Incident date

Add the incident date, or press Enter to accept the current Payroll processing date default.

Incident time

Add the time at which the incident occurred.

Reported date

Add the date the incident was reported to the company, or press Enter to accept the current Payroll processing date default.

Days missed

Add the number of days missed due to the incident.

Days restricted

Add the number of days the employee is assigned restricted tasks.

Company

The current company code displays.

Job

Enter the job the employee was working on at the time of the incident.

OSHA location

Enter a brief description of the location of the incident, for example, Parking lot or Loading dock.

Work start time

Enter the time the employee began work on the day of the incident, for example, type '9' to indicate 9:00 a.m. or type '14' to indicate 2:00 p.m.

Crew number

Enter the crew code to which the employee was assigned at the time of the incident.

Department

Add the department to which the employee was assigned at the time of the incident.

Supervisor

Add the supervisor to whom the employee was assigned at the time of the incident.

Location

Add the location code for the employee at the time the incident occurred.

Claim number

Enter the OSHA claim number for the selected incident.

Claim type

Add the claim type code.

Claim status

Add or edit the claim status code.

Claim cost

Add or edit the claim cost reported by the insurance company.

Valuation date

Add the valuation date of the claim cost.

Work-related?

Select this checkbox if the incident was work related; otherwise, leave this checkbox clear.

When is an injury or illness considered work-related?

If an event or exposure that occurred in the work environment caused or contributed to an injury or illness, or significantly aggravated a preexisting condition, then that injury or illness is considered work-related. Work-relatedness is considered for injuries and illnesses that are results of events or exposures that happen in the workplace--unless there is an exception (see 29 CFR Part 1904.5(b)(2)). The work environment consists of the establishment and other locations where at least one employee is working or present as a condition of his or her employment (see 29 CFR Part 1904.5(b)(1)).

Which work-related injuries and illnesses should be recorded?

Work-related injuries and illnesses that result in the following should be recorded: death, loss of consciousness, days away from work, restricted work activity or job transfer, or medical treatment beyond first aid.

Record any significant work-related injury or illness diagnosed by a physician or other licensed health care professional. Any work-related case involving cancer, chronic irreversible disease, a fractured or cracked bone, or a punctured eardrum must also be recorded.

Work-related injuries and illnesses that meet any additional criteria listed below must also be recorded.

What are the additional criteria?

Record the following conditions when they are work-related:

• Any needlestick injury or cut from a sharp object that is contaminated with another person's blood or other potentially infectious material.

• Any case requiring an employee to be medically removed under the requirements of an OSHA health standard.

• Tuberculosis infection as evidenced by a positive skin test or diagnosis by a physician or other licensed health care professional after exposure to a known case of active tuberculosis.

• An employee's hearing test (audiogram) reveals that:

  1. The employee has experienced a Standard Threshold shift (STS) in hearing in one or both ears (averaged at 2000, 3000, and 4000 Hz), and

  2. The employee's total hearing level is at 25 decibels (dB) or more above audiometric zero (also averaged at 2000, 3000, and 4000 Hz) in the same ear(s) as the STS.

OSHA eligible?

Select this checkbox if the incident is OSHA (Occupational and Safety Health Administration) eligible.

For more information about OSHA, you can visit the U.S. Department of Labor Occupational Safety & Health Administration website. OSHA programs vary by state. You can determine if your state operates its own OSHA program on the State Occupational Safety and Health Plans webpage.

Incident type

Select the option that corresponds with the incident type: Injury, Skin disorder, Respiratory condition, Poisoning, Hearing loss, FMLA, or Other.

OSHA classification

Select one of the options that corresponds with the OSHA classification: Death, Days away from work, Job transfer or restriction, or Other. The seriousness of the outcome corresponds with OSHA form columns G, the most serious (Death) through J, the least serious (Other recordable cases).