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Federal Reporting Requirements
The Occupational Safety and Health Administration (OSHA) requires that employers report certain serious incidents within a specific timeframe[1]:
- Fatalities must be reported within 8 hours.
- Hospitalizations, amputations, or loss of an eye must be reported within 24 hours.
Reports can be filed in person, online, or by phone at 1-800-321-6742.
OSHA Recordkeeping
Employers covered by OSHA’s recordkeeping rule who have 11 or more employees must complete OSHA Form 301 within seven days of a serious workplace injury or illness (see general recording criteria for reportable incidents).[2]
Each case must also be logged on OSHA Form 300, and an annual summary of all incidents must be recorded on OSHA Form 300A. At the end of the year, the 300A summary must be posted in a clearly visible location.
Important: Employers must submit all OSHA-required incident data annually through the Injury Tracking Application and retain all OSHA forms for five years.[3]
Sample
INDIVIDUAL FILING REPORT
Full Name: [FULL NAME] Title/Role: [TITLE/ROLE]
Signature: Date: [MM/DD/YYYY]
INCIDENT DETAILS
Date of Incident: [MM/DD/YYYY] Time: [TIME] ☐ AM ☐ PM
Location: [INCIDENT LOCATION]
Incident Type: ☐ Injury ☐ Illness ☐ Near Miss ☐ Fire ☐ Equipment / Property Damage
☐ Violence ☐ Harassment ☐ Improper Safety Procedures ☐ Other: [OTHER]
Describe the Incident: [DESCRIBE INCIDENT]
Describe what could have been done to prevent the incident: [DESCRIBE MEASURES]
PARTIES INVOLVED
- Full Name: [FULL NAME] Phone: [PHONE] E-Mail: [E-MAIL] Address: [ADDRESS]
- Full Name: [FULL NAME] Phone: [PHONE] E-Mail: [E-MAIL] Address: [ADDRESS]
- Full Name: [FULL NAME] Phone: [PHONE] E-Mail: [E-MAIL] Address: [ADDRESS]
- Full Name: [FULL NAME] Phone: [PHONE] E-Mail: [E-MAIL] Address: [ADDRESS]
INJURIES
Was anyone injured? ☐ Yes ☐ No
If yes, describe: [DESCRIBE INJURIES]
If an employee was injured, did they see a doctor? ☐ Yes ☐ No
If yes, complete the following: (use additional forms for each injured employee)
- Injured Employee Name: [INJURED EMPLOYEE NAME]
- Doctor / Hospital Name: [DOCTOR / HOSPITAL NAME]
- Doctor / Hospital Phone: [DOCTOR / HOSPITAL PHONE]
- Date of Visit: [DATE]
- Time of Visit: [TIME] ☐ AM ☐ PM
- Has this part of the employee’s body been injured before? ☐ Yes ☐ No
- If yes, when? [DATE]
WITNESSES
Were there witnesses to the incident? ☐ Yes ☐ No
If yes, enter the witnesses’ names and contact info:
- Full Name: [NAME] Phone: [PHONE] E-Mail: [E-MAIL]
- Full Name: [NAME] Phone: [PHONE] E-Mail: [E-MAIL]
- Full Name: [NAME] Phone: [PHONE] E-Mail: [E-MAIL]
POLICE / EMERGENCY MEDICAL SERVICES
Police Notified? ☐ Yes ☐ No | If yes, was a report filed? ☐ Yes ☐ No
Was emergency medical treatment provided? ☐ Yes ☐ No ☐ Refused
If yes, where? ☐ On site ☐ Hospital ☐ Other: [OTHER]