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OSHA Forms for Recording Work-Related Injuries and Ill

U.S. Department of Labor 

Occupational Safety and Health Administration 

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The (Form 300) is used to classify work-related injuries and illnesses and to note the extent and severity of each case. When an incident occurs, use the to record specific details about what happened and how it happened. The — a separate form (Form 300A) 

— shows the totals for the year in each category. At the end of the year, post the 

in a visible location so that your 

employees are aware of the injuries and illnesses occurring in their workplace. 

Employers must keep a for each 

establishment or site. If you have more than one establishment, you must keep a separate 

and for each physical location that 

is expected to be in operation for one year or longer. 

Note that your employees have the right to 

review your injury and illness records. For more information, see 29 Code of Federal Regulations Part 1904.35, 

Cases listed on the 

are not necessarily eligible 

for workers’ compensation or other insurance benefits. Listing a case on the does not mean that the employer or worker was at fault or that an OSHA standard was violated. 

Record those work-related injuries and illnesses that result in: 

death, loss of consciousness, days away from work, restricted work activity or job transfer, o

medical treatment beyond first aid. 

You must also record work-related injur

and illnesses that are significant (as defined below) or meet any of the additional criteria listed below. 

Log of Work-Related Injuries and Illnesses 

Log 

Summary 

Summary 

Log 

Log Summary 

Employee Involvement. 

Log of Work-Related 

Injuries and Illnesses 

Log 

When is an injury or illness considered work-related? 

Which work-related injuries and 

illnesses should you record? �����

An injury or illness is considered work-related if an event or exposure in the work environment caused or contributed to the condition or significantly aggravated a preexisting condition. Work-relatedness is 

presumed for injuries and illnesses resultinfrom events or exposures occurring in the workplace, unless an exception specifically applies. See 29 CFR Part 1904.5(b)(2) for texceptions. The work environment includethe establishment and other locations wherone or more employees are working or are present as a condition of their employmentSee 29 CFR Part 1904.5(b)(1). 

You must record any significant workrelated injury or illness that is diagnosed by 

physician or other licensed health care professional. You must record any work-relcase involving cancer, chronic irreversible disease, a fractured or cracked bone, or a 

punctured eardrum. See 29 CFR 1904.7. 

An Overview: Recording Work-Related Injuries 

The Occupational Safety and Health (OSH) Act of 1970 requires certain employers to prepare and maintain records of wdefinitions when you classify cases on the Log. OSHA’s recordkeeping regulation (see 29 CFR Part 1904) provides more 

U.S. Department of Labor 

Occupational Safety and Health Administration 

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U.S. Department of Labor 

Occupational Safety and Health Administration 

What is first aid? If the incident required only the following types of treatment, consider it first aid. Do NOT record the case if it involves only: 

� using non-prescription medications at nonprescription strength; � administering tetanus immunizations; � cleaning, flushing, or soaking wounds on the 

skin surface; 

� using wound coverings, such as bandages, 

BandAidsTM, gauze pads, etc., or using SteriStripsTM or butterfly bandages. 

� using hot or cold therapy; � using any totally non-rigid means of support, 

such as elastic bandages, wraps, non-rigid back belts, etc.; 

� using temporary immobilization devices 

while transporting an accident victim (splints, slings, neck collars, or back boards). 

� drilling a fingernail or toenail to relieve 

pressure, or draining fluids from blisters; 

� using eye patches; � using simple irrigation or a cotton swab to 

remove foreign bodies not embedded in or adhered to the eye; 

� using irrigation, tweezers, cotton swab or 

other simple means to remove splinters or foreign material from areas other than the eye; 

� using finger guards; � using massages; � drinking fluids to relieve heat stress 

How do you decide if the case involverestricted work? Restricted work activity occurs when, as the result of a work-related injury or illness, an employer or health care professional keeps, recommends keeping, an employee from dothe routine functions of his or her job or from working the full workday that the employee would have been scheduled to work before tinjury or illness occurred. How do you count the number of days restricted work activity or the number days away from work? Count the number of calendar days the employee was on restricted work activity or waway from work as a result of the recordable injury or illness. Do not count the day on whthe injury or illness occurred in this numberBegin counting days from the day after the 

incident occurs. If a single injury or illness involved both days away from work and dayrestricted work activity, enter the total numbof days for each. You may stop counting dayrestricted work activity or days away from woonce the total of either or the combination oboth reaches 180 days. 

Under what circumstances should yoNOT enter the employee’s name on thOSHA Form 300? You must consider the following types of injuries or illnesses to be privacy concern cas� an injury or illness to an intimate body pa

or to the reproductive system, 

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U.S. Department of Labor 

Occupational Safety and Health Administration 

Classifying illnesses Skin diseases or disorders Skin diseases or disorders are illnesses involving the worker’s skin that are caused by work exposure to chemicals, plants, or other substances. 

Examples: Contact dermatitis, eczema, or 

rash caused by primary irritants and sensitizers or poisonous plants; oil acne; friction blisters, chrome ulcers; inflammation of the skin. 

Respiratory conditions Respiratory conditions are illnesses associated with breathing hazardous biological agents, chemicals, dust, gases, vapors, or fumes at work. 

Examples: Silicosis, asbestosis, pneumonitis, 

pharyngitis, rhinitis or acute congestion; farmer’s lung, beryllium disease, tuberculosis, occupational asthma, reactive airways dysfunction syndrome (RADS), chronic obstructive pulmonary disease (COPD), hypersensitivity pneumonitis, toxic inhalation injury, such as metal fume fever, chronic 

obstructive bronchitis, and other pneumoconioses. 

Poisoning Poisoning includes disorders evidenced by abnormal concentrations of toxic substances in blood, other tissues, other bodily fluids, or the breath that are caused by the ingestion or absorption of toxic substances into the body. 

Examples: Poisoning by lead, mercury, 

cadmium, arsenic, or other metals; poisoning by carbon monoxide, hydrogen sulfide, or other 

gases; poisoning by benzene, benzol, carbon tetrachloride, or other organic solvents; poisoning by insecticide sprays, such as parathion or lead arsenate; poisoning by othchemicals, such as formaldehyde. 

All other illnesses 

All other occupational illnesses. 

Examples: Heatstroke, sunstroke, heat 

exhaustion, heat stress and other effects of environmental heat; freezing, frostbite, and other effects of exposure to low temperaturedecompression sickness; effects of ionizing radiation (isotopes, x-rays, radium); effects ononionizing radiation (welding flash, ultra-vrays, lasers); anthrax; bloodborne pathogenidiseases, such as AIDS, HIV, hepatitis B or hepatitis C; brucellosis; malignant or benign 

tumors; histoplasmosis; coccidioidomycosi

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U.S. Department of Labor 

Occupational Safety and Health Administration 

Optional 

Calculating Injury and Illness In

What is an incidence rate? An incidence rate is the number of recordable injuries and illnesses occurring among a given number of full-time workers (usually 100 fulltime workers) over a given period of time (usually one year). To evaluate your firm’s injury and illness experience over time or to compare your firm’s experience with that of your industry as a whole, you need to compute your incidence rate. Because a specific number of workers and a specific period of time are involved, these rates can help you identify problems in your workplace and/or progress you may have made in preventing workrelated injuries and illnesses. How do you calculate an incidence rate? You can compute an occupational injury and illness incidence rate for all recordable cases or for cases that involved days away from work for your firm quickly and easily. The formula requires that you follow instructions in paragraph (a) below for the total recordable cases or those in paragraph (b) for cases that involved days away from work, and for both 

rates the instructions in paragraph (c). 

(a) To find out the total number of recordable 

injuries and illnesses that occurred during the year, 

count the number of line entries on your OSHA Form 300, or refer to the OSHA Form 300A and sum the entries for columns (G), (H), (I), and (J). 

(b) To find out the number of injuries and 

illnesses that involved days away from work, count 

the number of line entries on your OSHA Form 300 that received a check mark in column (H), or refer to the entry for column (H) on the OSHA Form 300A. 

(c) The number of hours all employees actual

worked during the year. Refer to OSHA Form 

300A and optional worksheet to calculate thnumber. 

You can compute the incidence rate for 

recordable cases of injuries and illnesses usithe following formula: 

Total number of injuries and illnesses ÷ Number hours worked by all employees X 200,000 hours Total recordable case rate 

(The 200,000 figure in the formula represethe number of hours 100 employees workin40 hours per week, 50 weeks per year woulwork, and provides the standard base for calculating incidence rates.) 

You can compute the incidence rate for 

recordable cases involving days away from work, days of restricted work activity or job transfer (DART) using the following formul

(Number of entries in column H + Number of entries in column I) ÷ Number of hours worked all employees X 200,000 hours = DART inciden

rate 

You can use the same formula to calculate incidence rates for other variables such as cinvolving restricted work activity (column (on Form 300A), cases involving skin disorde(column (M-2) on Form 300A), etc. Just substitute the appropriate total for these cafrom Form 300A, into the formula in place the total number of injuries and illnesses. What can I compare my incidence rate to? The Bureau of Labor Statistics (BLS) condua survey of occupational injuries and illnesseach year and publishes incidence rate data 

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The is

used to classify work-related injuries andillnesses and to note the extent and severity

of each case. When an incident occurs, use

the to record specific details about what

happened and how it happened.

