Reporting an Incident or Accident

Download Report of Incident or Accident in Word format

As you may already know, a Report of Incident or Accident must be completed within 24 hours of an employee work-related injury or illness. In addition, a California law, effective January 1, 2003, mandates the issuance of an Occupational Safety and Health Administration (OSHA) citation, with a penalty of $5000, to employers who fail to report a “SERIOUS INJURY OR ILLNESS” to OSHA within 8 hours of the incident.

Title 8 of the California Code of Regulations § 330 (h) defines a “serious injury or illness” as follows:

“Serious injury or illness” means any injury or illness occurring in a place of employment or in connection with any employment which requires inpatient hospitalization for a period in excess of 24 hours for other than medical observation or in which an employee suffers a loss of any member of the body or suffers any serious degree of permanent disfigurement, but does not include any injury or illness or death caused by the commission of a Penal Code violation, except the violation of Section 385 of the Penal Code, or an accident on a public street or highway.”

If you become aware of a “serious”Sac State employee work-related injury or illness, as defined above, please immediately contact the Office of Environmental Health & Safety (EH&S) at extension 8-6456 and provide the following information regarding the injured or ill person:

Name
Date of injury or illness
Birth date or age
Home address and home phone number
Nature of injury or illness
Location of incident
A basic description of the incident that resulted in the injury or illness.

If you are unable to speak directly to a member of Risk Management Services, and the injury or illness meets the definition of “serious”, you are directed to report the “serious injury or illness” to OSHA at 916-263-2800.

If you have any questions regarding the content of this memorandum, please contact Mike Christensen.