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The OSHA 300 Form is a critical tool for employers to document and track work-related injuries and illnesses within the workplace. It requires a detailed record of all serious incidents resulting in death, loss of consciousness, restricted work activity, job transfers, or days away from work due to injuries or illnesses. Significant issues diagnosed by a physician or healthcare professional also need to be logged here. This form helps ensure compliance with OSHA regulations, particularly the specific recording criteria laid out in 29 CFR Part 1904. Employers must complete an accompanying Injury and Illness Incident Report (OSHA Form 301) for each event recorded. Confidentiality is paramount; thus, it is essential that information is handled respectfully throughout this process. If there is any uncertainty regarding whether a case is recordable, employers can reach out to their local OSHA office for assistance. Proper completion of the OSHA 300 Form is not just a regulatory requirement but also a step toward fostering a safer work environment by identifying and addressing health and safety issues proactively.

Osha 300 Example

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

 

 

_____

________________________

____________

/___

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__________________________________________________

 

 

 

month/day

 

 

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/___

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month/day

 

 

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month/day

 

 

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month/day

 

 

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month/day

 

 

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month/day

 

 

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month/day

 

 

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month/day

 

 

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month/day

 

 

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month/day

 

 

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month/day

 

 

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/___

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__________________________________________________

 

 

 

month/day

 

 

(G)

(H)

(I)

(J)

(K)

(L)

(1) (2) (3) (4) (5) (6)

____ days

____ days

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

____ days

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____ days

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____ days

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____ days

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____ days

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____ days

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____ days

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____ days

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____ days

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____ days

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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 ____

Injury

(1)

Skindisorder

Respiratory condition

Poisoning

Hearingloss

Allother illnesses

(2)

(3)

(4)

(5)

(6)

 

 

 

 

 

 

OSHA’s Form 300A (Rev. 01/2004)

Year 20__ __

 

Summary of Work-Related Injuries and Illnesses

 

 

Occupational Safety and Health Administration

 

U.S. Department of Labor

 

 

 

 

Form approved OMB no. 1218-0176

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

__________________

(G)

Total number of cases with days away from work

__________________

(H)

Total number of

Total number of

cases with job

other recordable

transfer or restriction

cases

__________________

__________________

(I)

(J)

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

transfer or restriction

___________

___________

____ ____ ____ ____ ____ ____

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

______________

(K)

Injury and Illness Types

Total number of . . .

 

(M)

 

(1)

Injuries

______

(2)

Skin disorders

______

(3)

Respiratory conditions

______

(L)

(4)

Poisonings

______

(5)

Hearing loss

______

(6)

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

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.

U.S. Department of Labor

Occupational Safety and Health Administration

Form approved OMB no. 1218-0176

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 _______________________________________________________________

City ______________________________________ State _________ ZIP ___________

8)Was employee treated in an emergency room?

Yes

No

9)Was employee hospitalized overnight as an in-patient?

Yes

No

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.

Form Characteristics

Fact Name Description
Purpose The OSHA 300 form serves to log work-related injuries and illnesses, ensuring that essential information about employee health is documented properly.
Required Recording Employers must record any work-related injury or illness that results in death, loss of consciousness, restricted work activity, job transfer, or medical treatment beyond first aid.
Confidentiality All entries in the OSHA 300 form must be handled sensitively to protect the confidentiality of employees while fulfilling occupational safety obligations.
Significant Cases Injuries diagnosed by a physician or licensed healthcare professional, along with other significant work-related injuries, are mandatory to record.
Compliance Standards The recording criteria are outlined in 29 CFR Part 1904.8 through 1904.12, which provides specific guidelines for reporting.
Accompanying Forms For each injury or illness recorded, an Injury and Illness Incident Report (OSHA Form 301) or an equivalent form must be completed.
Public Reporting Burden The average time spent filling out the form is estimated at 14 minutes, which includes reviewing instructions and gathering necessary data.
State-Specific Forms Some states may have their own specific rules and forms regarding workplace injury and illness reporting, governed by respective state occupational health laws.

