(USA) Opening an Injury or Illness Case for the United States

Access the Injury/Illness Case form.

(USA) To open an injury or illness case for the United States:

1. Complete the Case Number/Description field.

   If you leave this field blank, the system assigns the next available number.

2. Complete these fields:

   • Individual

   • Case Status

3. Select Case Information and select these options, if necessary:

   • Government Reportable

   • Involved Days Away from Work

   • Involved Restricted Work

4. If you select the Involved Days Away From Work option, complete the No. Days Away from Work field.

   Additionally, if you select the Involved Restricted Work option, complete the No. Days Restricted Work Activity field.

5. Complete these fields, if necessary:

   • Date Reported

   • Date Closed

   • Date Returned to Work

   • Date Deceased

6. Select Injury/Illness Information and complete these fields:

   • Injury or Illness

   • Injury/Illness Date

     Note: Steps 7 through 10 indicate the various methods that you need to use when completing the Injury or Illness Type field in order to comply with changes in OSHA regulations and retain history for a five year period.

7. If you are entering an injury that occurred prior to January 1, 2002, leave the Injury or Illness Type field blank.

8. If you are entering an illness that occurred prior to January 1, 2002, complete the Injury or Illness Type field using codes A through G.

9. If you are entering an illness that occurred on or after January 1, 2002 and before January 1, 2004, complete the Injury or Illness Type field using codes 01 through 05.

10. If you are entering an illness that occurred after January 1, 2004, complete the Injury or Illness Type field using codes 01,02,03,04,05A, or 06.

11. Complete these fields, if necessary:

    • Time of Accident

    • Part of Body

    • Occurrence Type

    • Establishment

    • Occurrence Location

    • Country of Occurrence

12. Select the Incident Occurred on Employer Premises option, if necessary.

13. Complete these fields or select the option to retain additional information required by legislative changes to OSHA:

    • Time Employee Began Work

    • Facility

    • Hospitalized Overnight

    • Emergency Room

14. Select Individual Information and complete this information:

    • Home Company

    • Home Business Unit

15. Complete these fields, if necessary:

    • Job Type/Step

    • Workers Comp

    • Supervisor

    • Foreman

16. Select Category Codes and complete any of the optional fields.

17. Click OK.