Appendix V

Operational Guidelines For Determination Of
Injury At Work

  1. Complete the injury at work item if any other than natural cause of death is mentioned in Part I or Part II of the medical certification, including homicides, suicides, and accidents, including motor vehicle deaths.

  2. The injury at work item must be completed for decedents ages 14 or over and may be completed for those less than 14 years of age if warranted. Consider possibility of work injury regardless of whether injury occurred in the course of work in "usual" or other occupation and/or industry. If decedent’s "usual" occupation is housewife, student, or retired consider possible injury during other employment. If occupation is transportation-related, suspect injury at work and evaluate per criteria.

  3. Consider available information with regard to location and activity at time of injury. If location is farm, suspect work-related and evaluate per criteria.

CRITERIA

INJURY
AT WORK
Yes No
On Employer Premises
     • Engaged in work activity, apprentice, vocational training
    • On break, in hallways, rest room, cafeteria, storage area
    • In employer parking lots while working, arriving, or leaving
    • Engaged in recreational activities on employer controlled facilities
        (games, etc.) for personal enjoyment
    • As a visitor for non-work purposes, not on official business
Off Employer Premises
    • Working for pay or compensation, including at home
    • Working as a volunteer EMS, firefighter, or law enforcement 
       officer
    • Working in a family business, including family farm. Activity should
        be clearly related to a profit-oriented business.
    • Traveling on business, including to and from customer/business  
       contacts
    • Engaged in work activity where vehicle is considered the work
        environment (e.g., taxi driver, truck driver, etc.)
    • Homemaker working at homemaking activities
    • Working for self—non profit, i.e., mowing lawn, repairing own 
        roof, hobby, or recreation activities
    • Student engaged in school activities
    • Operating vehicle (personal or commercial) for non-work
        purposes
    • Commuting to or from work site

These guidelines were developed jointly by: The Association for Vital Records and Health Statistics (AVRHS), the
National Institute for Occupational Safety and Health (NIOSH), the National Center for Health Statistics, (NCHS), and
the National Center for Environmental Health and Injury Control (NCEHIC).

PUBLISHED AND DISTRIBUTED BY AVRHS

For questions contact your State Vital Statistics Office

March 30, 1992

 

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