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Mandatory Reporting of Injuries/ Illnesses to VOSHA Online Form

Mandatory Reporting of Injuries/ Illnesses to VOSHA Online Form
Basic Requirements -1904.39(a):

  1. Within eight (8) hours after the death of any employee as a result of a work-related incident, you must report the fatality to the Occupational Safety and Health Administration (OSHA), U.S. Department of Labor or the Vermont Occupational Safety and Health Administration (VOSHA).
  2. Within twenty-four (24) hours after the in-patient hospitalization of one or more employees or an employee’s amputation or an employee’s loss of an eye, as a result of a work-related incident, you must report the in-patient hospitalization, amputation, or loss of an eye to OSHA or VOSHA.
  3. You must report the fatality, in-patient hospitalization, amputation, or loss of an eye using one of the following methods:
    1. By telephone or in person to the OSHA Area Office that is nearest to the site of the incident.
    2. By Telephone to the OSHA toll-free central telephone number, 1-800-321-OSHA (1-800-321-6742).
    3. By electronic submission using the form below.
Did the incident occur at the employer's address or a jobsite?
Type of Incident
Please provide a detailed description of the incident. Include where exactly the incident occurred, the work being performed at the time of the incident, what exactly happened, the type of injury sustained, and what you believe was the cause of the incident. 
Has this injury/illness occurred before?
(First Name, Last Name, Title, Phone, Email)
more items
First Name
Last Name
Street Address
Address Line 2
City
State
Zip Code
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