (body part, first aid given, treated where, panel physician used Y/N):

Employee info (OSHA 301 fields): Home address: _______ DOB: _ Date hired: ___

Treatment (OSHA 301 fields): Physician/facility name & address: _________

Treated in ER? ☐ Yes ☐ No Hospitalized overnight? ☐ Yes ☐ No

Checklist: ☐ Photos taken & filed ☐ Owner called ☐ Carrier notified (claim #: ____) ☐ Drug/alcohol test — where impairment could plausibly have contributed (NU-SAF-120 §2.4/§3.2), not automatic ☐ Equipment held ☐ Client notified (if client site)

Root cause — 5 whys through the 3-factor lens (complete within 48 hrs — Supervisor writes, Owner reviews):

Why 1: ________________

Why 2: ________________

Why 3: ________________

Why 4 (if needed): ___________

Why 5 (if needed): ___________

Which factor(s) does the root cause land on? ☐ Man ☐ Method ☐ Machine

Fix going into the book: __________

OSHA recordability (NU-SAF-122 §2 — complete within 7 days):

Recordable? ☐ Yes ☐ No — call made by: ___ Date: _______

If yes: ☐ 300 log line entered (NU-SAF-122-F) ☐ 301 detail attached ☐ Severe-injury phone call made (fatality/hospitalization/amputation/eye) — time/date: _______

Completed by: ___ Supervisor (root cause): ___ Owner (reviewed & signed): ___ Date: _______

File in the incident folder + WO folder same day.

8. WHAT THIS DOCUMENT NEEDS FROM ADAM

1. New WC carrier — name, policy #, claims phone. Frankenmuth cancelled 7/16; nothing has filled that blank yet, and §2 step 3 can't run without it.
2. Post the Panel of Physicians (6 physicians minimum, GA requirement) with the new carrier once it binds — until it's posted, Nova doesn't control where an injured employee gets treated.
3. Drug/alcohol screening vendor — same open decision as NU-SAF-120's collection site. Activates §2 step 4 and unlocks the GA Drug-Free Workplace ~7.5% WC credit.
4. CCG notification requirement — confirm whether a financed unit damaged in an accident requires a separate CCG notice; check the loan docs.
5. Georgia specifics (panel of physicians mechanics, WC-1 filing, posting requirements) — confirm with the new carrier and attorney; tracked here and in NU-SAF-122 §1, not a blocker to this document standing as issued.
6. Register update — NU-GOV-000's line for NU-SAF-121 currently reads "Draft — needs 300 log + root cause"; both are now built (this document + NU-SAF-122). Worth a pass to mark it Issued.

9. THE NEVER LIST

• Never admit fault to anyone — employee, client, utility, other driver.
• Never promise "we'll cover everything."
• Never let the injured employee drive themselves to treatment.
• Never negotiate a side cash deal instead of filing a WC claim — a $200 clinic bill handled off-books becomes an uninsured $50K claim when it gets worse.
• Never let a root cause slip past the 48-hour window unwritten — an incident with no cause is a story with no ending.
• Never let the recordability call wait on the WC claim or the adjuster's timeline — it runs off NU-SAF-122 §2, on its own 7-day clock.
• Never skip the OSHA phone call because "the guy seems okay now" — the call is triggered by what happened, not by how the employee looks afterward.
• Never cover, hide, or let anyone else cover a utility strike, however minor it looks.
• Never treat post-incident drug/alcohol testing as automatic for every injury — it runs on individualized impairment-plausibility judgment per NU-SAF-120 §2.4/§3.2, not a blanket test-every-scrape rule.
• Never close the file without one complete folder — report, photos, medical notes, carrier correspondence, drug test (if run), root cause, RTW offer.

NU-SAF-121 · Rev 1.0 · Nova Underground · Legacy ID: NU-OPS-009 · Parent: NU-SAF-100 §5 element 17 · Feeds: NU-SAF-122 · Record: NU-SAF-121-F · Companions: NU-FLD-200, NU-GOV-001, NU-PPL-403, NU-FLT-315, NU-SAF-120 · Update NU-GOV-000 register on issue · Uncontrolled when printed.