Guidelines on Utilizing Osha 300

Filling out the OSHA 300 Form requires careful attention to detail to ensure that all work-related injuries and illnesses are accurately documented. Keeping track of these incidents not only helps maintain safety standards but is also essential for record-keeping and compliance. After completing the form, it is important to transfer the total counts to the Summary page (Form 300A) before posting it publicly.

  1. Gather necessary information: Collect details about the work-related injuries and illnesses from your records.
  2. Identify the establishment: Write the name of the business, along with the city and state where the incidents occurred.
  3. Record employee details: For each case, enter the employee's name, job title, date of the injury, and where it happened.
  4. Describe the case: Provide a description of the injury or illness, including the parts of the body affected and any objects or substances involved.
  5. Classify the case: Check one box that indicates the most serious outcome for the employee, such as ‘Death,’ ‘Days away from work,’ or ‘Job transfer.’
  6. Track days: Enter the number of days the employee was away from work or transferred due to the incident.
  7. Record additional cases: Repeat steps 3 to 6 for each case that needs to be documented on the form.
  8. Summarize totals: At the end of the form, total the number of cases for each category and ensure accuracy.
  9. Post the summary: After completing the form, remember to transfer the totals to Form 300A and post it as required.

What You Should Know About This Form

What is the OSHA Form 300?

The OSHA Form 300 is a log used to record work-related injuries and illnesses that occur within an establishment. Employers must maintain this record to monitor workplace safety and health. This form is essential for complying with safety regulations and helps ensure the well-being of employees by tracking and addressing incidents that may pose health risks.

Who needs to maintain an OSHA Form 300?

What types of incidents must be recorded on the OSHA Form 300?

Employers must document every work-related death and injuries or illnesses that involve loss of consciousness, restricted work activity, job transfer, days away from work, or medical treatments beyond first aid. Additionally, significant work-related injuries and illnesses diagnosed by a physician must also be included. It's key to refer to specific criteria outlined in the OSHA regulations to determine recordability.

What is the purpose of completing OSHA Form 301 in relation to Form 300?

The OSHA Form 301, or an equivalent form, must be completed for each case recorded on Form 300. This form offers a detailed account of the incident, providing necessary information that complements the summary captured in Form 300. It allows for a clearer understanding of the nature of each injury or illness and assists in developing strategies for prevention.

How can employers ensure the confidentiality of the information on the OSHA Form 300?

Confidentiality is crucial when handling sensitive employee health information. Employers must take appropriate measures to protect this data from unauthorized access. This includes limiting access to the log to only those who need to know, such as safety personnel and management. Additionally, ensure that identifying information is kept secure when sharing any details for safety assessments or workplace improvements.

What should an employer do if they are unsure whether an incident is recordable?

When there's uncertainty about the recordability of an incident, employers should reach out to their local OSHA office for guidance. OSHA officials can provide clarification and help determine whether a specific case meets the criteria for recording. It's better to ask than risk failing to comply with safety regulations.

What happens after completing the OSHA Form 300?

After completing the OSHA Form 300, employers must transfer totals to the Summary page, documented on Form 300A. This summary must be posted in a visible location within the workplace to inform employees about the incidents that have occurred over the past year. This practice fosters a culture of safety and keeps all employees informed about potential risks in their environment.

Common mistakes

Completing the OSHA 300 Form can seem straightforward, yet many people make common mistakes that can lead to inaccuracies or compliance issues. One prevalent error is failing to include all recordable incidents. According to OSHA guidelines, each work-related injury or illness that meets certain criteria must be documented. Ignoring any injuries or illnesses, particularly those that may seem minor, can result in inadequate reporting.

Another mistake that often occurs is unclear descriptions of the injuries or illnesses. It's crucial to provide detailed information about the incident, including the nature of the injury, the body parts affected, and how the injury occurred. Vague descriptions may not only hinder understanding but also pose challenges during any necessary follow-up investigations.

Some individuals overlook the importance of classifying the cases correctly. Each incident should be categorized based on the most serious outcome. Not checking the appropriate box can lead to misleading records, which may impact overall workplace safety statistics and OSHA's ability to assess risks.

