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OSHA\'s Form 300A (Rev. 01/2004)YearSummary of Correlated Injuries and Illnesses. S. Department of Labor2021Occupational 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 related to the work-related injury such as date, time, location, and details of the incident.

02

Fill out the summary form with accurate and detailed information about the injury, including any treatment received.

03

Include any witness statements or reports if applicable.

04

Review the completed summary form for accuracy and completeness before submitting it to the appropriate party.

Who needs summary of work-related injuries?

01

Employers who are required to keep records of work-related injuries and illnesses.

02

Employees who have experienced a work-related injury and need to report it to their employer or insurance company.

03

Health and safety professionals who are responsible for tracking and analyzing work-related injuries in the workplace.

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What is summary of work-related injuries?

The summary of work-related injuries is a report that provides a summary of all 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 are required to file the summary of work-related injuries if they have more than 10 employees and are covered under the OSHA recordkeeping requirements.

How to fill out summary of work-related injuries?

The summary of work-related injuries can be filled out by recording all work-related injuries and illnesses on the OSHA Form 300A and submitting it to OSHA by the specified deadline.

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

The purpose of the summary of work-related injuries is to provide a snapshot of the workplace's safety record and help identify areas where improvements may be needed to prevent future injuries.

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

The summary of work-related injuries must include a list of all work-related injuries and illnesses that occurred during the reporting period, as well as information on the number of days away from work, job transfer, or restriction for each case.

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