Minnesota Safety Council: Governor's Award Application
Examples of How to Distinguish By Location and By Function
You may elect to submit separate applications for various divisions/operating units/branches/offices within your organization if the reporting units have twenty or more employees each and maintain their safety results separately within your organization.
Example 1 – how to distinguish by location
My Company, Anoka
My Company, Fridley
My Company, St. Paul
Example 2 – how to distinguish by function:
My Company, Parts Manufacturing
My Company, Adhesives
My Company, Final Production
My Company, Office Only
Choosing an NAICS Code
Your reporting code will be a North American Industry Classification System (NAICS) code chosen from the drop-down menu on the application form. Please choose a reporting code that corresponds to an industry that has a hazard exposure that is similar to yours.
Years of Data Required
Please submit annual information for the past three years. Report Minnesota figures only for calendar years 2011, 2012, and 2013. NOTE: If you submitted data last year, check that box on the application. You will then only be required to enter 2014 data.
Definition of DART Cases and OSHA Recordable Cases
For purposes of this awards program, DART (Days Away Restricted Transferred) cases are cases which involve days away from work, days of restricted work activity, and/or days of job transfer.
OSHA recordable injury and illness cases are those which require recording on your OSHA Log of Work-Related Injuries and Illnesses (300 Log). Criteria for deciding whether to record cases on your OSHA 300 Log can be found by clicking the "Regulatory Text" link at www.osha.gov/recordkeeping/index.html. The Minnesota Safety Council also presents a workshop on OSHA recordkeeping. Information can be found at www.minnesotasafetycouncil.org/courses/courses.cfm.
Formulas Used to Calculate Incidence Rates
Rates will be automatically calculated for you based on the data you enter. For reference, here are the formulas that are used.
Recordable Case Incidence Rate:
Total number of entries on 300 log, multiplied by 200,000, then divided by the total hours worked by all employees during the year covered.
DART (Days Away Restricted Transferred) Rate
Number of CASES with days away from work or job transfer or restrictions (cases on 300 log with either column H or I checked) multiplied by 200,000, then divided by total hours worked by all employees during the year covered.
About the Safety Program Evaluation Scorecard
The Safety Program Evaluation Scorecard was developed by a team of experienced safety professionals from Minnesota Safety Council member organizations. The scorecard is an important piece of the Governors Safety Awards Program, but it was also designed to be a helpful guide for those working to strengthen their safety programs.
Elements in the scorecard are organized into specific categories consistent with a comprehensive safety program. Your points will be automatically totaled when you have completed the scorecard. There is a total of 100 possible points. After submitting your application, you will receive a confirmation e-mail that will include your total points for the Safety Program Evaluation Scorecard.
The scorecard also asks for sign-off from your head of management.
These are the categories of awards for which your organization may be eligible. Please note: you must have earned the Meritorious Achievement Award to be considered for an Outstanding Achievement Award, and you must have earned the Outstanding Achievement Award to be considered for the Award of Honor.
- Meritorious Achievement:
- Minimum of three years of DART rates which are better than the average for your industry classification
- Total points of between 50 and 74 on the Safety Program Evaluation Scorecard
- Outstanding Achievement:
- Continuing improvement and/or a continuing outstanding record for DART rate and Incidence Rate which is at least 51-90% better than the average for your industry classification
- Total points of between 75 and 90 on the Safety Program Evaluation Scorecard
- Award of Honor
- DART rate and Incidence Rate that is at least 91% better than the average for your industry
- Total points of between 91 and 100 on the Safety Program Evaluation Scorecard
Experienced workplace safety and health professionals comprise the Awards Judging Committee. Award results are based on above criteria and the discretion of the judges. The judges' findings are considered final.
Please direct questions regarding the Governor's Workplace Safety and Health Awards program to Kristy Zack (651-228-7332/800-444-9150) or Jan Fedora (651-228-7310/800-444-9150), Minnesota Safety Council.