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Privacy Act Systems - DOL/OASAM-4

DOL/OASAM-4

SYSTEM NAME:

Safety and Health Information Management System (SHIMS).

SECURITY CLASSIFICATION:

None.

SYSTEM LOCATION:

a. Office of Worker Safety and Health, OASAM, U.S. Department of Labor, 200 Constitution Avenue, NW, Washington, DC 20210;

b. DOL regional offices;

c. A copy of the modified CA-1/CA-2 Form used by the Office of Workers' Compensation Programs (OWCP) and the Form 301 used by the Occupational Safety and Health Administration (OSHA) may be reproduced and retained in the office of the supervisor who files the form.

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:

DOL employees, Job Corps students and Contractors involved in occupationally related accidents, injuries and illnesses. (SHIMS host other Federal agencies, and their employees would be included in coverage as well.)

CATEGORIES OF RECORDS IN THE SYSTEM:

Reports of on-the-job accidents, injuries, and illnesses generated as a result of filing forms CA-1, CA-2, and OSHA Form 301.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:

29 U.S.C. 651 et seq., 29 CFR Part 1960, 5 U.S.C. 7902, the Occupational Safety and Health Act of 1970 (PL 91-596), Executive Order 12196; Federal Employees' Compensation Act, as amended (codified in 5 U.S.C. 8101 et seq.), and to related regulations in Title 20, Code of Federal Regulations (CFR), Part 10; DOL Secretary's Order 5-2009.

PURPOSE(S):

This system is used (a) to provide an information source for compliance with the Occupational Safety and Health Act; (b) to provide a documented record of job related accidents, injuries, and illnesses for the purpose of measuring safety and health programs' effectiveness; (c) to provide summary data of accident, injury and illness information to Departmental agencies in a number of formats for analytical purposes in establishing programs to reduce or eliminate loss producing hazards or conditions; (d) to provide summary listings of individual cases to Departmental agencies to ensure that all work-related injury/illness cases are reported through the SHIMS; and (e) to use as a reference when adjudicating tort and employee claims.

ROUTINE USES OF RECORDS MAINTAINED IN THE SYSTEM, INCLUDING CATEGORIES OF USERS AND PURPOSES OF SUCH USES:

None, except for those universal routine uses listed in the General Prefatory Statement to this document.

DISCLOSURE TO CONSUMER REPORTING AGENCIES:

None.

POLICIES AND PRACTICES FOR STORING, RETRIEVING, ACCESSING, RETAINING, AND DISPOSING OF RECORDS IN THE SYSTEM:

STORAGE:

Files are stored electronically and/or on paper.

RETRIEVABILITY:

Files are retrieved by claimant's last name, social security number, and employee category (DOL employee or Job Corps student) and SHIMS Incident Claim Number (ICN).

SAFEGUARDS:

Access by authorized personnel only. Computer security safeguards are used for electronically stored data and locked locations for paper files.

RETENTION AND DISPOSAL:

All workers' compensation records contained in SHIMS should be disposed of in accordance with applicable records schedules under General Records Schedule (GRS) 1.31. All OSHA 301 records contained in SHIMS should be disposed of in accordance with applicable records schedules under GRS 1.34.

SYSTEM MANAGER(S) AND ADDRESS:

Director, Office of Worker Safety and Health, OASAM, U.S. Department of Labor, 200 Constitution Avenue, NW, Washington, DC 20210.

NOTIFICATION PROCEDURE:

Inquiries should be mailed to the System Manager.

RECORD ACCESS PROCEDURES:

A request for access should be mailed to the System Manager.

CONTESTING RECORD PROCEDURES:

A petition for amendment should be mailed to the System Manager.

RECORD SOURCE CATEGORIES:

Information contained in this system is obtained from:

a. The employee (or someone acting on his/her behalf);

b. Witness (if any);

c. Employing agency (supervisor or comp specialist);

d. CA-1 and CA-2, forms used by OWCP; and/or

e. Form 301 used by OSHA.

SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT

None.