DOL/OASAM-4

SYSTEM NAME:

Safety and Health Information Management System (SHIMS).

SECURITY CLASSIFICATION:

None.

SYSTEM LOCATION:

1. Safety and Health Center, OASAM, U.S. Department of Labor, 200 Constitution Avenue, NW, Washington, DC 20210 and

2. DOL regional offices.

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

CATEGORIES OF INDIVIDUALS COVERED BY THE SYSTEM:

DOL employees and Job Corps students involved in occupationally related accidents, injuries and illnesses.

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 CA-6.

AUTHORITY FOR MAINTENANCE OF THE SYSTEM:

29 U.S.C. 651 et seq., 29 CFR Part 1960, 5 U.S.C. 7902, DOL Secretary's Order 5-95, Executive Order 12196.

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, INCLUDINGCATEGORIES 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:

Records are stored on computer disks, and on hard copies filed in locked file cabinets.

RETRIEVABILITY:

Records are retrieved by claimant's last name, social security number, and employee category (DOL employee or Job Corps student.)

SAFEGUARDS:

Records are maintained in locked storage equipment. Computer files are accessible only to authorized users through password/user ID system.

RETENTION AND DISPOSAL:

Records are maintained for five (5) years after each report is filed with the agency. Electronic copies are maintained for five (5) years and then downloaded onto a disk.

SYSTEM MANAGER(S) AND ADDRESS:

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

NOTIFICATION PROCEDURE:

Individuals wishing to inquire whether this system of records contains information about them should contact the systems manager, or the servicing regional office in which they are employed. Individuals must furnish in writing the following information for their records to be located and identified:

a. Full name

b. Date of birth

c. Signature

RECORD ACCESS PROCEDURES:

Individuals wishing to request access to records should contact the appropriate office (national/regional). Individuals must furnish the following information for their records to be located:

a. Full name

b. Date of birth

c. Signature

Individuals requesting access must also comply with the Privacy Act Regulations on verification of identity and access to records (5 CFR 297.201 and 297.203).

CONTESTING RECORD PROCEDURES:

Individuals wishing to request information about their records should contact in writing the systems manager. Individual must furnish the following information for their records to be located:

a. Full name

b. Signature

RECORD SOURCE CATEGORIES:

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

b. Witness (if any).

c. Employing agency (supervisor or comp specialist).

d. CA-1, CA-2, CA-6, forms used by OWCP.

SYSTEMS EXEMPTED FROM CERTAIN PROVISIONS OF THE ACT

None.