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OSHA\'s Form 300AYear 20(Rev. 01/2004)Summary of Correlated Injuries and Illnesses20U. S. Department of LaborOccupational Safety and Health Administration Form approved OMB no. 12180176All establishments

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How to fill out summary of work-related injuries

01

Gather all relevant information such as date, time, and location of the injury.

02

Provide details about the nature of the injury and how it occurred.

03

List any witnesses or individuals who were present at the time of the injury.

04

Describe any immediate actions taken after the injury, such as seeking medical attention or notifying a supervisor.

05

Include any documentation or medical records related to the injury.

Who needs summary of work-related injuries?

01

Employees who have experienced work-related injuries

02

Employers and supervisors responsible for reporting and documenting work-related injuries

03

Insurance companies and legal entities involved in compensation claims

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What is summary of work-related injuries?

Summary of work-related injuries is a form that provides a snapshot of the total number of work-related injuries and illnesses that occurred in a workplace during a specific time period.

Who is required to file summary of work-related injuries?

Employers in certain industries with 11 or more employees are required to file summary of work-related injuries.

How to fill out summary of work-related injuries?

Employers must use the OSHA Form 300A to fill out the summary of work-related injuries. They must record the total number of cases, total days away from work, and other relevant information.

What is the purpose of summary of work-related injuries?

The purpose of the summary of work-related injuries is to provide a summary of workplace injuries and illnesses to help identify trends and implement preventative measures.

What information must be reported on summary of work-related injuries?

The summary of work-related injuries must include the total number of cases, days away from work, types of injuries, and other relevant information.

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