2.3 Injury/Illness Recordkeeping & Fatality Reporting

2.3 Injury/Illness Recordkeeping & Fatality Reporting

Core Rule: Under 29 CFR Part 1904, employers must log work-related injuries and illnesses that result in death, lost workdays, job transfer/restriction, medical treatment beyond first aid, loss of consciousness, or significant clinical diagnosis. Severe incidents trigger strict direct reporting rules: 8 hours for fatalities and 24 hours for in-patient hospitalizations, amputations, or loss of an eye.

Accurate recordkeeping is critical for identifying workplace hazards, tracking injury trends, and evaluating safety management effectiveness. OSHA's recordkeeping regulations are codified under 29 CFR Part 1904. Understanding the precise boundaries between recordable injuries and non-recordable first aid, along with employer size exemptions and executive certification requirements, is a major focus of the OSHA 500 exam.

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Scope, Coverage & Exemptions Under Part 1904

Not every employer is required to maintain routine injury and illness logs. Part 1904 provides two specific exemption categories:

1. The Small Employer Exemption (29 CFR 1904.1)

If a company employed 10 or fewer employees at all times during the preceding calendar year across the entire enterprise (counting full-time, part-time, seasonal, and temporary employees across all company locations combined), the employer is exempt from routinely keeping OSHA injury and illness records, unless specifically required in writing by OSHA or the Bureau of Labor Statistics (BLS) to participate in an annual statistical survey.

2. The Low-Hazard Industry Exemption (29 CFR 1904.2)

Establishments classified in specific low-hazard retail, service, finance, insurance, or real estate industries (listed in Appendix A to Subpart B of Part 1904) are exempt from routinely maintaining injury and illness logs.

Critical Construction Distinction: Construction (NAICS Sector 23 / SIC Major Groups 15, 16, and 17) is classified as a high-hazard industry. Construction companies are never eligible for the low-hazard industry exemption. A construction employer is only exempt from routine log maintenance if it satisfies the 10-or-fewer small employer rule.

The Universal Reporting Mandate Under 1904.39

Exempt employers are NOT exempt from reporting severe incidents! Even if an employer has only two employees and is completely exempt from maintaining OSHA Form 300 logs, that employer is still legally required under 29 CFR 1904.39 to report any work-related fatality within 8 hours and any work-related in-patient hospitalization, amputation, or eye loss within 24 hours.

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The Three Core OSHA Recordkeeping Forms

Employers covered by Part 1904 must maintain three standardized forms:

┌────────────────────────────────────────────────────────────────────────┐
│                     THE THREE OSHA RECORDKEEPING FORMS                 │
├──────────────┬─────────────────────────────┬───────────────────────────┤
│ Form Number  │ Official Title              │ Function & Rules          │
├──────────────┼─────────────────────────────┼───────────────────────────┤
│ OSHA 300     │ Log of Work-Related         │ Line-item running log of  │
│              │ Injuries and Illnesses      │ cases; log within 7 days  │
├──────────────┼─────────────────────────────┼───────────────────────────┤
│ OSHA 301     │ Injury and Illness          │ Detailed single-case      │
│              │ Incident Report             │ narrative; 7-day deadline │
├──────────────┼─────────────────────────────┼───────────────────────────┤
│ OSHA 300A    │ Summary of Work-Related     │ Annual aggregate summary; │
│              │ Injuries and Illnesses      │ posted Feb 1 to April 30  │
└──────────────┴─────────────────────────────┴───────────────────────────┘

1. OSHA Form 300 (Log of Work-Related Injuries and Illnesses)

• A continuous, running record of each recordable injury or illness occurring at the establishment during the calendar year.
• Must record the employee's name, case number, job title, date of injury/onset, location of incident, description of injury/illness, and classification of case severity.
• Severity is classified into four mutually exclusive categories (the case is classified under the most severe outcome): (1) Death, (2) Days away from work, (3) Job transfer or restriction, or (4) Other recordable cases.
• Must be completed within 7 calendar days of receiving notice that a recordable case has occurred.

