OSHA Injury and Illness Incident Report Example for Form 301

A complete Form 301 explains what the employee was doing, what happened, what the injury was, and what object or substance caused it. It also records the employee's details, the treating provider, whether the employee was treated in an emergency room or admitted overnight, and the case number that links it to the log.

The incident report should explain enough case detail to support the log entry.

OSHA recordkeeping uses three forms (29 CFR 1904.29). The OSHA 300 Log lists every recordable case with a one- or two-line description. The OSHA 301 Incident Report, or an equivalent form such as an insurance first report of injury that carries the same information, holds the detail for each case. The OSHA 300A Summary totals the log at year end. Each recordable case must be on the 300 and the 301 within 7 calendar days of receiving information that it occurred. The 300A is the only form you post, from February 1 to April 30, and a company executive certifies it first (29 CFR 1904.32).

Complete the 301 or equivalent for each recordable case entered on the OSHA 300 Log. When the three forms live in separate files, the log, the incident reports, and the summary drift apart, and the certified numbers stop matching the case files. The fix is to treat the forms as one record with three views: a case number ties each 300 row to its 301, and the 300A is only ever totaled from the reviewed log.

Coordinators tend to do the data entry and chase the facts, so a short list of what to ask for, and from whom, saves more time than any template.

Teams keep narratives in email while the 301 packet stays thin.

Every 300 entry feeds the 300A totals, the TRIR and DART rates built from them, and, for establishments that must submit case data, a row in the ITA file. A description written carelessly in March is the one an employee reads when they ask for the log in October.

• Privacy cases may need careful descriptions without intimate detail.
• Records kept in software count if the system can produce equivalent forms on demand: by the end of the next business day for an employee request and within 4 business hours for a government request.

Case 2026-031, as it reads on the 301:

• What was the employee doing just before the incident? “Restocking the top shelf of aisle 14 from a rolling ladder.”
• What happened? “The ladder rolled when the employee leaned to reach a carton, and they fell about four feet to the floor.”
• What was the injury or illness? “Fractured left wrist.”
• What object or substance directly harmed the employee? “Concrete floor.”

The matching 300 entry reads “Fractured left wrist, fell from rolling ladder”, with the same case number.

1. Start from the incident intake notes.
2. Answer the four case questions in specific, plain language.
3. Add the treatment details and dates.
4. Match the case number to the 300 entry.

What to keep in the case file:

• The 300 Log with stable case numbers
• A 301 or equivalent for every case on the log
• The confidential privacy case list, if you have privacy cases
• The certified 300A and the worksheet behind its totals

300log builds the 300 row, the 301 detail, and the 300A totals from a single incident record, so the three forms cannot drift apart, and it exports each one as a PDF when you need to post, print, or hand over a copy.

For a quick answer without an account, use the free recordability checker.

• Supervisor Incident Intake Checklist for OSHA Recordkeeping
• OSHA 300 vs 300A vs 301: What Each Form Does in 2026
• OSHA 300 Log Requirements for 2026: A Practical Recordkeeping Guide
• Multi-Location OSHA 300 Logs: How to Keep Establishment Records Straight