OSHA’s Form 300 is a Log of Work-Related Injuries and Illnesses that employers must maintain to document workplace incidents. This form is essential for tracking every work-related death, injury, or illness that results in significant consequences, such as loss of consciousness or medical treatment beyond first aid. Ensure compliance by accurately filling out the form and protecting employee confidentiality—click the button below to get started.
The OSHA 300 form serves as a crucial tool for employers to document work-related injuries and illnesses within their organizations. This form is designed to track incidents that result in significant consequences, such as loss of consciousness, restricted work activity, job transfers, or medical treatment beyond first aid. Employers must record every work-related death and any injury or illness diagnosed by a healthcare professional that meets specific criteria outlined by OSHA regulations. The form allows for detailed descriptions of each case, including the employee's name, job title, date of injury, and a thorough account of the injury or illness itself. Additionally, it requires classification of the case based on the most serious outcome, ensuring that all relevant information is captured. It is important to note that each entry on the OSHA 300 form must correspond to an Injury and Illness Incident Report, which provides further detail about the incident. Employers are encouraged to seek guidance from their local OSHA office if they are uncertain about whether a case is recordable. This systematic approach not only aids in compliance with safety regulations but also contributes to a safer workplace environment by identifying and addressing potential hazards.
OSHA’s Form 300 (Rev. 01/2004)
Log of Work-Related Injuries and Illnesses
Attention: This form contains information relating to employee health and must be used in a manner that protects the confidentiality of employees to the extent possible while the information is being used for occupational safety and health purposes.
Year 20__ __
U.S. Department of Labor
Occupational Safety and Health Administration
You must record information about every work-related death and about every work-related injury or illness that involves loss of consciousness, restricted work activity or job transfer, days away from work, or medical treatment beyond first aid. You must also record significant work-related injuries and illnesses that are diagnosed by a physician or licensed health care professional. You must also record work-related injuries and illnesses that meet any of the specific recording criteria listed in 29 CFR Part 1904.8 through 1904.12. Feel free to use 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 each injury or illness recorded on this form. If you’re not sure whether a case is recordable, call your local OSHA office for help.
Form approved OMB no. 1218-0176
Establishment name ___________________________________________
City ________________________________ State ___________________
Identify the person
Describe the case
Classify the case
CHECK ONLY ONE box for each case
(A)
(B)
(C)
(D)
(E)
(F)
Enter the number of
Check the “Injury” column or
based on the most serious outcome for
days the injured or
Case
Employee’s name
Job title
Date of injury
Where the event occurred
Describe injury or illness, parts of body affected,
that case:
ill worker was:
choose one type of illness:
no.
(e.g., Welder)
or onset
(e.g., Loading dock north end) and object/substance that directly injured
Remained at Work
of illness
or made person ill (e.g., Second degree burns on
Away
On job
right forearm from acetylene torch)
Job transfer
Other record-
from
transfer or
Days away
Death from work
or restriction
able cases
work
restriction
(M)
Injury
Skindisorder
Respiratory condition
Poisoning
Hearingloss
Allother illnesses
_____
________________________
____________
/___
__________________
__________________________________________________
month/day
(G)
(H)
(I)
■■❑
(J)
■■❑ ■■❑ ■■❑ ■■❑ ■■❑ ■■❑ ■■❑ ■■❑ ■■❑ ■■❑ ■■❑ ■■❑ ■■❑
(K)
(L)
(1) (2) (3) (4) (5) (6)
____ days
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 Statistical Analysis, Room N-3644, 200 Constitution Avenue, NW, Washington, DC 20210. Do not send the completed forms to this office.
Page totals
Be sure to transfer these totals to the Summary page (Form 300A) before you post it.
Page ____ of ____
(1)
(2)
(3)
(4)
(5)
(6)
OSHA’s Form 300A (Rev. 01/2004)
Summary of Work-Related Injuries and Illnesses
All establishments covered by Part 1904 must complete this Summary page, even if no work-related injuries or illnesses occurred during the year. Remember to review the Log 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 from every page of the Log. If you 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 access to the OSHA Form 301 or 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
Establishment information
Your establishment name __________________________________________
Street
_____________________________________________________
City
____________________________ State ______ ZIP _________
Total number of deaths
Total number of cases with days away from work
Total number of
cases with job
other recordable
transfer or restriction
cases
Industry description (e.g., Manufacture of motor truck trailers)
_______________________________________________________
Standard Industrial Classification (SIC), if known (e.g., 3715)
____ ____ ____ ____
OR
North American Industrial Classification (NAICS), if known (e.g., 336212)
Number of Days
Total number of days away
Total number of days of job
from work
___________
____ ____ ____ ____ ____ ____
Employment information (If you don’t have these figures, see the Worksheet on the back of this page to estimate.)
