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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: |
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