Days away from work, job restrictions, and transfers need careful tracking. Failing to accurately record the number of these days can skew the data and provide a false representation of workplace safety and health. It's essential to document these details right away to avoid memory lapses later.

Confidentiality concerns must be addressed as well. While you need to record personal information about the employees involved, it’s important to maintain their privacy as much as possible. This includes limiting the sharing of sensitive information outside of necessary channels.

Finally, some organizations neglect the requirement of completing an Injury and Illness Incident Report for each record. Every incident documented in the OSHA 300 Form also needs a corresponding report, such as OSHA Form 301. Missing this step can result in incomplete records and potential compliance issues.

Documents used along the form

The OSHA 300 form is pivotal for tracking workplace injuries and illnesses, but it does not stand alone. Various other forms and documents complement its use. Here is a list of those commonly utilized alongside the OSHA 300 form. Understanding each of these documents will aid employers in maintaining clear records and adhering to safety regulations.

  • OSHA Form 301: This Incident Report details each injury or illness recorded on the OSHA 300 form. It includes a thorough description of the incident, providing critical information for further investigation.
  • OSHA Form 300A: Known as the Summary of Work-Related Injuries and Illnesses, this form compiles data from the OSHA 300 form. It is posted annually to communicate workplace safety statistics to employees and visitors.
  • First Aid Records: These documents capture all first-aid treatments provided for workplace injuries or illnesses. They help in documenting minor incidents that may not require formal OSHA reporting.
  • Incident Investigation Reports: These reports document the findings of an investigation into workplace incidents. They include analyses of causes and recommendations for preventative measures, promoting a safer work environment.
  • Safety Data Sheets (SDS): SDS provide information about hazardous substances used in the workplace. They are crucial for understanding potential risks and ensuring safety practices related to chemicals.
  • Employee Injury or Illness Charts: These charts track patterns in workplace injuries and illnesses over time. Employers can use this information to identify trends and make informed decisions regarding safety protocols.
  • Training Records: These documents show that employees have received training on safety procedures and equipment. They are important for maintaining compliance with safety standards and ensuring worker knowledge.
  • Worker’s Compensation Claims: If an employee files a claim for work-related injury, this document details the claim process and outcome. It is critical for understanding the financial responsibilities associated with injuries.
  • Return to Work Forms: These forms confirm that an employee is fit to return after an injury or illness. They often include medical clearance and any necessary work restrictions to ensure safety upon re-entry.

Utilizing these documents along with the OSHA 300 form fosters a safer work environment and promotes compliance with health and safety regulations. By maintaining thorough and organized records, employers can better protect their workforce and reduce the risk of future incidents.

Similar forms

The OSHA Form 300 is vital for tracking work-related injuries and illnesses. It serves a specific purpose in safety management and is similar to several other documents used in occupational health and safety contexts. Below are nine comparable forms, along with the ways they align with the OSHA Form 300.

  • OSHA Form 301: This form is an Incident Report used for more detailed documentation of each work-related injury and illness that is recorded on the OSHA 300 log. It provides specifics about the incident, offering a deeper understanding of the situation.
  • OSHA Form 300A: This is the Summary of Work-Related Injuries and Illnesses. After completing the OSHA Form 300, employers transfer totals from this log to Form 300A, which is then posted for employees to see and understand workplace injury trends.
  • First Report of Injury (FROI): Often used by insurance companies, this document reports worker injuries or illnesses to occupational benefits systems. Similar to Form 300, it ensures that injuries are officially recorded and tracked.
  • State-specific Injury and Illness Forms: Various states require employers to complete their own reporting forms for workplace injuries. Like the OSHA Form 300, these documents aim to record incidents and facilitate workplace health strategy.
  • Employee Injury Report: This internal document allows employees to report their injuries or illnesses. It gathers relevant details for management to assess and compare with the data compiled in the OSHA Form 300.
  • Accident Investigation Reports: These reports delve into specific incidents, analyzing causes and recommending safety measures. While the OSHA Form 300 logs incidents, investigation reports provide qualitative insights for prevention.
  • Medical Treatment Files: These files maintain a record of any medical treatment provided to employees following a work-related incident. They support the data recorded in the OSHA Form 300 by documenting ongoing care and recovery processes.
  • Return-to-Work Documentation: This paperwork details the employee's return timeline and conditions after an injury or illness. It complements the OSHA form by ensuring that recovery is monitored and supported.
  • Compliance Audit Records: These documentation records track compliance with safety regulations and assess the organization’s adherence to safety protocols. Similar to the OSHA Form 300, these audits confirm ongoing improvement processes for workplace safety.

