Fillable Form OSHA Form 300
The OSHA Form 300 is a log record of all work-related injuries. Employers with more than 10 employees are required to log all serious injuries and illnesses in this form.
What is Form 300?
Form 300, Log of Work-Related Injuries and Illnesses, is an Occupational Safety and Health Administration form used by employers to classify work-related injuries and illnesses and to note the extent and severity of each case. When an incident occurs, use OSHA Form 300 to record specific details about what happened and how it happened.
Employers must keep a log for each establishment or site. If you have more than one establishment, you must keep a separate log and summary (Form 300A, Summary of Work-Related Injuries and Illnesses) for each physical location that is expected to be in operation for one year or longer. Note that your employees have the right to review your injury and illness records.
Cases listed on Form 300 OSHA are not necessarily eligible for workers’ compensation or other insurance benefits. Listing a case on the log does not mean that the employer or worker was at fault or that an Occupational Safety and Health Administration (OSHA) standard was violated.
An injury or illness is considered work-related if an event or exposure in the work environment caused or contributed to the condition or significantly aggravated a pre-existing condition. Work-relatedness is presumed for injuries and illnesses resulting from events or exposures occurring in the workplace unless an exception specifically applies. The work environment includes the establishment and other locations where one or more employees are working or are present as a condition of their employment.
Record on OSHA 300 Form work-related injuries and illnesses that result in the following: death, loss of consciousness, days away from work, restricted work activity, job transfer, or medical treatment beyond first aid. You must also record any significant work-related injury or illness that is diagnosed by a physician or other licensed healthcare professional and any work-related case involving cancer, chronic irreversible disease, a fractured or cracked bone, or a punctured eardrum.
Additionally, you must record the following conditions when they are work-related:
You must not enter the employee’s name on 300 Form OSHA for the following types of injuries and illnesses considered as privacy concern cases:
Instead, enter “privacy case” in the space normally used for the employee’s name. You must keep a separate confidential list of the case numbers and employee names for the establishment’s privacy concern cases so that you can update the cases and provide information to the government if asked to do so.
If you have a reasonable basis to believe that information describing the privacy concern case may be personally identifiable even though the employee’s name has been omitted, you may use discretion in describing the injury or illness on both the OSHA 300 and 301 (Injury and Illness Incident Report) forms. You must enter enough information to identify the cause of the incident and the general severity of the injury or illness, but you do not need to include details of an intimate or private nature.
If the outcome or extent of an injury or illness changes after you have recorded the case, simply draw a line through the original entry or, if you wish, delete or white out the original entry. Then write the new entry where it belongs. Remember, you need to record the most serious outcome for each case.
You must keep the Log and Summary for 5 years following the year to which they pertain. Lastly, you do not have to send the completed forms to Occupational Safety and Health Administration (OSHA) unless you were specifically asked to do so.
How to fill out Form 300?
Using PDFQuick, you can electronically fill out and download a PDF copy of OSHA’s Form 300 in minutes. Fill it out by following the instructions below.
Calculating Injury and Illness Incidence Rate (Optional)
An incidence rate is the number of recordable injuries and illnesses occurring among a given number of full-time workers (usually 100 full-time workers) over a given period of time (usually one year). To evaluate your firm’s injury and illness experience over time or to compare your firm’s experience with that of your industry as a whole, you need to compute your incidence rate. Because a specific number of workers and a specific period of time are involved, these rates can help you identify problems in your workplace and/or progress you may have made in preventing work-related injuries and illnesses.
To find out the total number of recordable injuries and illnesses that occurred during the year, count the number of line entries on your OSHA Form 300, or refer to the OSHA Form 300A, Summary of Work-Related Injuries and Illnesses, and sum the entries for columns H, I, and J.
To find out the number of injuries and illnesses that involved days away from work, count the number of line entries on your OSHA Form 300 that received a checkmark in column H, or refer to the entry for column H on the OSHA Form 300A, Summary of Work-Related Injuries and Illnesses.
To find out the number of hours all employees actually worked during the year, refer to OSHA Form 300A, Summary of Work-Related Injuries and Illnesses, and the optional worksheet to calculate this number.
You can compute the incidence rate for all recordable cases of injuries and illnesses using the following formula:
Total number of injuries and illnesses X 200,000 ÷ Number of hours worked by all employees = Total recordable case rate
You can compute the incidence rate for recordable cases involving days away from work, days of restricted work activity or job transfer (DART) using the following formula:
(Number of entries in column H + Number of entries in column I) X 200,000 ÷ Number of hours worked by all employees = DART incidence rate
You can use the same formula to calculate incidence rates for other variables such as cases involving restricted work activity (column I on Form 300A), cases involving skin disorders (column M-2 on Form 300A), and others. Just substitute the appropriate total for these cases, from Form 300A, Summary of Work-Related Injuries and Illnesses, into the formula in place of the total number of injuries and illnesses.
Note that this worksheet is optional and you may choose to proceed to fill out the log.
Log of Work-Related Injuries and Illnesses
Year
Enter the year the log is being recorded.
Establishment Name
Enter your establishment name.
City
Enter the city where your establishment is located.
State
Enter the state where your establishment is located.
Identify the Person
Column A
Enter the case number.
Column B
Enter the full name of the employee. If privacy concern cases, enter “Privacy Case”.
Column C
Enter the job title of the employee, for example: welder, electrician, machine operator.
Describe the Case
Column D
Enter the date of injury or onset of the illness, following the format: Month, Day.
Column E
Enter where the work-related injury or illness occurred, for example: second-floor storeroom.
Column F
Enter a description of the injury or illness, parts of the body affected, and object or substance that directly injured or made a person ill. Be as specific as possible. You can use two lines if you need more space.
Classify the Case
Classify the case by recording the most serious outcome of the case, with Column G (death) being the most serious and Column J (other recordable cases) being the least serious.
Columns G to J
Mark the appropriate box for each case based on the most serious outcome of the case. You may select:
Revise the log if the injury or illness progresses and the outcome is more serious than you originally recorded for the case. You can cross out, erase, or white out the original entry.
Enter the page totals at the end of each column. Be sure to transfer these totals to Form 300A, Summary of Work-Related Injuries and Illnesses, before you post it.
Column K
Enter the number of days the injured or ill worker was away from work.
Enter the page totals at the end of the column.
Column L
Enter the number of days the injured or ill worker was on the job transfer or restriction.
Enter the page totals at the end of the column.
Column M
Mark the appropriate box indicating whether the case involves an injury or an illness. You may select:
Enter the page totals at the end of each column. Be sure to transfer these totals to Form 300A, Summary of Work-Related Injuries and Illnesses, before you post it.