Annual average number of employees
______________
Injury and Illness Types
Total number of . . .
Injuries
______
Skin disorders
Respiratory conditions
Poisonings
Hearing loss
All other illnesses
Total hours worked by all employees last year ______________
Sign here
Knowingly falsifying this document may result in a fine.
I certify that I have examined this document and that to the best of my knowledge the entries are true, accurate, and complete.
___________________________________________________________
Company executive
Title
(
)
-
/ /
Phone
Date
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 58 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 Statistical Analysis, Room N-3644, 200 Constitution Avenue, NW, Washington, DC 20210. Do not send the completed forms to this office.
OSHA’s Form 301
Injury and Illness Incident Report
This Injury and Illness Incident Report is one of the first forms you must fill out when a recordable work- related injury or illness has occurred. Together with 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 and severity of work-related incidents.
Within 7 calendar days after you receive information that a recordable work-related injury or illness has occurred, you must fill out this form or an 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.
According to Public Law 91-596 and 29 CFR 1904, OSHA’s recordkeeping rule, you must keep this form on file for 5 years following the year to which it pertains.
If you need additional copies of this form, you may photocopy and use as many as you need.
Completed by _______________________________________________________
Title _________________________________________________________________
Phone (________)_________--_____________
Date _____/ _____ / _____
Information about the employee
1)Full name _____________________________________________________________
2)Street ________________________________________________________________
City ______________________________________ State _________ ZIP ___________
3)Date of birth ______ / _____ / ______
4)Date hired ______ / _____ / ______
5) Male
Female
Information about the physician or other health care professional
6) Name of physician or other health care professional __________________________
________________________________________________________________________
7)If treatment was given away from the worksite, where was it given?
Facility _________________________________________________________________
Street _______________________________________________________________
8)Was employee treated in an emergency room?
Yes
No
9)Was employee hospitalized overnight as an in-patient?
Information about the case
10)Case number from the Log _____________________ (Transfer the case number from the Log after you record the case.)
11)
Date of injury or illness
______ / _____ / ______
12)
Time employee began work ____________________
AM / PM
13)
Time of event
____________________
AM / PM Check if time cannot be determined
14)What was the employee doing just before the incident occurred? Describe the activity, as well as the tools, equipment, or material the employee was using. Be specific. Examples: “climbing a ladder while carrying roofing materials”; “spraying chlorine from hand sprayer”; “daily computer key-entry.”
15)What happened? Tell us how the injury occurred. Examples: “When ladder slipped on wet floor, worker fell 20 feet”; “Worker was sprayed with chlorine when gasket broke during replacement”; “Worker developed soreness in wrist over time.”
16)What was the injury or illness? Tell us the part of the body that was affected and how it was affected; be more specific than “hurt,” “pain,” or sore.” Examples: “strained back”; “chemical burn, hand”; “carpal tunnel syndrome.”
17)What object or substance directly harmed the employee? Examples: “concrete floor”; “chlorine”; “radial arm saw.” If this question does not apply to the incident, leave it blank.
18) If the employee died, when did death occur? Date of death ______ / _____ / ______
Public reporting burden for this collection of information is estimated to average 22 minutes per response, including time for reviewing instructions, searching existing data sources, gathering and maintaining the data needed, and completing and reviewing the collection of information. Persons are not required to respond to the 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, including suggestions for reducing this burden, contact: US Department of Labor, OSHA Office of Statistical Analysis, Room N-3644, 200 Constitution Avenue, NW, Washington, DC 20210. Do not send the completed forms to this office.
Filling out the OSHA 300 form is an important step in documenting work-related injuries and illnesses. This process ensures that you accurately record incidents that may impact employee health and safety. Follow these steps to complete the form correctly.
What is the OSHA 300 form?
The OSHA 300 form is a log used to record work-related injuries and illnesses. Employers must fill it out for every work-related death, injury, or illness that results in loss of consciousness, restricted work activity, or medical treatment beyond first aid. It helps track workplace safety and health issues.
Who needs to complete the OSHA 300 form?
All employers covered by OSHA regulations must complete the OSHA 300 form if they have 10 or more employees and are not in a low-hazard industry. This includes businesses in construction, manufacturing, and healthcare, among others.
