RD Instruction 2042-B

Table of Contents

PART 2042 - TORT CLAIMS

SUBPART B - Reporting Accidents

## [Table of Contents]{.underline}

[Sec]{.underline}. [Page]{.underline}

2042.51 Scope. 1

2042.52 General. 1

2042.53 Motor vehicle (including aircraft) accidents. 2

\(a\) Accidents that must be reported. 2

\(b\) Standard Form (SF) 91, \"Motor Vehicle Accident

Report." 2

\(c\) Dollar amount of actual or estimated damage. 3

\(d\) National Transportation Safety Board (NTSB) Form 4

6120.1/2, "Pilot/Operator Aircraft Accident Report."

\(e\) Accidents involving General Services Administration

(GSA) motor pool vehicles. 4

\(f\) Payment of GSA claims. 4

\(g\) Opinions and statements. 5

\(h\) Failure to report accidents and complete records. 5

\(i\) Billing for repairs. 5

2042.54 Accidents other than motor vehicle. 5

\(a\) Reportable accidents. 5

\(b\) Investigation report (accidents other than motor

vehicle). 5

2042.55 Supervisor\'s report of traumatic injury. 6

2042.56 Processing accident forms. 6

2042.57 Statement of witnesses. 6

2042.58 - 2042.100 \[Reserved\] 7

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RD Instruction 2042-B

PART 2042 - TORT CLAIMS

SUBPART B - Reporting Accidents

§ 2042.51 [Scope]{.underline}.

This subpart contains procedures for reporting accidents resulting in
personal injury or property damage arising from Rural Development
operations. Additional reports must be filed as required by local or
state authorities. See the following parts for appropriate regulations:

Part 2018: General.

Part 2063: Employee Relations and Services.

Part 2069: Safety and Injury Compensation.

§ 2042.52 [General]{.underline}.

\(a\) This reporting system is mandatory so as to protect the interests
of the United States, and to show the causes of accidents. Report
accidents promptly and accurately using the standard forms described in
§ 2042.52(c).

\(b\) The Federal Tort Claims Act (see RD Instruction 2042-A) places
liability on the United States for the negligent acts of its employees
acting within the scope of their employment which result in personal
injury or property damage to private persons or concerns. Under this
Act, a claim can be filed for property damage, death, or personal injury
resulting from an accident caused by negligent or wrongful acts, or
omission.

\(c\) The following forms will be used as required herein, and will be
submitted to the appropriate jurisdictional officials (State Director
for State, Area, and Local Office employees; Deputy Chief Financial
Officer, St. Louis Office for St. Louis Office employees; and Director,
Support Services Division (SSD), for National Office employees in
Washington, D.C.):

\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_\_

DISTRIBUTION: WSAL Administrative Services

Tort Claims

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RD Instruction 2042-B

§ 2042.52(c) (Con.)

\(1\) Standard Form (SF) 91, \"Motor Vehicle Accident Report.\"

(See § 2042.53(b).)

\(2\) USDA Modified Form CA-1, \"Federal Employee\'s Notice of Traumatic
Injury and Claim for Continuation of Pay/Compensation,\" which can be
found at
[www.usda.gov/da/shmd/owcpforms2.htm](http://www.usda.gov/da/shmd/owcpforms2.htm).

(See § 2042.55.)

\(3\) SF-94, \"Statement of Witness,\" for use in obtaining witness
information and statements. (See § 2042.57.)

\(4\) National Transportation Safety Board (NTSB) Form 6120.1/2,
"Pilot/Operator Aircraft Accident Report." Rural Development employees
operating airplanes may obtain these forms from the nearest NTSB
Regional Office. (See § 2042.53(d).)

\(5\) Police report, if one is issued.

\(6\) Two estimates for auto damages, when applicable.

\(7\) When an accident results in an employee\'s injury, follow the
procedures regarding the Federal Employee\'s Compensation Act in §
2069.70 of\
RD Instruction 2069-B.

§ 2042.53 [Motor vehicle (including aircraft) accidents]{.underline}.

\(a\) [Accidents that must be reported]{.underline}. Report any accident
involving a motor vehicle or aircraft operated by a Rural Development
employee while on official business if accident results in any death,
injury, or property damage.

\(b\) [Standard Form (SF) 91, \"Motor Vehicle Accident
Report]{.underline}.\"

\(1\) Every Rural Development employee must have this form when
operating any vehicle on Rural Development business.

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RD Instruction 2042-B

§ 2042.53(b) (Con.)

\(2\) This form must be prepared by the driver at the time, if possible,
and at the scene of the accident. It should be sent immediately to the
appropriate official (see § 2042.52(c)) with any reported statements by
the private party accepting responsibility; include names, addresses,
and telephone numbers of witnesses. When an accident results in death,
injury, or total disability of more than 10 calendar days, report
immediately by telephone to the appropriate official, who will notify
the Director, SSD, National Office. (See RD Instruction 2063-G for
notification of the Office of the General Counsel (OGC).) If the Rural
Development employee in the accident suffers an injury or is killed,
another Rural Development employee must prepare an SF-91 and send it to
the appropriate official, who will examine and send it, with any
additional, pertinent information to the Director, SSD, National Office.

> \(3\) The official (see § 2042.52(c)) will immediately assign a grade
> GS-7 or above Rural Development employee to be the investigating
> officer. The investigating officer must:

\(i\) Prepare an SF-91 within 48 hours after the accident and send it to
the appropriate official. This official will send the original copy to
the Director, SSD, National Office. To report additional information,
the investigating officer may add a written statement to the form.

\(ii\) Provide a clear copy of the police report, traffic investigation,
and other pertinent details, when applicable.

\(iii\) Provide a clear copy of the traffic ticket, if one is issued.

