Accident and Investigation Center

Accident and Investigation Forms

White car hitting bumper of silver pickup truck.
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Supervisor’s Report of Employee Accident or Near Miss

Fillable PDF (English)
Fillable PDF (Spanish)

A women and two men talking at a table.

Witness’ Statement of Employee Accident or Near Miss

Fillable PDF (English)
Fillable PDF (Spanish)

These forms are also available in the SafetyOne™ mobile app. For questions about these forms, please contact the Client Services Department at (619) 438-6869.

Additional Resources

Accident and Investigation Articles
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Most Commonly Reclassified Lawn Care and Landscape Workers Compensation Governing Codes
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Employer’s Guide to Handling Cumulative Trauma Claims
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Three Industry Benchmarks all Landscape Companies Should Track
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Using Rancho Mesa’s KPI Dashboard to Improve Your Workers’ Compensation Program
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Understanding the Importance of Your Workers’ Compensation Unit Stat Filing Date
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WCIRB 2024 Construction Dual Wage Threshold Increases Approved
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Return to Work Programs: Best Practices for Handling Workers’ Comp Claims
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Focus on Frequency with a Small Work Comp Deductible
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WCIRB Files for Workers’ Comp Rate Increase
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Dual Wage Thresholds Set to Increase Again
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California Updates Required Employment Pamphlets
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How to Strategically Grow Your Construction Company
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Cracking the Code: Deciphering the Primary Threshold’s Impact
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The Billion-Dollar Cost of Working at Height: The Critical Questions to Ask Before Climbing a Ladder
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WCIRB Proposes 2024 Construction Dual Wage Threshold Increase
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Implementing Technology and Other Safety Tactics to Protect Your Fleet
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Pure Premium Increase for Landscape (0042) in Consecutive Years
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Implementing Best Practices when Hiring in the Construction Industry
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Guidance for Developing an Effective Injury and Illness Prevention Program
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Properly Utilizing Tailgate Meetings
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Inflation Increases Cost of Workers’ Compensation Claims
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Important Updates to Minimum Wage Policies for 2023
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Construction Death Rate Not Decreasing as Expected
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All Licensed California Tree Care Companies Now Required to Carry Workers’ Comp. Insurance
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Training Supervisors on Workplace Injury Protocol Can Improve Claim Outcomes
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Benefits of Offering Modified Work to Injured Workers
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Roofing Contractors Prepare for the Dual Wage Threshold Increase
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Rise in Pure Premium Rates Impacts Tree Care Industry
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The Link Between Your EMR and Primary Threshold
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California Insurance Commissioner Leaves Workers’ Comp Rates Flat