What types of incidents must be recorded?
Employers must record:
How do I determine if an incident is recordable?
To determine if an incident is recordable, consider the nature of the injury or illness and whether it meets the criteria mentioned above. If you’re unsure, you can contact your local OSHA office for guidance.
What is the purpose of the OSHA 301 form?
The OSHA 301 form, also known as the Injury and Illness Incident Report, must be completed for each injury or illness recorded on the OSHA 300 form. It provides detailed information about the incident, including how it happened and what injuries occurred.
How long do I need to keep the OSHA 300 form?
Employers must keep the OSHA 300 form for five years following the end of the calendar year that the records cover. This allows for ongoing analysis of workplace safety trends.
What happens if I fail to complete the OSHA 300 form?
If you do not complete the OSHA 300 form as required, you may face penalties from OSHA. It’s essential to maintain accurate records to ensure compliance and promote a safe work environment.
Can I use multiple lines for one case on the OSHA 300 form?
Yes, you can use two lines for a single case if necessary. This is helpful when you need to provide additional details about the incident.
What should I do with the completed OSHA 300 form?
Once you complete the OSHA 300 form, be sure to transfer the totals to the Summary page (Form 300A) before posting it. The summary must be displayed in a visible location for employees to see.
Filling out the OSHA 300 form is a critical task that requires attention to detail. One common mistake is failing to include every work-related injury or illness. It's essential to record incidents involving loss of consciousness, restricted work activity, or medical treatment beyond first aid. Omitting any of these cases can lead to serious compliance issues.
Another frequent error occurs when the description of the injury or illness is vague. It is crucial to provide a clear and specific account of what happened. For example, instead of writing "burn," specify "second-degree burns on right forearm from acetylene torch." This clarity helps in understanding the severity and nature of the incident.
Some people mistakenly believe that only serious injuries need to be recorded. However, significant work-related injuries and illnesses diagnosed by a physician must also be documented. This includes cases that may not seem severe at first glance but meet the criteria set by OSHA.
Inaccurate classification of the case is another common mistake. Each case should be checked against the most serious outcome. Misclassifying an injury can skew data and potentially lead to penalties. Always ensure that the classification aligns with the actual circumstances of the incident.
Additionally, failing to complete the Injury and Illness Incident Report (OSHA Form 301) for each recorded injury or illness is a critical oversight. This form provides detailed information that complements the data on the OSHA 300 form. Without it, the record may be incomplete and less useful for safety evaluations.
Another mistake is neglecting to transfer totals to the Summary page (Form 300A). This step is vital for ensuring that the information is accurately reported and posted as required. Missing this can result in inaccurate reporting to OSHA.
People often forget to maintain the confidentiality of employee health information. The OSHA 300 form contains sensitive data, and it must be handled with care to protect employees' privacy. Ensure that only authorized personnel have access to this information.
Lastly, many individuals do not seek help when unsure about whether a case is recordable. If there's any doubt, it’s best to consult your local OSHA office. They can provide guidance and help ensure that all necessary information is accurately recorded.
The OSHA 300 form is an essential document for tracking work-related injuries and illnesses in the workplace. Alongside this form, several other documents are frequently utilized to ensure comprehensive reporting and compliance with safety regulations. Below is a list of these documents, each serving a specific purpose in the reporting process.
Utilizing these documents alongside the OSHA 300 form helps create a safer work environment. Proper record-keeping and compliance are essential for protecting employees and meeting regulatory requirements.
The OSHA 300 form is essential for documenting work-related injuries and illnesses. Several other documents serve similar purposes in tracking workplace safety and health incidents. Below is a list of nine documents that share similarities with the OSHA 300 form:
Each of these documents plays a role in maintaining workplace safety and ensuring that employees receive appropriate care and support following any incidents.
Filling out the OSHA 300 form is a crucial task for maintaining workplace safety and ensuring compliance with regulations. Here’s a handy list of dos and don’ts to guide you through the process.
By following these guidelines, you can ensure that your OSHA 300 form is filled out correctly and comprehensively. This not only helps in maintaining compliance but also fosters a safer workplace for everyone.
Understanding the OSHA 300 form is crucial for workplace safety and compliance. However, several misconceptions can lead to confusion. Here are eight common misunderstandings about this important document:
By addressing these misconceptions, employers can better navigate the requirements of the OSHA 300 form and promote a safer workplace for everyone.
Here are key takeaways for filling out and using the OSHA 300 form: