Workplace incident notification form

COVID-19 (Coronavirus)

Notification of a COVID-19 virus case is required if:

  • it can be reliably attributed to a workplace exposure; and either
    • the person is required to have treatment as an in-patient in hospital; or
    • death.

A person conducting a business or undertaking (PCBU) must notify us of fatalities and certain serious injuries/illnesses or dangerous incidents that occur at work as a result of the conduct of the business or undertaking.

Incidents may relate to anyone at a workplace such as a worker, contractor or member of the public.

It is an offence to fail to report a notifiable incident.

How to notify us

While anyone at a workplace can report a notifiable incident, the PCBU is legally obligated to do so. You must notify us as soon as practicable after having become aware of the incident.

Life threatening issues or a death

  • call us on 1800 777 209 (statewide – 24 hours)

Non-life threatening injuries/issues

Safe Work Australia's incident notification fact sheet provides more information about mandatory reporting requirements with examples.

Fatalities

We will investigate the cause of all reported fatalities within or related to a workplace. Workplace fatalities will fall into one of three categories:

  • notifiable, work-related fatality
  • non-notifiable, non work-related fatality
  • non-jurisdictional fatality, e.g. a road traffic death travelling between home and work.

Serious injuries or illnesses

A serious injury or illness of a person includes:

  • immediate treatment as an in-patient in hospital for any duration, even if the stay is not overnight or longer
  • immediate treatment for:
    • amputation of any body part
    • serious head, eye or burn injury
    • degloving or scalping
    • spinal injury
    • loss of bodily function
    • serious lacerations
  • medical treatment within 48 hours of exposure to a substance.

The following prescribed serious illnesses are also required to be reported:

  • any infection where the work is a significant contributing factor or is reliably attributable to:
    • working with micro-organisms
    • providing treatment or care to a person
    • contact with human blood or body substances
    • handling or contact with animals, or animal hides, skins, wool, hair, carcasses or waste products
  • occupational zoonoses contracted in the course of work involving handling or contact with animals, or animal hides, skins, wool, hair, carcasses or waste products, including:
    • Q fever
    • Anthrax
    • Leptospirosis
    • Brucellosis
    • Hendra Virus
    • Avian Influenza
    • Psittacosis.

Dangerous incidents

A dangerous incident means an incident in relation to a workplace that exposes a worker, or any other person, to a serious risk to a person's health or safety emanating from an immediate or imminent exposure to:

  • uncontrolled escape, spillage or leakage of a substance
  • uncontrolled implosion, explosion or fire
  • uncontrolled escape of gas, steam or a pressurised substance
  • electric shock
  • fall or release from a height of any plant, substance or thing
  • collapse, overturning, failure or malfunction of, or damage to, any plant that requires authorisation for use in accordance with the Work Health and Safety Regulations 2012 (SA)
  • collapse or partial collapse of a structure
  • collapse or failure of an excavation or any shoring supporting an excavation
  • inrush of water, mud or gas in workings, an underground excavation or tunnel
  • interruption of the main system of ventilation in an underground excavation or tunnel
  • unplanned loss of control of heavy earthmoving machinery, including brake or steering failure, at a mine
  • any other event prescribed by the Work Health and Safety Regulations 2012 (SA).