OSHA Form 300A
Employers must complete the 300A summary form and post the summary in the workplace from February 1 to April 30 of the year following the year covered by the form at each job site in a conspicuous area where notices to employees are customarily placed
Annual electronic submission of OSHA Form 300A Summary of Work-Related Injuries and Illnesses by establishments with 20 or more employees but fewer than 250 employees in designated industries.
Complete the OSHA Form 300A
Employers must take the following steps to fill out the OSHA Form 300:
- Fill in the year, establishment name, city and state.
- Assign each event an employer-created case number on the OSHA log. This can be as simple as number 1, 2, 3, 4 and so on. The only requirement is that each case number for a given year is unique.
- Identify the employee, the employee’s job title, the date of the injury or onset of the illness and the exact location where the event occurred.
- Specifically describe the case, along with the parts of the body affected and the object/substance that directly injured or made the employee ill, using more than one line if necessary.
- Classify the case by choosing only one of the categories. The most serious outcome will need to be recorded; the employer should revise the log if the injury or illness progresses or the outcome is more serious than was originally recorded. The original entry must be crossed out, deleted or concealed with correctional fluid.
- Enter the number of days the employee was on restricted work or job transfer, the number of days away from work, or both.
- Indicate whether the case is an injury or an illness.
- Total all columns at the end of the year.
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OSHA Form 300A PDF Fillable
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