Occupational Injury Illness Report

State:
Multi-State
Control #:
US-AHI-275
Format:
Word; 
Rich Text
Instant download
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Description

This AHI form is used to document an incident of injury or illness that is work-related. The form is to be completed by the employee involved in the incident.

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FAQ

What is the most commonly reported type of occupational illness? According to the CDC or Centers for Disease Control and Prevention, the most common type of occupational illness is allergies and skin dermatitis. Skin conditions make up about 15% to 20% of the total reported occupational illnesses and diseases.

Find the Facts. First, you must determine the facts surrounding the injury. Determine the Sequence or Timeline. It is important to document in the report the sequence of events or timeline surrounding the incident that resulted in the injury. Analyze and Provide Feedback.

Cal/OSHA's prior, longstanding reporting rule defined serious injury or illness as any injury or illness occurring in a place of employment or in connection with any employment that requires in-patient hospitalization for a period in excess of 24 hours for treatment other than medical observation, or in which an

The main OSHA injury and illness forms that are required to be filed are: 300: Log of Work-Related Injuries and Illnesses This is a log of each workplace illness, accident, or injury, and must be kept current. All incidents must be recorded within 6 working days of being reported.

Employers must report work-related fatalities within 8 hours of finding out about it. For any in-patient hospitalization, amputation, or eye loss employers must report the incident within 24 hours of learning about it. Only fatalities occurring within 30 days of the work-related incident must be reported to OSHA.

Cal/OSHA regulations require that employers must report any Serious Injury/Illness or Fatality to the nearest Cal /OSHA District Office. practically possible but not longer than 8 hours after the employer knows or with diligent inquiry would have known of the serious injury or illness.

Employers must report any worker fatality within 8 hours and any amputation, loss of an eye, or hospitalization of a worker within 24 hours. Learn details and how to report online or by phone.

Type of incident (injury, near miss, property damage, or theft) Address. Date of incident. Time of incident. Name of affected individual. A narrative description of the incident, including the sequence of events and results of the incident.

All employers are required to notify OSHA when an employee is killed on the job or suffers a work-related hospitalization, amputation, or loss of an eye. A fatality must be reported within 8 hours.

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Occupational Injury Illness Report