We have given you several copies of the

in this package. If you need more than

we provided, you may photocopy and use asmany as you need.

The — a separate form —

shows the work-related injury and illnesstotals for the year in each category. At the

end of the year, count the number ofincidents in each category and transfer thetotals from the to the Thenpost the in a visible location so thatyour employees are aware of injuries and

illnesses occurring in their workplace.

Log of Work-Related Injuries and Illnesses

Log

Log

Summary

Log Summary.

Summary

If your company has more than one

establishment or site, you must keep

separate records for each physical locationthat is expected to remain in operation for

one year or longer.

You don’t post the Log. You post only the

Summary at the end of the year.

How to Fill Out the Log

Be as spec

can use twmore room

U.S. Department of Labor

Occupational Safety and Health Administration

R

(A) (B) (C) 

You must record information about every work-related death and days away from work, or medical treatment beyond first aid. You care professional. You must also record work-related injuries an

use two lines for a single case if you need to. You must completform. If you’re not sure whether a case is recordable, call your lo

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OSHA’s Form 300 

Log of Work-Related Injuries and Illnesses 

You must record information about every work-related death and about every work-related injury or illness that involves loss of consciousness, redays away from work, or medical treatment beyond first aid. You must also record significant work-related injuries and illnesses that are diagnosecare professional. You must also record work-related injuries and illnesses that meet any of the specific recording criteria listed in 29 CFR Part 19use two lines for a single case if you need to. You must complete an Injury and Illness Incident Report (OSHA Form 301) or equivalent form for eform. If you’re not sure whether a case is recordable, call your local OSHA office for help. 

month/day 

month/day 

month/day 

month/day 

month/day 

month/day 

month/day 

month/day 

month/day 

month/day 

month/day 

month/day 

month/day 

Identify the person Describe the case Case Employee’s name Job title Date of injury Where the event occurred Describe injury or illness, 

of illness or made person ill 

no. (e.g ) or onset ( and object/substance that d

( 

., Welder e.g., Loading dock north end 

e.g., Second degree burns on ri

_____ ________________________ ____________ ______/___ _______ __________________ ___________________ __________

_____ ________________________ ____________ ______/___ _______ __________________ _______________________

_____ ________________________ ____________ ______/___ _______ __________________ ______________________ _______

_____ ________________________ ____________ ______/___ _______ __________________ ______________________ _______

_____ ________________________ ____________ ______/___ _______ __________________ ___________________ __________

_____ ________________________ ____________ ______/___ _______ __________________ _______________________

_____ ________________________ ____________ ______/___ _______ __________________ _______________________

_____ ________________________ ____________ ______/___ _______ __________________ _______________________

_____ ________________________ ____________ ______/___ _______ __________________ _______________________

_____ ________________________ ____________ ______/___ _______ __________________ ___________________ __________

_____ ________________________ ____________ ______/___ _______ __________________ _______________________

_____ ________________________ ____________ ______/___ _______ __________________ _______________________

_____ ________________________ ____________ ______/___ _______ __________________ ___________________ __________

(A) (B) (C) (D) (E) (F) 

) 

Public reporting burden for this collection of information is estimated to average 14 minutes per response, including time to review the instructions, search and gather the data needed, and complete and review the collection of information. Persons are not required to respond to the collection of information unless it displays a currently valid OMB control number. If you have any comments about these estimates or any other aspects of this data collection, contact: US Department of Labor, OSHA Office of Statistics, Room N-3644, 200 Constitution Avenue, NW, Washington, DC 20210. Do not send the completed forms to this office. 

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OSHA’s Form 300A 

Summary of Work 

-Related Injuries an

All establishments covered by Part 1904 must complete this Summary page, even if no work-related injuries or illnesses occurred during the to verify that the entries are complete and accurate before completing this summary. 

Using the Log, count the individual entries you made for each category. Then write the totals below, making sure you’ve added the entries 

had no cases, write “0.” 

Employees, former employees, and their representatives have the right to review the OSHA Form 300 in its entirety. They also have limited 

its equivalent. See 29 CFR Part 1904.35, in OSHA’s recordkeeping rule, for further details on the access provisions for these forms. 

Number of Cases 

Total number of Total number of Total number of Total number of deaths cases with days cases with job other recordable 

away from work transfer or restriction cases 

__________________ __________________ __________________ __________________ 

(G) (H) (I) (J) 

Number of Days 

Total number of days of Total number of days job transfer or restriction away from work ___________ ___________ 

(K) (L) 

Injury and Illness Types 

Total number of . . . 

(M) 

(1) Injuries ______ (2) Skin disorders ______ (3) Respiratory conditions ______ 

(4) (5) 

Poisonings ______ All other illnesses ______ 

Post this Summary page from February 1 to April 30 of the year following the year covered by the form. 

