LOCAL RULES: 34 PA. CODE 121

Pennsylvania incident report requirements

Your Pennsylvania incident report has 6 rules to meet. ReportDraft puts every one on your checklist and checks your draft before you sign.

  • A death: the first report within 48 hours
  • Disabled for the rest of the shift or longer: the first report within 7 days
  • A copy of the first report to the employee when it is filed
Start free: draft your Pennsylvania report

ReportDraft Safety from $12 a month. 14-day free trial with your first report and up to 5 template downloads. Card required, nothing charged today, cancel anytime. Need just one? One incident report for $19, no subscription.

Pennsylvania employers follow federal OSHA recordkeeping and add the Bureau of Workers' Compensation's rules (34 Pa. Code ch. 121): the Workers' Compensation Information to the employee right after an injury, and a first report of injury within 48 hours for a death or within 7 days once a disability begins, with a copy to the employee. Here is each Pennsylvania rule with a link to the Pennsylvania Code, and what a Pennsylvania incident report should record.

Last reviewed October 15, 2026 against the official sources listed below.

Incident reportPENNSYLVANIA / SAMPLE

Sample notes, 140 words

Company: Northgate Fabrication
Site: 1840 Industrial Pkwy, shipping dock 2
Date: 10/08/2026, about 2:15pm
Injured: Luis Romero, material handler, warehouse crew
Supervisor: Tom Reilly
...
FREE PREVIEW OF THESE NOTES
58%of your draft is ready from these notes

We sorted 5 items into 4 sections and flagged 1 to fix first.

6 Pennsylvania rules on your checklist, including a death: the first report within 48 hours.

Still to add

  • NeededType of incident
  • NeededCompleted by
  • RecommendedNotes for damage to property, equipment or the environment

Filled in for you

Company or organizationNorthgate Fabrication
Site address or location1840 Industrial Pkwy, shipping dock 2
Date of the incidentOct 8, 2026
Employee or person involved (full name)Luis Romero, material handler, warehouse crew
Start free and draft yours

14 days free, nothing to pay today. After your first report, your name, license and company details fill in by themselves. Or preview your own notes first, no sign-up.

What Pennsylvania requires

  • The employer files a first report of injury within 48 hours for every injury resulting in death34 Pa. Code 121.5 (a) (1)
  • For other injuries covered by section 438 of the Workers' Compensation Act, the first report of injury is filed within 7 days after the date disability begins; a disability needing a first report is one continuing the entire day, shift or turn in which the injury was received, or longer34 Pa. Code 121.5 (a) (2), (c)
  • The employer sends a copy of the first report of injury to the employee at the same time it files the report with the Bureau; if there is no disability, a copy is not sent to the Department34 Pa. Code 121.5 (a) (3), (b)
  • Every employee gets the "Workers' Compensation Information" at hire and immediately after an injury, or as soon as possible under the circumstances (after emergency care if the injury needs it)34 Pa. Code 121.3b (a)
  • The information, titled "Workers' Compensation Information" and printed on paper at least 8 1/2 by 11 inches in at least 11-point type, explains wage loss and medical benefits, who pays them and the posting of the insurer's name, that injuries should be reported immediately and late notice can delay or deny benefits, the right to a hearing if a claim is denied, and the Bureau's contact details34 Pa. Code 121.3b (b), (c)
  • The employer posts the name of the company responsible for paying workers' compensation benefits at its primary place of business and its work sites, in a prominent, easily accessible place, including areas used for first aid or treating injured employees34 Pa. Code 121.3b (b) (2)

Right after the injury: the information sheet

Give the injured employee the "Workers' Compensation Information" immediately after the injury, or as soon as possible after emergency care. It must be on paper at least 8 1/2 by 11 inches in at least 11-point type and explain the benefits, who pays them, reporting injuries promptly, the right to a hearing, and how to reach the Bureau. Post your insurer's name where employees, including those getting first aid, can see it.

The first report of injury

File the first report within 48 hours for a death. For other injuries, file it within 7 days after disability begins, meaning the employee missed the rest of the day, shift or turn or longer. Send the employee a copy at the same moment. An injury with no disability is not sent to the Department.

From field notes to a finished Pennsylvania report

Note what happened, whether the employee left before the end of the shift, and when you gave them the information sheet. ReportDraft writes the incident up and keeps fields for the start of disability, the information sheet and the first report.

Common mistakes

  • Not giving the Workers' Compensation Information after the injury because it was handed out at hire.
  • Counting the 7 days from the injury instead of from when disability began.
  • Filing the first report without sending the employee a copy.
  • Missing the 48 hours for a death.
  • No posted insurer name in the first aid area.

Sources

Last reviewed October 15, 2026. Next review due January 15, 2027. This page explains published rules to help you write your report. It is not legal advice; the official text linked above governs.