Published 26 May 2023
What is an Injury Report Form?
An injury report form is a tool used to document injuries that have occurred in the workplace and similar settings. It captures vital details about the injured person, the circumstances surrounding the injury, and any immediate actions taken. Employees can submit this form to their managers as a formal record of the injury incident.
Injury Report Form
This injury report form can be used to record work-related injuries, causes, and actions taken to address them. It follows the Occupational Safety and Health Administration (OSHA)’s framework for reporting occupational injuries, illnesses, and incidents from an employee perspective. With this digital form, workers can:
- Fill out the date, time, location, and other general details about the injury.
- Specify the names of the injured employee, their supervisor, and any witnesses
- Describe the happenings that led to the injury and the body parts affected.
- Note any visits to the doctor and previous cases of injuries on the same body parts.
- Affix electronic signatures to the form as proof of completion.
- Generate and submit the completed injury report form in PDF, Excel, Web, and other formats.
In this article
- Why is Timely Reporting Important?
- What to Include in an Injury Report Form
- Do’s and Dont’s When Filling Out This Form
- FAQs about Injury Report Forms
- Efficiently Report Work-Related Injuries with SafetyCulture (formerly iAuditor)
- Related Injury Report Forms and Checklists
Why is Timely Reporting Important?
Timely reporting of injuries and similar workplace incidents is crucial to workplace safety for many reasons. For one, it swiftly informs supervisors and relevant authorities about an injury that has fallen upon an employee. This way, the injured individual can receive the assistance they need, may it be through medical treatment or preventive measures.
In addition, filling out an injury report form in the soonest time is key to obtaining an accurate account of the incident. This practice allows employees to capture all essential details while they’re still fresh in the memory of the individuals and witnesses involved. Having a reliable injury record can aid in resolving any subsequent legal and insurance disputes.
Lastly, employers can use these accounts to identify trends and patterns in their organization or work environment. By consistently documenting and analyzing reported incidents, they can spot recurring issues or conditions that put their employees at risk. This, in turn, allows them to make informed decisions about preventive measures and safety protocols to reduce the likelihood of future accidents and injuries.
What to Include in an Injury Report Form
An employee report of injury form gives employers and authorities an overview of the injury, its potential causes, and actions taken. For a comprehensive account of the injury, the form should contain the following items:
- Employee name
- Job title of the employee
- Supervisor name
- Date and time of reporting
- Date and time of injury
- Name(s) of witness(es), if any
- Communication with the supervisor
- Site/location where the injury occurred
- Incident description
- Cause(s) of the injury
- Injured body part(s) and description
- Actions taken (e.g., doctor’s visit)
- Previous injuries, if any
- Name and signature of the employee
- Name and signature of the supervisor
The image below shows an example of a digital injury report form for your reference:
Do’s and Dont’s When Filling Out This Form
Just like with incident reporting, it’s important to keep in mind the following best practices and common mistakes to avoid when writing an injury report form:
- Report the injury to the supervisor as soon as possible after it happens.
- Give a detailed account of the incident, including the date, time, location, and a thorough description of how the injury occurred.
- Stick to the facts for more accurate documentation of the case.
- If there are witnesses, include their statements in the injury report.
- Seek urgent medical care to ensure that the injury is diagnosed and treated properly.
- Fabricate or exaggerate the information written in the report.
- Speculate or assign blame without concrete evidence.
- Attempt to diagnose the injury unless you’re a trained medical professional.
- Leave out essential details or have blank fields from the report.
- Neglect to follow up on recommended actions from the employer or medical provider.
FAQs about Injury Report Forms
Generally, anyone who has witnessed or experienced an injury at the scene should fill out an injury report form. These individuals can include the injured employee, their supervisor, safety officers, or any other personnel responsible for reporting these cases within the given context.
According to OSHA, employees must document “any work-related injury that results in loss of consciousness, days away from work, restricted work, or transfer to another job.” It includes injuries that need treatment beyond first aid, with special provisions for injuries involving sharp objects and hearing loss.
In most cases, injury reports must be completed within 30 days after the incident to ensure that the employee receives compensation benefits due to the injury. The time frame can be shorter in cases of severe injuries. Hospitalizations, amputations, and eye loss must be reported within 24 hours, while fatalities must be alerted within 8 hours.
After accomplishing the injury report form, the person or department responsible for managing incidents will review the information. They may initiate an investigation, assess the severity of the injury, and determine the next steps (e.g., medical treatment, safety measures). They may also reach out to the incident reporter for further information.
Efficiently Report Work-Related Injuries with SafetyCulture (formerly iAuditor)
Time is of the essence when it comes to reporting injuries in the workplace. And more often than not, paper-based forms can take time to complete and submit. They can also be prone to errors due to illegible handwriting or misplacement due to improper handling. These problems can be remedied with the help of digital tools like SafetyCulture.
With its comprehensive suite of digital solutions, SafetyCulture makes it easier to document work-related injuries and incidents. Instead of manually filling out papers every time there’s an injury, employees can simply download and use the app’s digital forms from their laptop, tablet, or mobile phone.
In addition, this mobile-first platform also keeps frontline workers safe by empowering them to:
- Take photos, record videos, and add notes to support their statements in the report.
- Accomplish injury report forms even when offline and have the data synced once the connection is restored.
- Notify supervisors and authorities about workplace injuries and other issues in real time.
- Export and submit completed injury reports in PDF, Excel, Web, and other formats.
- Analyze trends and frequently failed items to improve safety practices and protocols.
- Maintain a cloud-based repository of previous injury reports for future reference.
- Hold training sessions about reporting procedures without disrupting worker productivity.
Related Injury Report Forms and Checklists
Accident Injury Report Form
This accident injury report form can be used to gather information about accidents that have led to injured employees in the workplace, whether on-site or in the field. Discover the root cause of the accident and develop strategies to prevent them from occurring again.
Employee Incident Report
This employee incident report template lets workers document incidents such as injuries, near misses, accidents, property damage, and more. Use this template to collect specific details of the incidents, no matter how minor they are, and help organizations improve their safety and security measures.
OSHA Form 301
Use this OSHA Form 301 Injuries and Illnesses Incident Report form to record work-related injuries or illnesses. With this SafetyCulture-powered template, employers can explain the incident in full detail, attach supporting evidence, and report injuries as they occur at work.