Public reporting burden for this collection of information is estimated to average 50 minutes per response, including time to review the instructions, search and gatcomplete and review the collection of information. Persons are not required to respond to the collection of information unless it displays a currently valid OMB con

comments about these estimates or any other aspects of this data collection, contact: US Department of Labor, OSHA Office of Statistics, Room N-3644, 200 ConstitDC 20210. Do not send the completed forms to this office. 

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U.S. Department of Labor 

Occupational Safety and Health Administration 

Optional Worksheet to Help You Fill Out the 

At the end of the year, OSHA requires you to enter the average number of employees and the total hours worked by your 

information on this page to estimate the numbers you will need to enter on the Summary page at the end of the year. 

How to figure the average number of employees 

who worked for your establishment during the
year:
 

� Add the total number of employees your 

establishment paid in all pay periods during the year. Include all employees: full-time, part-time, The number of employees temporary, seasonal, salaried, and hourly. paid in all pay periods = 

� Count the number of pay periods your 

establishment had during the year. Be sure to 

include any pay periods when you had no The number of pay employees. periods during the year = 

� Divide the number of employees by the number of 

= 

pay periods. 

� Round the answer to the next highest whole 

number. Write the rounded number in the blank The number rounded = marked Annual average number of employees. 

For example, Acme Construction figured its average employment this way: For pay period... Acme paid this number of employees... 1 10 Number of employees paid = 830

2 0 

�

3 15 Number of pay periods = 26 �4 30 5 ▼24 

40 

▼

20 

830 = 31.92 �26 31.92 rounds to 32 �

25 15 26 +10 32 is the annual average number of employees 

830 

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OSHA’s Form 301 

Injury and Illness Incident Report


Information about the employee 

This Injury and Illness Incident Report is one of the first forms you must fill out when a recordable work- 1) Full name ________________________________________________related injury or illness has occurred. Together with 

2) Street ___________________________________________________

the Log of Work-Related Injuries and Illnesses and the accompanying Summary, these forms help the 

employer and OSHA develop a picture of the extent 

City ______________________________________ State _________ 

and severity of work-related incidents. 3) Date of birth ______ / _____ / ______ 

Within 7 calendar days after you receive 4) Date hired ______ / _____ / ______ 

information that a recordable work-related injury or 5) � Male illness has occurred, you must fill out this form or an � Female equivalent. Some state workers’ compensation, insurance, or other reports may be acceptable substitutes. To be considered an equivalent form, any substitute must contain all the information asked for on this form. 

Information about the physician or other hprofessional 

According to Public Law 91-596 and 29 CFR 6) Name of physician or other health care professional _________

1904, OSHA’s recordkeeping rule, you must keep this form on file for 5 years following the year to __________________________________________________________which it pertains. 7) If treatment was given away from the worksite, where was it giv

If you need additional copies of this form, you 

may photocopy and use as many as you need. Facility __________________________________________________

Street _________________________________________________City ______________________________________ State _________ 

8) Was employee treated in an emergency room? 

� Yes 

Completed by _______________________________________________________ � No Title _________________________________________________________________ 9) Was employee hospitalized overnight as an in-patient? � Yes 

� No Phone (________)_________--_____________ Date _____/ _____ _ / _____ 

Public reporting burden for this collection of information is estimated to average 22 minutes per response, including time for reviewing instructions, searching existing d

collection of information unless it displays a current valid OMB control number. If you have any comments about this estimate or any other aspects of this data collection

Washington, DC 20210. Do not send the completed forms to this office. 

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If you need help deciding whether a case is recordable, or if you have questions about the information in this package, f

contact us. We’ll gladly answer any questions you have.

If You Need Help...



Visit us online at www.osha.govCall your OSHA Regional officeand ask for the recordkeepingcoordinatororCall your State Plan office

Federal Jurisdiction 

Region 1 - 617 / 565-9860Region 2 - 212 / 337-2378Region 3 - 215 / 861-4900Region 4 - 404 / 562-2300Region 5 - 312 / 353-2220Region 6 - 214 / 767-4731Region 7 - 816 / 426-5861Region 8 - 303 / 844-1600Region 9 - 415 / 975-4310Region 10 - 206 / 553-5930Connecticut; Massachusetts; Maine; NewHampshire; Rhode IslandNew York; New JerseyDC; Delaware; Pennsylvania; West VirginiAlabama; Florida; Georgia; MississippiIllinois; Ohio; WisconsinArkansas; Louisiana; Oklahoma; TexasKansas; Missouri; NebraskaColorado; Montana; North Dakota; SouthDakotaIdaho

U.S. Department of Labor

Occupational Safety and Health Administration
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U.S. Department of Labor 

Occupational Safety and Health Administration 

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