Workplace incident investigation template

An incident investigation should explain what happened, which conditions made it possible, what controls failed or were missing, and who will verify that the fixes work. The form below can be copied into a document or adapted to a controlled system for an injury, occupational illness, equipment event or near miss. It is designed to move from first facts to effective corrective action, not to assign blame before evidence is gathered.

This is an internal investigation worksheet. It is not OSHA Form 301, the OSHA 300 Log or a serious-event notification to OSHA. Employers must separately decide which records and reports are required under federal or applicable State Plan rules. OSHA's hazard identification guidance recommends promptly investigating incidents and close calls with worker participation and looking beyond a single immediate error. Use a trained investigator for serious or complex events, and obtain specialist, legal or medical assistance as appropriate.

Immediate response: protect people before investigating

Call emergency services, provide appropriate first aid and stop any unsafe work. Make the area safe without creating another hazard. Preserve equipment, photographs and witness details as far as compatible with rescue and hazard control. If the scene must change to protect people, document why, who authorized it and what was altered. Notify the site lead and affected employers. Do not wait for a full investigation before removing a known serious hazard.

Separate OSHA reporting decision: [Decision-maker; time informed; event facts; applicable authority; decision and rationale; report date/time/channel/reference]. Under 29 CFR 1904.39, federal OSHA generally requires a report of a work-related fatality within eight hours and certain work-related in-patient hospitalizations, amputations and losses of an eye within 24 hours, subject to the regulation's definitions and timing/exceptions. If uncertain about a potentially reportable event, escalate immediately and check the exact current rule. An internal form or software record does not submit the OSHA report. Preserve State Plan differences and any client, insurer or other notice requirements separately.

1. Case identification and investigation control

Keep the investigation record under access controls suited to the event. Medical details should be limited to people who need them; record functional and event facts without circulating diagnoses across the workforce. If a recordable case is a privacy-concern case, follow 29 CFR 1904.29 for the OSHA log and confidential name list. Do not treat an internal case ID as permission to expose sensitive information in a general dashboard.

2. Immediate facts and scene record

Write an initial factual account before interpreting causes. Identify what is confirmed, what is reported by someone, and what remains unknown. The record should be corrected as evidence arrives; do not quietly overwrite the first account.

For a near miss, record the credible potential outcome without inventing an injury that did not occur. For an occupational illness, an investigator may need a different timeline and qualified exposure/medical input; this form cannot determine diagnosis or causation on its own.

Evidence log

Avoid editing original photos or data without preserving a source copy. If equipment is secured, record custody, isolation status and who may release it for use. The aim is a traceable reconstruction, not a legal conclusion.

3. People and accounts

Talk with affected workers and witnesses promptly, separately when practical, and in a way they can understand. Explain that the purpose is to prevent recurrence. Ask what they saw and what the normal work process is; avoid leading questions such as “Why did you ignore the rule?” Record the person's own account as accurately as possible, mark uncertain recollections, and let them correct factual errors. Get a translator or representative when needed.

A witness may know that the guard was often removed or that a route changed that morning. That information can reveal management-system weaknesses even if the witness did not see the exact moment of contact. Do not force accounts to agree; explain differences and seek independent evidence.

4. Build the timeline and test causes

List key events from planning through response. Distinguish verified facts from hypotheses.

Then ask four levels of question:

1. Hazard and exposure: What energy, substance, height, vehicle, work process or other hazard reached a person or asset?
2. Immediate control: Which barrier should have prevented or reduced contact? Was it missing, ineffective, bypassed or overwhelmed?
3. Work system: Why was that control absent or ineffective? Check design, maintenance, workload, staffing, competence, handover, contractor coordination and supervision.
4. Program weakness: Had similar warnings or near misses occurred? Were risk assessments and work instructions current? Could workers report a problem and pause work? Were corrective actions closed without checking effectiveness?

OSHA says an investigation should find underlying causes, often more than one, and should not stop at “worker error.” Its recommended practices ask whether the worker had the right tools, time, training and supervision. Record evidence for each causal finding. A “five whys” conversation can help, but it is not proof on its own; test answers against the scene, process records and worker accounts.

Worked example: A worker trips over a hose in an aisle. “They were not looking” is incomplete. The investigation may find that the hose was routed across a designated walkway because the normal reel was broken, no temporary barrier was supplied, and the pre-shift inspection did not include temporary services. Those findings point to repairing the reel, changing hose routing, maintaining a crossing control until repaired, and improving inspection and reporting. The exact findings for a real event must come from evidence; do not copy the example as a predetermined cause.

5. Corrective actions: interim, lasting and verified

Controls should address the identified causes and protect workers immediately. Prefer eliminating the hazard or engineering it out where practicable, then use work-method, administrative and personal protective measures as appropriate. A toolbox talk may support an action but is rarely enough when the source hazard remains. Give each action an owner and completion evidence; then verify it works during real work.

Closeout decision: [Investigator recommendation; worker/supervisor feedback; approver/date; remaining risk or follow-up interval]. Close the case only after the necessary actions have been completed or a documented accountable plan manages any longer-term work, and after the critical controls have been tested. If the same event recurs, reopen or link the investigation and examine why the earlier action failed. Feed lessons into the JHA, procedure, maintenance system, training and other affected sites, with personal details redacted where appropriate. OSHA's program evaluation guidance emphasizes verifying that controls remain effective.

6. Example of a useful investigation handoff

A maintenance team has a hand injury during a conveyor jam clearance. The initial supervisor report says “worker reached into machine.” The investigator preserves the isolation record, the jam procedure, a photograph of the access panel and maintenance history. Interviews show that jams had become frequent and the team was pressured to keep the line moving. The actual isolation point was remote and not identified on the temporary repair sheet. A defensible handoff would separate the worker's movement from the failed guarding, jam prevention, isolation procedure and production planning. Interim action may include stopping access until a competent person secures the equipment; permanent actions may include engineered guarding, addressing the recurrent jam and revising the isolation process. An instruction to “be careful” alone would not address those causes. Technical lockout/tagout and machine-guarding duties require specialist review for the actual equipment.

Internal links and Complys relationship

The live Complys US OSHA software page discusses program, JHA and record organization. The Complys US severe-injury reporting guide owns the 8-hour/24-hour explainer. This worksheet owns the investigation task and should link to the reporting guide only for the separate regulator decision. A future internal link to the planned OSHA 301 page should be added only after its exact route and content exist; OSHA 301 is a recordkeeping form, not a cause-analysis worksheet.

The public Complys incident reporting software page is UK-positioned, so do not present it as a verified US investigation workflow. A US-specific CTA may be added only after the current product, country route and feature set are confirmed. Do not claim that software interviews witnesses, finds root causes, files an OSHA report or certifies compliance.

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