Health and Safety case form
Summarize
Summary of Health and Safety case form
The Health and Safety case form in ServiceNow allows safety case managers to address health and safety questions submitted by employees. When such a question is submitted, a safety case is created automatically, with some fields populated from the original request. After assignment, a safety agent completes the case details using the Health and Safety Workspace.
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Key Features
- Case Identification: Each case has a unique system-generated number and a brief description summarizing the request.
- Requester Information: The form captures the employee for whom the information is requested.
- Category Selection: Cases can be categorized into health and safety procedures, training, equipment, injury/incident-related leave, or general inquiries to streamline handling.
- Related Incidents: If the Health and Safety Incident Management application is installed, related incidents or observations can be linked to the case.
- Return to Work Cases: These are specific cases related to employees returning to work after injury or illness. Only users with the Return to work case writer role can edit these fields. Selecting "Yes" reveals detailed sections for return to work planning, including leave details and work restrictions.
- Compensation Claim Cases: Cases related to compensation claims can be designated, with additional sections for employee claim details and closure. Editing rights are restricted to users with the Claim case writer role.
- Case Assignment: Cases are assigned to a safety assignment group and optionally to a specific user within that group.
- Contact Methods: Specifies how to contact the employee (email, phone, etc.).
- Detailed Description: Captures comprehensive information about the case for clarity and resolution.
Return to Work Details
When a case is marked as a return to work case, additional fields appear to help assess the employee’s readiness to resume work. Only users with the Return to work case writer role can edit these fields, which include:
- Leave Category: Reason for the employee’s absence.
- Expected Return Date: When the employee is anticipated to return.
- Medical Clearance Received: Indicates if medical approval has been obtained.
- Accommodations Needed: Any modifications required to support the employee’s return.
- Work Restrictions: Limitations identified for the employee during return-to-work planning.
Practical Value for ServiceNow Customers
This form streamlines the management and resolution of health and safety queries by automating case creation and guiding safety agents through structured data capture. It ensures proper tracking of employee-related health and safety issues, supports compliance with return to work processes, and facilitates integration with incident management and compensation claim workflows. Role-based editing ensures sensitive information is handled appropriately, enhancing security and accountability.
Safety case manager can use the safety case form to resolve health and safety questions that they receive from employees.
When a health and safety question is submitted, it creates a safety case. Some of the fields on the case form are populated from the request from which it is created.
After the case is assigned, a safety agent fills out the fields on the case from Health and Safety Workspace.
| Field | Description |
|---|---|
| Number | System-generated unique number for the case. |
| Short description | Brief description of the request. |
| Requested for | Person for whom the information is requested. |
| Category | Type of the case or employee's question.
|
| Related incidents / observations | Safety incident or observation this case is related to. This field appears only when the Health and Safety Incident Management (sn_hs_im_incident) application is installed on your ServiceNow instance. For more information, see Install Health and Safety Incident Management. |
| Return to work case | Option whether this case is related to an employee returning to work after an injury or illness. Only a user with the Return to work case writer
[sn_hs_cm.rtw_writer] role can edit this field. A Return to work case is usually opened related to an incident where an employee was injured and required time off to recover. The following items
appear when Yes is selected in this field:
|
| Compensation claim case | Option whether this case is related to a to compensation claim. The following sections appear when Yes is selected in this field. Only a user with the Claim case writer
[sn_hs_cm.claim_case_writer] role can edit fields in these sections.
|
| Parent case | Parent Health and Safety case ID number this case is related to. |
| State | State of the case. |
| Assignment group | Safety assignment group the case is assigned to. If the case isn’t assigned to a user yet, any member of this group can work on the case. |
| Assigned to | User assigned to this case. |
| Contact type | Method to contact the person this information is requested for, such as email or phone number. |
| Description | Detailed description of the case. |
Return to work details
The Return to work details section on the Health and Safety case form appears only when Yes is selected from Return to work case. The fields enable you to assess the employee's capability to work before they return from an injury or illness.
Only a user with the Return to work case writer [sn_hs_cm.rtw_writer] role can edit fields in this section.
| Field | Description |
|---|---|
| Leave category | Reason the employee was away from work. |
| Expected return date | Date the employee is expected to return to work. |
| Medical clearance received | Option to indicate whether a medical clearance is received for the employee before they return to work from an injury or illness returning. |
| Accommodations needed | Changes required to help the employee return to work. |
| Work restrictions | Limitations identified during the return to work planning for the employee. |