Drug-Free Safety Program Help Zone
Your helpful resource for navigating the Ohio Bureau of Workers’ Compensation’s Drug-Free Safety Program (DFSP).
Scroll down the page for links to DFSP checklists, forms and program guides. For more assistance, contact Safex at DFWP_Training@safex.us
ANNUAL REPORT ASSISTANCE
4 DFSP Annual Report Tricks
https://youtu.be/8YmbA8WrN1U
Organizational Tips for DFSP Annual Report Success
https://www.workingpartners.com/resources/go-ahead-ask/tipsfordfspannualreport/
DFSP FORMS
Enrollment Form (U-140)
Blank template: https://www.bwc.ohio.gov/downloads/blankpdf/U-140.pdf
Electronic form: https://www.bwc.ohio.gov/employer/forms/dfsp/u140/default.aspx
Safety Management Self-Assessment (SH-26)
Blank template: https://www.bwc.ohio.gov/downloads/blankpdf/SH-26.pdf
Electronic form: https://www.bwc.ohio.gov/employer/forms/SafetyMgtSelfAssessment/Default.aspx
Accident Report (DFSP-1)
Blank template: https://www.bwc.ohio.gov/downloads/blankpdf/DFSP-1.pdf
Electronic form: https://www.bwc.ohio.gov/employer/forms/dfsp/accidentreport/default.aspx
Annual Report – Basic and Advanced levels (DFSP-3)
Sample: https://www.bwc.ohio.gov/downloads/blankpdf/DFSP-3Sample.pdf
Blank template, last 4 pages of packet: https://www.bwc.ohio.gov/downloads/blankpdf/dfspselfimplementationworkbook.pdf
Electronic form: https://www.bwc.ohio.gov/employer/forms/dfsp/annualreport3/default.aspx
Annual Report – Comparable level (DFSP-4)
Sample: https://www.bwc.ohio.gov/downloads/blankpdf/DFSP-4Sample.pdf
Blank template, last 3 pages of packet: https://www.bwc.ohio.gov/downloads/blankpdf/ConstructionDrugFreeGuide.pdf
Electronic form: https://www.bwc.ohio.gov/employer/forms/dfsp/annualreport4/default.aspx
Safety Action Plan (DFSP-5)
Blank template: https://www.bwc.ohio.gov/downloads/blankpdf/DFSP-5.pdf
Electronic form: https://www.bwc.ohio.gov/employer/forms/dfsp/actionplan/default.aspx
PROGRAM GUIDES
Substance Use Recovery and Workplace Safety Program
Overview: https://info.bwc.ohio.gov/for-employers/workers-compensation-coverage/rates-and-bonuses/sur-overview
Summary of Reimbursable Expenses: https://info.bwc.ohio.gov/static/Employers/SUR-ReimbursementExpensesChart.pdf
Drug-Free Safety Program Guide
https://www.bwc.ohio.gov/downloads/blankpdf/DFSPGuide.pdf
Drug-Free Safety Program Self-Implementation Workbook
https://www.bwc.ohio.gov/downloads/blankpdf/dfspselfimplementationworkbook.pdf
Program Discount Compatibility
https://www.bwc.ohio.gov/downloads/blankpdf/OAC4123-17-74AppendixC.pdf
Drug-Free Safety Program SafetyGRANT$ Procedural Guide
https://www.bwc.ohio.gov/downloads/blankpdf/DFSPGrantsProcGuide.pdf
State Construction Employer Drug-Free Guide (DFSP Comparable level)
https://www.bwc.ohio.gov/downloads/blankpdf/ConstructionDrugFreeGuide.pdf
State Construction Contractor Look-Up
https://www.bwc.ohio.gov/employer/services/StateContract/nlbwc/StateContract1.aspx