Incident report template
- Report to OSHA within, hours (0 = no phone report due)
- 0
- Recordable on the OSHA 300 log (1 = yes)
- 1
- Lost work hours
- 24
- Cost of lost time at the loaded rate
- $1,344
Every figure on this page is computed from the inputs you enter, by the method stated below it. The only constants DailyLogDesk supplies are the published reporting clocks and assessment steps, each cited where it is used. The defaults are a worked example to replace with your own.
The figures above start from a worked example (0). Change any input and the answer updates as you type.
Download the Incident report template worked example (CSV)
This builds the figures an incident report carries and puts the two rules on it that matter most in the first day. Pick what happened, from a near miss to a fatality, enter the workers involved, the days away and on restricted duty, your loaded hourly cost, the direct costs and your own indirect multiplier, and the page returns the hours within which the incident must be reported to OSHA, whether it is recordable on the OSHA 300 log, the cost of the lost time and the total cost of the incident. The clock and the recordability rule are the published federal rules, cited below; every dollar figure is yours.
Eight hours for a fatality, twenty-four for a hospitalization
The federal rule is short and unforgiving: within eight hours after the death of any employee as a result of a work-related incident, you must report the fatality to OSHA, and within twenty-four hours after the in-patient hospitalization of one or more employees or an employee's amputation or loss of an eye, you must report it. The page prints the clock that applies to the incident type you picked, and zero where no phone report is due. Recording it on the log is a separate duty, below.
Recordable is a wider net than reportable
An injury is recordable on the OSHA 300 log if it results in death, days away from work, restricted work or transfer to another job, medical treatment beyond first aid, or loss of consciousness, or is a significant injury or illness diagnosed by a physician. A first-aid-only case is not recordable and a near miss is not an injury at all, but both belong in your own log, because the near miss is the incident you get to learn from for free. The page marks the recordable cases and leaves the rest to your own book.
The indirect cost is the one that closes small contractors
The medical bill and the damaged plant are the direct cost, and they are the smaller part. The investigation, the retraining, the lost production while the crew stands down, the schedule slip and the premium increase are the indirect cost, and the page applies the multiplier you set from your own experience rather than a national figure. The lost time is priced at your loaded rate, with restricted-duty days at half, so the number is the one your profit and loss will actually see.
Incident report template: common questions
Is this a free incident report template?
Yes: the reporting clock, the recordability rule and the cost are computed here for free with no account, and you can print the report. DailyLogDesk Pro turns it into the incident report document with your company name and license on it, filed against the project and the site day, with the follow-up actions as reminders.
When do I have to report an incident to OSHA?
Within eight hours of a work-related fatality, and within twenty-four hours of an in-patient hospitalization, an amputation or the loss of an eye, under 29 CFR 1904.39. Other recordable injuries go on the OSHA 300 log rather than a phone report. The page prints the clock for the incident type you select.
Does this cover the UK?
The reporting clock on this page is the US federal rule. In Great Britain the equivalent is RIDDOR: an injury that keeps a worker off their normal duties for more than seven consecutive days must be reported within 15 days of the accident, and one of more than three consecutive days recorded in the accident book. The risk assessment and method statement tools on this site are written for that side; a RIDDOR clock on this page is on the list.
What is a near miss worth recording?
Anything that could have caused an injury and did not: the dropped tool, the unguarded edge somebody noticed, the reversing truck that stopped in time. It costs nothing, the page prices it at nothing, and the record is how the same thing does not happen with a person under it next week.
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The answers are free forever. Pro turns them into your site records: your logo and license on them, no watermark, every report filed against the project and the day, reminders to the people who owe a signature, and clean exports when the inspector or the client asks.
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Where the constants in this tool come from
29 CFR 1904.39, Reporting fatalities, hospitalizations, amputations, and losses of an eye as a result of work-related incidents to OSHA (eCFR). The eight-hour and twenty-four-hour reporting clocks the page prints for a fatality and for an in-patient hospitalization, amputation or loss of an eye.
29 CFR 1904.7, General recording criteria (eCFR). What makes an injury recordable on the OSHA 300 log: death, days away from work, restricted work or transfer, medical treatment beyond first aid, or loss of consciousness.
HSE, RIDDOR: types of reportable incidents. The GB side of the same duty: over-seven-day incapacitation is reportable within 15 days of the accident; over-three-day incapacitation is recorded, not reported.
Cite or embed this figure
Incident report template (Report to OSHA within, hours (0 = no phone report due)): 0, DailyLogDesk, worked example.
Cite as: "Incident report template, DailyLogDesk", updated 2026-09-03, https://dailylogdesk.com/tools/incident-report/.