Work Injury and Illness Log Template (OSHA 300, 300A, 301)

Work-Related Injury and Illness Log: [Establishment name], [Year]

A log of recordable work-related injuries and illnesses for one establishment, an incident detail record per case and an annual summary with incidence rates. The fields follow the US OSHA recordkeeping rule, 29 CFR Part 1904 (Forms 300, 300A and 301), used here as the dated example (October 2026); employers elsewhere can adapt the structure to their national reporting rules. Replace every [bracketed] value and every row marked Example. This is a documentation format, not legal advice: use the official OSHA forms or an equivalent, and check the current regulation and a qualified professional.

Contents

1. Who must keep records (check first)
2. Recording decision
3. Log of recordable cases (Form 300 fields)
4. Privacy concern cases
5. Incident detail record (Form 301 fields)
6. Severe events reported to OSHA
7. Annual summary (Form 300A fields)
8. Retention, access and electronic submission
9. Other jurisdictions
10. Standard and licence note

Document control

Revision history

1. Who must keep records (check first)

• Did the company have more than 10 employees at any time during the last calendar year? If not, it is partially exempt (29 CFR 1904.1), but must still report severe events (section 6).
• Is the establishment in an industry listed as partially exempt under 29 CFR 1904.2? Check the current list.
• Has OSHA or the Bureau of Labor Statistics asked in writing for records? That request applies even to exempt employers.
• Does a State Plan apply, with its own rules?

2. Recording decision

A work-related new case is recordable if it results in any of:

1. death,
2. days away from work,
3. restricted work or transfer to another job,
4. medical treatment beyond first aid,
5. loss of consciousness, or
6. a significant injury or illness diagnosed by a physician or other licensed health care professional (for example, a fracture, cancer or a punctured eardrum).

Count days away and restricted days in calendar days, starting the day after the injury, and stop counting at 180.

3. Log of recordable cases (Form 300 fields)

4. Privacy concern cases

Write "privacy case" instead of the name, and keep a separate, confidential list linking case numbers to names, for:

• an injury or illness to an intimate body part or the reproductive system,
• an injury or illness resulting from sexual assault,
• mental illness,
• HIV infection, hepatitis or tuberculosis,
• a needlestick or cut from a sharp object contaminated with another person's blood or other potentially infectious material,
• other illnesses, if the employee voluntarily asks for their name to be left off.

5. Incident detail record (Form 301 fields)

Link each case to its investigation and corrective action (compliance/capa-nonconformity), and update the hazard register.

6. Severe events reported to OSHA

Report by phone to the nearest Area Office, to 1-800-321-OSHA (1-800-321-6742) or through the online reporting application.

7. Annual summary (Form 300A fields)

Incidence rates use the BLS formula: number of cases multiplied by 200,000 (100 full-time workers for a year), divided by hours worked.

8. Retention, access and electronic submission

• Retention: keep the log, the privacy case list, the summary and the incident records for 5 years after the end of the year they cover, and update the log for newly found or reclassified cases (29 CFR 1904.33).
• Employee access: give employees, former employees and their representatives a copy of the log by the end of the next business day when asked (29 CFR 1904.35).
• Reporting procedure: tell employees how to report injuries and that they will not face retaliation for reporting (29 CFR 1904.35).
• Electronic submission (29 CFR 1904.41): by 2 March of the next year, establishments with 20 to 249 employees in industries listed in Appendix A, and those with 250 or more employees, submit the 300A data; establishments with 100 or more employees in industries listed in Appendix B also submit 300 and 301 data, without employee names and addresses. Example: the 85-employee Quillfen plant submits its 300A only if its industry is listed in Appendix A.

9. Other jurisdictions

Standard and licence note

Based on US OSHA 29 CFR Part 1904 (sections 1904.1, 1904.7, 1904.29, 1904.32, 1904.33, 1904.35, 1904.39 and 1904.41) and the OSHA Forms 300, 300A and 301 package (forms marked Rev. 04/2004, package file dated June 2019), checked on osha.gov on 2026-10-30, and the BLS incidence rate method. Original text written for this collection; it does not replace the official forms. Organisations, people and figures are fictional. Not legal advice: check the current official text and a qualified professional. Template licence: MIT.