2. OSHA Form 301 (Injury and Illness Incident Report)

• A comprehensive individual incident report for each recordable entry on the Form 300.
• Records detailed medical and narrative facts: what the employee was doing before the incident, what happened, the specific injury or illness, parts of the body affected, and medical provider information.
• Must also be completed within 7 calendar days of receiving information that a recordable case occurred.
• An employer may substitute equivalent state workers' compensation First Reports of Injury or insurance forms, provided they contain all identical data fields required by Form 301.

3. OSHA Form 300A (Summary of Work-Related Injuries and Illnesses)

• The annual aggregate summary displaying total numbers of deaths, lost workday cases, restricted work cases, other recordable cases, total days away, and total days on restriction.
• Omits employee names and personal details to protect worker privacy.
• Executive Certification Requirement: Must be reviewed and certified (signed and dated) by a Company Executive before posting. Qualified executives include: an owner of the business (sole proprietorship/partnership), an officer of the corporation, the highest-ranking company official working at the establishment, or the immediate supervisor of that highest-ranking official.
• Annual Posting Window: Must be posted from February 1 through April 30 of the year following the year covered by the log (e.g., the 2025 summary must be posted from February 1, 2026, through April 30, 2026). It must be displayed in a conspicuous place where employee notices are customarily posted, and must not be altered, defaced, or covered.

Retention & Updating Rules (29 CFR 1904.33)

• Records must be retained for 5 years following the end of the calendar year that the records cover.
• During the 5-year retention period, the employer must update the OSHA Form 300 log to include newly discovered recordable injuries or illnesses, or to reflect changes in severity (e.g., if a restricted work case later results in days away from work).
• Employers are not required to update OSHA Form 300A summaries or Form 301 reports during the 5-year retention period.

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Recordability Determination Criteria (29 CFR 1904.4 - 1904.12)

An injury or illness is recordable if it meets a three-step inquiry:

1. Did an injury or illness occur?
2. Is it work-related? (Under 1904.5, an injury is presumed work-related if an event or exposure in the work environment caused or contributed to the condition, or significantly aggravated a pre-existing injury/illness).
3. Does it meet one or more of the General Recording Criteria under 29 CFR 1904.7?

The General Recording Criteria

An injury or illness meets the general recording criteria if it results in any of the following:

• Death.
• Days Away from Work: Count starts the day after the injury occurred. The employer counts calendar days, including weekends, holidays, and scheduled days off if the employee was medically unable to work. Day counts are capped at 180 calendar days.
• Restricted Work Activity or Job Transfer: When the employer or a Physician or Other Licensed Health Care Professional (PLHCP) restricts an employee from performing one or more routine job functions (duties regularly performed at least once per week), or limits the employee to working less than full shift hours. Capped at 180 calendar days.
• Medical Treatment Beyond First Aid.
• Loss of Consciousness (regardless of duration; even a 2-second loss of consciousness is recordable).
• Significant Diagnosed Injury or Illness: A significant case diagnosed by a PLHCP, even if it does not involve days away, restriction, or medical treatment (specifically: fractured or cracked bones, punctured eardrum, or chronic irreversible diseases like silicosis or cancer).

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Medical Treatment vs. First Aid (29 CFR 1904.7(b)(5))

One of the most heavily tested areas on the OSHA 500 exam is distinguishing Medical Treatment from First Aid. Under 29 CFR 1904.7(b)(5)(i), medical treatment means the management and care of a patient to combat disease or disorder. It does not include visits to a physician solely for observation or counseling, diagnostic procedures (such as X-rays and blood tests), or first aid.

Under 29 CFR 1904.7(b)(5)(ii), OSHA provides an exhaustive list of 14 specific treatments that constitute first aid. If a treatment is on this list, it is first aid. If a treatment is not on this list, it is classified as medical treatment!

