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person subject to this policy. Any act of intimidation should be reported to our railroad
president/operating officer/[ title ] ,_____________________.
FRA Guide for Preparing Accident/Incident Reports
APPENDIX I – Continued
Appendix I - 4 Model Internal Control Plans
Model 2:
Model Internal Control Plan for Smaller Railroads
(suggested size: fewer than 200 employees)
RAILROAD
NAME: ________________________________________________________________
ADDRESS: _________________________TELEPHONE: _____________________
__________________________FAX: ___________________
OTHER
ADDRESS,
(if any): __________________________TELEPHONE: __________________
__________________________FAX: ___________________
FEDERAL RAILROAD ADMINISTRATION (FRA) ACCESS
TO INTERNAL CONTROL PLAN
The Internal Control Plan shall be maintained at the office where the railroad’s accident/incident
Reporting Officer conducts his or her official business. The Plan shall be available for
examination and copying by Federal Railroad Administration representatives (including
participating State personnel) during normal business hours.
Policy Statement of [Name of Railroad Company]
Concerning Complete and Accurate Reporting
of Accidents, Incidents, Injuries, and Occupational Illnesses
without Harassment or Intimidation
This railroad is committed to complete and accurate reporting of all accidents, incidents, injuries,
and occupational illnesses arising from the operation of the railroad, to full compliance with the
letter and spirit of FRA’s accident reporting regulations, and to the principle, in absolute terms,
that harassment or intimidation of any person that is calculated to discourage or prevent such
person from receiving proper medical treatment or from reporting such accident, incident, injury,
or illness will not be permitted or tolerated and will result in the following disciplinary action
FRA Guide for Preparing Accident/Incident Reports
APPENDIX I – Continued
Appendix I - 5 Model Internal Control Plans
against any employee, supervisor, manager, or officer of the railroad committing such
harassment or intimidation.
Disciplinary Action: _______________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
The preceding Policy Statement has been disseminated to all employees, supervisory personnel,
and management.
[NOTE: 49 CFR § 225.33(a)(2) requires disclosure to all railroad employees, supervisors,
and management of the railroad’s procedures for dealing with complaints of violations of
the preceding policy and the railroad’s guarantee of “whistleblower” protection to any
person subject to the policy. Disclosure may be accomplished by combining the following
paragraph with the preceding policy statement and disseminating the combination.
Alternatively, the following information may be disclosed separately, by other means.]
COMPLAINT PROCEDURES
Railroad procedures to process a complaint of violation of the Policy:
________________________________________________________________________
________________________________________________________________________
Railroad procedures to impose the appropriate prescribed disciplinary actions on each employee,
supervisor, manager, or officer of the railroad found to have violated the Policy:
________________________________________________________________________
________________________________________________________________________
 These procedures have been disclosed to railroad employees, supervisors, managers, and
officers, including the stipulation that “whistleblower” protection is provided to any
person subject to the Policy.
FRA Guide for Preparing Accident/Incident Reports
APPENDIX I – Continued
Appendix I - 6 Model Internal Control Plans
INTERNAL REPORTING FORMS AND PROCEDURES
The following internal forms or computer reporting system, or both, are used for the collection
and internal recording of accident/incident information:
Forms (attached)
1. _____________________ 3. _____________________
2. _____________________ 4. _____________________
Description of the internal procedures used by the railroad for the processing of forms or
computerized data, or both, regarding accident/incident information:
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
______________________________________________________________________
INTERNAL REVIEW PROCEDURES
Description of the internal review procedures for accident/incident information collected and
reports prepared by the railroad’s safety, claims, medical, and other departments engaged in
collecting and reporting accident/incident information:
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
________________________________________________________________________
Description of internal procedures for collecting cost data and compiling costs with respect to
accident/incident information:
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
_________________________________________________________________________
FRA Guide for Preparing Accident/Incident Reports
APPENDIX I – Continued
Appendix I - 7 Model Internal Control Plans
Description of internal procedures for ensuring adequate communication between the railroad
department responsible for reporting accidents/incidents to FRA and any other railroad
department responsible for collecting, receiving, processing, and reporting information on
accidents/incidents: