Oklahoma incident report template

Oklahoma rules for this report

These rules are about how and when you report, not the template's fields. Check them before you deliver.

• Within ten days after notice or knowledge of a death or an injury that causes lost time beyond the shift or needs medical attention away from the work site, the employer files a CC-Form-2 Employer's First Notice of Injury with the Commission, or the claim administrator files a First Report of Injury by EDI, with the information 85A O.S. 63 requires; failing to report can bring the sanctions in 85A O.S. 63OAC 810:10-1-4 (a) · CC-Form 1A, Notice and Instruction to Employers and Employees
• An employer intending to controvert files its notice within fifteen days of notice or knowledge of the injury (CC-Form-2A, or by EDI); a request for more time to investigate, made within those fifteen days, is granted for thirty more days, forty-five in all; a claim administrator not controverting reports the first benefit payment within fifteen daysOAC 810:10-1-4 (b)
• The employer provides immediate first aid and the medical, surgical, hospital, optometric, podiatric, chiropractic and nursing services, medicine, crutches and other apparatus reasonably necessary for any injury or illness arising out of and in the course of employment, whatever its characterCC-Form 1A, Employer's Responsibilities
• The employer posts and keeps CC-Form 1A, the Oklahoma Workers' Compensation Notice and Instruction to Employers and Employees, in one or more conspicuous places on the work premises, signed and showing the insurer's name and address and the policy's expiration dateCC-Form 1A
• An injured employee should notify the employer immediately, however slight the injury, giving notice to a partner, a corporate officer or agent for legal process, and the person in charge at the location where the injury happened; without oral or written notice within thirty days the claim may be forever barred, and the employer should furnish the claim formsCC-Form 1A, Employee's Responsibilities
• A claim for an accidental injury is filed with the Commission within one year of the injury, or six months after the last benefits; a death claim within two years of the death; an occupational disease claim within two years of the last injurious exposure; a cumulative trauma claim within one yearCC-Form 1A (law effective 2019-05-28)
• Within ten days after the First Notice of Injury is filed, the injured worker is mailed notice of the Commission's counselor program and of mediation and other dispute resolutionOAC 810:10-3-3 (c)

What is in it

• What happenedWhat the person was doing just before the incident, with the tools, equipment or material used, then how the incident happened, in the order it happened.
• Injury or illness and treatmentThe part of the body affected and how, the object or substance that directly caused harm, and the first aid or medical treatment given and where.
• Damage to property, equipment or the environmentWhat was damaged, spilled or released, and how much, as the notes give it.
• Immediate actions takenWhat was done right away: first aid, emergency calls, the area made safe, equipment stopped or tagged out, and who was notified.
• CausesThe immediate cause and any underlying causes the notes identify: equipment, procedures, training, work conditions, supervision. Only what the notes support.
• Witness statementsName, Role, What they saw or said
• Corrective actionsAction, Responsible, Due, Status

Rules last reviewed October 15, 2026. Read the full Oklahoma incident report requirements.