Using these documents effectively allows businesses to manage and report workplace injuries and illnesses, creating a safer work environment while fulfilling regulatory requirements.

Dos and Don'ts

When filling out the OSHA 300 form, keeping a clear and precise approach is essential. Below is a list of things to do and not to do to ensure compliance with the requirements.

  • Do record every work-related death, injury, or illness that meets the criteria.
  • Do ensure that the details are accurate and reflect the most serious outcome.
  • Do complete an Injury and Illness Incident Report (OSHA Form 301) for each recorded case.
  • Do take care to protect employee confidentiality when completing the form.
  • Do contact your local OSHA office if you are unsure about recordability.
  • Don't omit any work-related injuries or illnesses that require medical treatment beyond first aid.
  • Don't use vague descriptions; be specific about the injuries and illnesses.
  • Don't forget to summarize the totals on the summary page (Form 300A) after completion.
  • Don't send the completed forms to the OSHA Office; only use them for reporting.
  • Don't provide information that could compromise employee confidentiality.

Misconceptions

Misconceptions about OSHA’s Form 300 often lead to confusion for employers and employees alike. Understanding the facts can help ensure proper compliance with workplace safety regulations. Here are eight common misconceptions:

  1. It is optional to keep the OSHA 300 form. Many believe that maintaining this log is elective, but it is mandatory for certain employers to document work-related injuries and illnesses.
  2. Only serious injuries need to be recorded. In reality, the form requires documentation of all cases that result in loss of consciousness, restricted work, or medical treatment beyond first aid.
  3. All injuries must be reported on the same day. While timely reporting is important, employers have up to seven days to enter the information on the form after being informed of the incident.
  4. You do not need to record injuries that occur in non-working hours. If an employee is injured while performing job duties, even after hours, that incident must be recorded on Form 300.
  5. All types of injuries are recorded in the same way. Different types of injuries and illnesses have specific criteria for documentation, which means not all cases are handled uniformly.
  6. The form should be submitted to OSHA. Contrary to this belief, completed forms do not need to be sent to OSHA but should be kept on file and made available for inspection if requested.
  7. Employers can hide details about employee injuries. Protecting employee privacy is crucial. However, general information must still be documented, and efforts must be made to keep individual identities confidential.
  8. Form 300 is the only record-keeping requirement. While it’s a critical part of the process, employers must also complete the Injury and Illness Incident Report (OSHA Form 301) for each recorded entry.

Understanding these misconceptions can lead to better safety practices and compliance with federal regulations. Employers should take the time to familiarize themselves with the requirements associated with OSHA's Form 300 to foster a safer work environment.

Key takeaways

When dealing with OSHA’s Form 300, it's important to understand its purpose and how to utilize it effectively. This form is essential for tracking work-related injuries and illnesses in the workplace.

  • Record All Relevant Incidents: You must document every work-related death, injury, or illness that fits certain criteria, such as loss of consciousness or medical treatment beyond first aid.
  • Use of Other Forms: For each case recorded on Form 300, you also need to complete OSHA Form 301 or an equivalent report.
  • Confidentiality Matters: Protect the confidentiality of employee information while ensuring that incidents are recorded for occupational safety and health purposes.
  • Clarification for Recordability: If uncertain whether a case is recordable, reach out to your local OSHA office for guidance.
  • Unique Cases: Utilize two lines for a single case if more detail is necessary.
  • Transfer Totals: Always ensure you transfer the monthly totals from the Form 300 to the Summary page (Form 300A) before posting it as required.

By adhering to these guidelines, you contribute to a safer work environment and compliance with occupational safety regulations.