Downloadable Employee Injury Report Form For Timely Reporting

If an injury occurs to someone in the workplace, one of the first things to do after seeking any required medical or emergency personnel is to fill out an employee injury report form.  It will need completion to happen on time.  Adding this to any workplace incident response procedure is a must for businesses who don’t want to pay hefty fines or worse.

Simply download, print, and fill out our Employee Report of Injury Form (PDF).  Or, you can go ten steps forward and get the 1st Incident Reporting App for your company, which we will discuss further.

This article will discuss the process and requirements required to complete the Employee Injury Report Form.  We’ll discuss the administrative requirements, deadlines to submit the form to keep your company on an even keel, and we’re going to answer some of the most common questions about employee injury report forms – so don’t miss the FAQ section!

The Downloadable Employee Injury Report Form Template

How To Use The Employee Injury Report Template

Important Note:  Remember to check the table below for your reporting time deadline.  Companies have to submit employee injury reports promptly, so make sure you stay compliant.

  1. Download the template.
  2. Print the template on regular 8” x 10” paper.
  3. Include template in your company emergency response plan.
  4. Train staff to fill out and submit the template in the case of an employee injury, as part of your coordinated response effort.

Employee Injury Report – Employer Obligations

When one of your employees is injured in an accident, there are rules that apply to how long and where you – the employer – must file a report with the proper authorities.

Failing to act within a reasonable amount of time to submit an employee injury report form could result in fines or even legal action.  For this reason, we’ve included some handy references for your employee injury report form reporting convenience.  

Let’s start with the deadlines to submit an employee report of injury form.  This form may be called something else, depending on where your business is located.  See the quick reference table below.  

Keep in mind that for reporting deadlines – should an injury be of a serious nature, the incident ought to be reported immediately.  The following chart deadlines are for non-life threatening accidents.  Serious accidents involving serious injury or death need immediate reporting in most places.

Country – State/ProvinceReport NameLink To Government Reporting Body Reporting Deadline
Canada – AlbertaEmployer Report of InjuryWorkers’ Compensation Board72 Hours
Canada – British ColumbiaReport of Work Related Injury or IllnessWorkSafeBC72 Hours
Canada – ManitobaWorkplace Injury ReportWorker’s Compensation Board5 Business Days
Canada – Newfoundland and LabradorEmployer’s Report of Injury (Form 7)WorkplaceNL3 Days
Canada – New BrunswickEmployer Report of Injury or IllnessWorkSafeNB3 Days
Canada – Northwest TerritoriesIncident ReportWorkers’ Safety and Compensation CommissionVaries – See website. (72 hours+)
Canada – Nova ScotiaWCB Injury Report FormWorkers’ Compensation Board5 Business Days
Canada – OntarioReport of Injury/Disease Form 7Workplace Safety and Insurance Board (WSIB)3 Days
Canada – Prince Edward IslandEmployer’s Report – Form 7 Workers’ Compensation Board3 Days
Canada – QuebecRegistre d’accidents, d’incidents et de premiers secoursCommission des normes, de l’équité, de la santé et de la sécurité du travail (CNESST)Consultez le site Web pour plus de détails.
Canada – SaskatchewanEmployer’s Initial report of injury (E1) formWorker’s Compensation Board5 Days
Canada – YukonEmployer’s Report of Injury/IllnessYukon Workers’ Compensation Health and Safety Board3 Working Days
United KingdomReport of an Injury (RIDDOR)Health and Safety ExecutiveSee website for further details.
United States of AmericaFor Federally regulated states: Employer’s First Report of Injury or Occupational IllnessUnited States Department of LaborSee interactive State map here10 Days

In many areas, the local state or province government body presiding over the employment injury reporting process utilizes their own form.  In these cases, you may find the link to the form above in the table provided.  

It is a smart practise to have your own company reporting form and process.  So, even if your business resides in an area where local government uses a specific form, having your own company form and records is a good move.

Don’t Print – Go Digital!

When you setup your company’s emergency response plans, incorporating an organized reporting system can be a headache to say the least.  The employee injury report form we have provided will suit a small company where a minimal amount of workers are employed.  

What if your company has many workers, or multiple locations?  Are you going to have multiple forms printed for each possible incident and in each location?  This seems like more work and expense than a company needs during these tough economic times.

Aside from the obvious company expense, with over 7 billion trees cut down each year in the US alone, nature could use our help. Why not consider a digital solution to help your business maintain a more eco-friendly approach to your employee injury report form processes? (source)

The Solution: Go Digital With 1st Incident Reporting

To track your company incidents without the need for printing multiple forms and then trying to manually track them, is to go digital with an incident reporting application like the one we provide here.

Our solution gives you and your employees the ability to create and submit reports instantly through the reporting software.  It tracks your incidents, can email the appropriate person(s) within your organization, allows for customization of forms and so much more.

Gone are the days of massive form printing and storage rooms of filing cabinets.  Take our incident reporting app out for a spin with a free trial and see for yourself how efficient and convenient incident reporting can be.

[Insert button to go to start free trial][Insert button to go to request demo]

FAQ & Interesting Facts

Did you know that in 2018 in the US, the age groups who were injured the most at work in the Tools, Instruments, and Equipment sub-characteristic were primarily those aged 55 to 64.  The secondary age group next for at-work injuries were from 16 to 19 years of age. (source)

The Employee Did Not Report Injury In A Timely Manner

As a part of your emergency response plan, you know you have a certain amount of time to submit your employee report of injury form to the proper authorities.  Depending on where your business resides, your employee may need to also submit a form.

When an employee fails to submit forms in a timely manner, there may be consequences with the reporting agency or government body.

To ensure your company has covered it’s legal obligations, make sure that your emergency response plan has fully documented employee emergency response training. Similarly, ensure that said training involves a sign off sheet to prove that you have provided training to your employees.

The training you provide your employees ought to face an updating process on an annual or semi-annual basis.  This refresher training should be documented and signed off by your staff.

Ensuring that your company is doing all reasonable due diligence to accommodate emergency situations by training and providing adequate responses is all that any company can do at the minimum to protect themselves from legal ramification.

Consulting the governing agency in your area is recommended to ensure your company is compliant with all local legislation regarding employee injury report forms and their filing requirements.

What Is The Statute Of Limitation On A Workplace Injury In The Us?

Each state in the United States carries it’s own statute of limitations regarding workplace injuries.  For a complete list see the list at the FindLaw® site here.  If not in the US, consult your local state or province agency residing over the workplace employee injury report form process from the links in the table above.

What To Do If An Employee Is Injured Outside Of Work?

When an employee is injured outside of work, it can have a drastic effect on their ability to perform their job.  As an employer, it can be tempting to want to punish an employee for causing grief to their management from a preventable injury outside of work.  However, good work ethics would dictate that this situation must still be addressed with concern and care from the employer.

A best practise for these situations is to do the following as an employer immediately upon finding out that an employee was injured outside of work.

  1. Create a Non-Workplace Employee Injury Report to document the situation.
  2. Have the employee provide medical documentation of their medical requirements.
  3. Create a reasonable return-to-work plan, based on the recommendations of medical professionals.
  4. Reasonably accomodate the employee to fulfill the return-to-work plan.

Following these steps ensures that you, the employer, are making a reasonable effort to accommodate the employee.  The documentation ought to be kept and the injury analysed to ensure that the injury does not cause a secondary injury that could be work-related.  For example, if an employee pulled their back while moving on the weekend, their employment may need modification to avoid possible work-related back injuries by the employee in the near future.  Always consult and follow the advice of medical professionals.

Sources