296-27-01119 - Forms
(1) The employer must use the following OSHA forms (or equivalent forms), for recording work-related injuries and illnesses:
(a) OSHA 300, Log of Work-Related Injuries and Illnesses;
(b) OSHA 300-A, Summary of Work-Related Injuries and Illnesses; and
(c)OSHA 301, Injury and Illness Incident Report.
(2) The employer must complete the OSHA forms as follows:
(a)At the top of the OSHA 300 Log, enter your business information and enter a one or two line description for each recordable injury or illness. Summarize this information on the OSHA 300-A form at the end of the year.
(b)Complete an OSHA 301 Incident Report form, or an equivalent form, for each recordable injury or illness entered on the OSHA 300 Log.
(c)Enter each recordable injury or illness on the OSHA 300 Log and 301 Incident Report within seven calendar days of receiving information that a recordable injury or illness has occurred.
|Note:||You may keep your injury and illness forms on a computer if you can produce equivalent forms when they are needed, as described under WAC 296-27-02111, 296-27-03101(1), and 296-27-03103.|
(3) The employer must follow these requirements for privacy concern cases when filling out the OSHA 300 Log:
(a) The employer may not enter the employee's name on the OSHA 300 Log. Instead, enter "privacy case" in the space normally used for the employee's name in order to protect the identity of the injured or ill employee when another employee, a former employee, or an authorized employee representative is provided access to the OSHA 300 Log under WAC 296-27-02111.
(b) The employer must keep a separate, confidential list of the case numbers and employee names for their privacy concern cases so they can update the cases and provide the information to the government if asked to do so.
(c)The following injuries or illnesses are the only types of privacy concern cases recognized by this section:
(i) An injury or illness to an intimate body part or the reproductive system;
(ii) An injury or illness resulting from a sexual assault;
(iii) Mental illnesses;
(iv) HIV infection, hepatitis, or tuberculosis;
(v) Needlestick injuries and cuts from sharp objects that are contaminated with another person's blood or other potentially infectious material (see definition in WAC 296-27-051 of this chapter); and
(vi) Other illnesses if the employee independently and voluntarily requests that their name not be entered on the log.
(4)If the employer has a reasonable basis to believe that information describing the privacy concern case may be personally identifiable even though the employee's name has been omitted, they may use discretion in describing the injury or illness on both the OSHA 300 and 301 forms. The employer must enter enough information to identify the cause of the incident and the general severity of the injury or illness, but they do not need to include details of an intimate or private nature. For example, a sexual assault case could be described as "injury from assault," or an injury to a reproductive organ could be described as "lower abdominal injury."
(5) If the employer decides to voluntarily disclose the forms to persons other than government representatives, employees, former employees or authorized representatives (as required by WAC 296-27-02111 and 296-27-03103), the employer must remove or hide the employees' names and other personally identifying information, except for the following cases. The employer may disclose the forms with personally identifying information only:
(a)To an auditor or consultant hired by the employer to evaluate the safety and health program;
(b) To the extent necessary for processing a claim for workers' compensation or other insurance benefits; or
(c) To a public health authority or law enforcement agency for uses and disclosures for which consent, an authorization, or opportunity to agree or object is not required under Department of Health and Human Services Standards for Privacy of Individually Identifiable Health Information, 45 C.F.R. 164.512.
(6) Falsification, failure to keep records or reports.
(a)RCW 49.17.190(2) of the act provides that "whoever knowingly makes any false statement, representation, or certification in any application, record, report, plan, or other document filed or required to be maintained pursuant to this chapter shall, upon conviction be guilty of a gross misdemeanor and be punished by a fine of not more than ten thousand dollars, or by imprisonment for not more than six months or by both."
(b)Failure to maintain records or file reports required by this chapter, or in the detail required by the forms and instructions issued under this chapter, may result in the issuance of citations and assessment of penalties as provided for in chapter 296-900 WAC, Administrative rules.(Amended by WSR 15-11-066, Filed 5/19/2015, effective 7/1/2015 Amended by WSR 19-17-068, Filed 8/20/2019, effective 1/1/2020)
Statutory Authority: RCW 49.17.010, 49.17.040, 49.17.050, 49.17.060. 07-03-163, § 296-27-01119, filed 1/24/07, effective 4/1/07; 03-24-085, § 296-27-01119, filed 12/2/03, effective 1/1/04; 02-22-029, § 296-27-01119, filed 10/28/02, effective 1/1/03. Statutory Authority: RCW 49.17.010,[49.17].040, and [49.17].050. 02-01-064, § 296-27-01119, filed 12/14/01, effective 1/1/02.
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