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Madison, Wisconsin 53701-2658 http://dsps.wi.gov/sb/SB-DivForms.html. Summary of Work-Related Injuries and Illnesses. Year . Return this summary by .

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How to fill out the Sbd 10710 Fillable online

Completing the Sbd 10710 Fillable form is essential for Wisconsin public employers to report work-related injuries and illnesses effectively. This guide provides step-by-step instructions to help you navigate the form easily, ensuring accuracy and compliance with legal requirements.

Follow the steps to fill out the Sbd 10710 Fillable online:

  1. Click ‘Get Form’ button to obtain the form and open it in the editor.
  2. Begin with the establishment information by entering the name of your establishment, the Federal Employer Identification Number (FEIN), and the street address. If your mailing address differs from the street address, fill that in as well.
  3. Next, navigate to the 'Number of Cases' section. Here, you will need to count and enter the total number of cases in various categories including deaths, days away from work, job transfers or restrictions, and other recordable cases. If there were no cases, write '0'.
  4. Proceed to the employment information section, where you will enter the annual average number of employees, the total number of days of job transfer or restriction, the total number of days away from work, and the total hours worked by employees last year.
  5. In the 'Contact Information' section, provide the contact name for the employer, a telephone number, and a work email address.
  6. Finally, in the 'Injury and Illness Types' section, input the total numbers for each type of injury or illness as specified, including injuries, poisonings, skin disorders, hearing losses, respiratory conditions, and all other illnesses.
  7. Review all the information you have entered to ensure it is complete and accurate. Once confirmed, you can save changes, download, print, or share the completed form.

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Related content

Industry Services Division P.O. Box 7302 Madison...
Per SPS 332.10, all Wisconsin public employers must complete and submit this summary form...
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How does OSHA define a recordable injury or illness? Any work-related fatality. Any work-related injury or illness that results in loss of consciousness, days away from work, restricted work, or transfer to another job. Any work-related injury or illness requiring medical treatment beyond first aid.

OSHA forms 300 and 301 are maintained on an ongoing basis. Recordable injuries and illnesses must be entered on these forms as they occur throughout the year. The OSHA Form 300A is completed after the end of the year, summarizing the number of recordable cases that occurred.

Occupational Safety and Health Administration (OSHA) Form 301, “Injury and Illness Incident Report,” is used by employers to keep a record of a single injury, illness, or death in a workplace. This form is found within OSHA Form 300, which is used to log and classify all such incidents for a workplace.

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