\(c\) [Dollar amount of actual or estimated damage]{.underline}. Within
15 calendar days after the accident, the Director, SSD, National Office
should also be provided with a statement of the actual or estimated
dollar amount of damage to the vehicle operated by the Rural Development
employee, as well as to the other vehicle or property involved.

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RD Instruction 2042-B

§ 2042.53 (Con.)

\(d\) [National Transportation Safety Board (NTSB) Form 6120.1/2
"Pilot/Operator Aircraft Accident Report."]{.underline} Report all
airplane accidents by Rural Development employees on NTSB Form 6120.1/2
at www.ntsb.gov/aviation/report.htm

\(1\) Send copies of accident reports to the nearest NTSB Regional
Office.

\(2\) Send two copies to the appropriate Rural Development
jurisdictional official (see § 2042.52(c)), who will keep one copy and
send the other to the Director, SSD, National Office.

\(e\) [Accidents involving General Services Administration (GSA) motor
pool vehicles]{.underline}. In addition to paragraphs (b) and (c) of
this section, the jurisdictional official and employee concerned shall
promptly provide the GSA Chief of the Motor Pool, who assigned the
vehicle, with copies of the completed accident reports and supporting
data, as follows:

\(1\) When total property damage is less than \$250 and no bodily injury
is involved, one copy of SF-91 and any other readily available data,
including estimates, when applicable.

\(2\) When total property damage is \$250 or more, or bodily injury is
involved, two copies of SF-91 and such photographs, measurements,
doctor\'s certificate of bodily injuries, police investigation report,
statement of witness(es), if any, and any other pertinent data, as are
obtainable. (See RD Instruction 2018.306(a) -- (d) for additional
information on custody and operation of GSA interagency motor pool and
leased vehicle(s).)

\(3\) One copy of all supportive accident forms must be sent to the
Director, SSD, National Office.

\(f\) [Payment of GSA claims]{.underline}. GSA will check to see if
payment is necessary; if so, the bill for damages should be sent to the
State Office concerned for payment to GSA via the Foundation Financial
Information System (FFIS). Repairs of leased vehicles will be processed
through the Budget Division, Administrative Programs Branch, National
Office.

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RD Instruction 2042-B

§ 2042.53 (Con.)

\(g\) [Opinions and statements]{.underline}. Neither the operator of a
vehicle involved in an accident, nor any other Rural Development
employee concerned, shall express opinion or make statements as to the
responsibility for the accident, except upon the request or direction of
the appropriate State Director, the Deputy Chief Financial Officer,

St. Louis Office, or the Director, SSD, National Office.

\(h\) [Failure to report accidents and complete records]{.underline}.
Violations of the accident reporting requirements contained herein or a
record of abnormal accident costs may result in disciplinary action.

\(i\) [Billing for repairs]{.underline}. GSA must be reimbursed for
damages caused by a Rural Development employee when fault or negligence
is involved.

§ 2042.54 [Accidents other than motor vehicle]{.underline}.

\(a\) [Reportable accidents]{.underline}. All accidents, except those
involving motor vehicles or aircraft, which result in property damage or
injury to private citizens.

\(b\) [Investigation report (accidents other than motor
vehicle)]{.underline}. When there is a serious injury, death, or
property damage, the official (see § 2042.52(c)) will immediately
appoint a grade GS-7 or above Rural Development employee near the place
of the accident to be the investigating officer. The investigating
officer\'s report to the appointing official will be in writing. It must
include:

\(1\) Maps or sketches of the place of accident.

\(2\) Photographs of the place showing the position of persons,
equipment, etc., involved in the accident.

\(3\) Any other important information.

\(4\) Names and addresses of the witnesses.

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RD Instruction 2042-B

§ 2042.55 [Supervisor\'s report of traumatic injury]{.underline}.

\(a\) USDA Modified Form CA-1 must be completed in all instances within\
7 calendar days of the accident by the injured Rural Development
employee\'s supervisor and the original submitted to the Director, SSD,
National Office.

\(b\) Use a separate form for each injured employee. One copy of each
report will be made to fill the needs of the appropriate jurisdictional
official.

\(c\) Send USDA Modified Form CA-1 to the appropriate jurisdictional
official. (See § 2042.52(c).)

§ 2042.56 [Processing accident forms]{.underline}.

Upon receipt of accident or claim forms by the State Office official,
the following steps must be taken to process the forms:

\(a\) State Office retains a copy of all forms.

\(b\) State Office sends a copy to the OGC Field Regional Attorney.

\(c\) State Office sends originals and two copies of all forms to the
Director, SSD, National Office.

\(1\) All accident forms must be completed in black ink (not pencil) or
typewritten, if possible, for clarity.

\(2\) The OGC Field Attorney has authority to determine the settlement
of tort claims for \$100,000 or less. After the attorney makes a
recommendation of payment to claimant(s), please see § 2042.6(d)(1)(i)
and (ii) of RD Instruction 2042-A.

§ 2042.57 [Statement of witnesses]{.underline}.

\(a\) A Rural Development employee involved in an accident will obtain
statements from witnesses in writing, at the scene of the accident,
utilizing SF-94. This form is included as a part of Form AD-651, "Motor
Vehicle Accident Report Kit," and will be provided for any owned vehicle
utilized on official business. On request, the Chief, Property,
Procurement and Mail Management Branch, in St. Louis, Missouri, will
supply a SF-95, "Claim for Damage, Injury, or Death," as well as Form
AD-651, which contains copies of Form CA-1, SF-91, and SF-94.

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RD Instruction 2042-B

§ 2042.57 (Con.)

\(b\) A Rural Development employee involved in an accident and the
investigating officer must obtain the full name and mailing address
(permanent home address, if witness is itinerant) of every witness to
the accident.

§§ 2042.58 - 2042.100 (Reserved)

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