┌────────────────────────────────────────────────────────────────────────┐
│         THE 14 EXHAUSTIVE FIRST-AID TREATMENTS (29 CFR 1904.7)         │
├────────────────────────────────────────────────────────────────────────┤
│ 1. Using non-prescription medication at non-prescription strength.     │
│ 2. Administering tetanus immunizations (other vaccines = medical).     │
│ 3. Cleaning, flushing, or soaking wounds on the surface of the skin.   │
│ 4. Using wound coverings (bandages, Band-Aids, gauze, butterfly strips)│
│    NOTE: Sutures, staples, and surgical skin glues = MEDICAL TREATMENT.│
│ 5. Using hot or cold therapy (ice packs, heating pads).                │
│ 6. Using non-rigid means of support (elastic wraps, non-rigid belts).  │
│    NOTE: Rigid splints, casts, or orthopedic braces = MEDICAL.         │
│ 7. Using temporary immobilization devices while transporting victims.  │
│ 8. Drilling fingernails/toenails for pressure relief; draining blister.│
│ 9. Using eye patches.                                                  │
│ 10. Removing foreign bodies from eye using ONLY irrigation/cotton swab.│
│ 11. Removing splinters/material from body with tweezers, swabs, flush. │
│ 12. Using finger guards.                                               │
│ 13. Using massages (physical therapy / chiropractic = MEDICAL).        │
│ 14. Drinking fluids for relief of heat stress.                         │
└────────────────────────────────────────────────────────────────────────┘

Critical First Aid vs. Medical Treatment Distinctions for the Exam

• Prescription vs. Non-Prescription Medications: A physician recommending a non-prescription medication (e.g., ibuprofen) at prescription strength (e.g., 800 mg four times daily) transforms the case into medical treatment! Conversely, if a physician issues a written prescription for an over-the-counter medication at standard OTC strength, it remains first aid.
• Wound Closures: Butterfly bandages and Steri-Strips are classified as wound coverings and are first aid. Sutures (stitches), surgical staples, and surgical adhesives (like Dermabond) are medical treatment.
• Physical Therapy: Physical therapy or chiropractic manipulation is medical treatment. Simple massage is first aid.
• Vaccines: Tetanus boosters are explicitly first aid. Hepatitis B vaccines or post-exposure rabies prophylaxis are medical treatment.

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Mandatory Reporting of Fatalities & Severe Injuries (1904.39)

Under 29 CFR 1904.39, all employers—including those exempt from routine recordkeeping—must report catastrophic and severe incidents directly to OSHA under strict statutory timelines:

┌────────────────────────────────────────────────────────────────────────┐
│                     MANDATORY REPORTING TIMELINES                      │
├───────────────────────────────────────┬────────────────────────────────┤
│ Incident Category                     │ Mandatory Reporting Deadline   │
├───────────────────────────────────────┼────────────────────────────────┤
│ Work-Related Fatality                 │ Within 8 HOURS of learning     │
├───────────────────────────────────────┼────────────────────────────────┤
│ In-Patient Hospitalization            │ Within 24 HOURS of learning    │
│ (Formal admission to inpatient bed)   │                                │
├───────────────────────────────────────┼────────────────────────────────┤
│ Amputation (Loss of limb or digit)    │ Within 24 HOURS of learning    │
├───────────────────────────────────────┼────────────────────────────────┤
│ Loss of an Eye                        │ Within 24 HOURS of learning    │
└───────────────────────────────────────┴────────────────────────────────┘

Important Rules Governing 1904.39 Reporting

• In-Patient Hospitalization Definition: In-patient hospitalization requires formal admission to the inpatient service of a hospital or clinic for care or treatment. Emergency room observation or diagnostic testing without formal inpatient admission does not trigger the 24-hour report.
• Time Window from Incident to Outcome:
  • A fatality must be reported within 8 hours only if the death occurs within 30 days of the work-related incident.
  • An in-patient hospitalization, amputation, or loss of an eye must be reported within 24 hours only if the hospitalization, amputation, or eye loss occurs within 24 hours of the incident.
• How to Report: The employer must report by phone to the nearest OSHA Area Office, by calling OSHA's 24-hour toll-free hotline (1-800-321-OSHA / 1-800-321-6742), or electronically using the reporting application on OSHA's public website.