What Questions Are Typically Included in an Employee Incident Report Form?


Quick Answer

An employee incident report form includes questions such as what the employee was doing before the incident, how the injury or sickness occurred, and what body part was injured, reports the University of Rochester. The form also covers questions about how the body part was affected, which object or substance caused the injury, and what factors led to the incident. The Occupational Safety and Health Administration requires employers to submit these reports in the event of workplace injuries or fatalities.

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Full Answer

Other information employers must provide when filling out an employee incident report form includes measures the employer has taken to prevent recurrence of the incident, the kind of safety training received by the employee, and the personal protective gear the employee used during the incident, states the University of Rochester. The employer should enter the date, time and location of incident; the employee's schedule; and injury and treatment details, particularly the length of time the employee may have to take off work and whether duty restrictions or physical limitations are applicable.

In addition to personnel and incident information, an employee incident report form requires information about the employee's action to seek medical treatment, notes the University of Rochester. The employer must complete the report form within 24 hours of learning about the incident if it resulted in hospitalization, amputation or eye loss. Any work-related incident that resulted in an employee's death must be reported within eight hours of finding about it.

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