Guide to Completing an Employer

Incident Investigation Report (EIIR)

Save time and money by using the EIIR template to easily create all your required incident investigation reports.

WorkSafeBC has developed an employer incident How do I submit a report to

investigation report (EIIR) template you can use to WorkSafeBC?
create all four reports that may be required
Generally, you are only required to submit full
following an incident in your workplace. This
investigation reports to WorkSafeBC. You can
template will help you collect all the necessary
submit full investigation reports:
information and reduce the work associated with
•• Online at the EIIR upload portal
completing multiple, separate reports.
•• By fax at 604.276.3247 in the Lower Mainland
or toll-free 1.866.240.1434
What is this guide for?
•• By mail to WorkSafeBC, PO Box 5350, Stn
This guide will walk you through the process of Terminal Vancouver, BC V6B 5L5
completing an EIIR, in conjunction with the
requirements of Part 3, Division 10, of the When is an investigation required?
Workers Compensation Act (the Act) and
prevention policies D10-175-1 and D10-176-1. Employers are required to immediately investigate
any incident that involves the following:
(1) Serious injury to or death of a worker
How many reports do I need to
(2) A major structural failure or collapse
complete?
(3) A major release of a hazardous substance
Depending on the incident, you may be required (4) Fire or explosion with potential for serious injury
to complete up to four separate reports. Each (5) A blasting accident causing personal injury
report represents the status of the investigation at (6) Dangerous incident involving explosives,
a specific point in the investigation process. whether or not there is personal injury

(7) A diving incident, as defined by the

Report When Template Occupational Health and Safety Regulation
type sections (8) Minor injury or no injury but had potential for
causing serious injury
Preliminary Complete 1 to 14
investigation within 48 hours (9) Injury requiring medical treatment beyond
first aid
Interim As soon as 1, 9, and 12
corrective action possible Note: For the first six types of incidents, you
must also notify WorkSafeBC immediately. Call
Full investigation Complete 1 to 19 toll-free 1.888.621.7233. After hours call
within 30 days
1.866.922.4357.
Full corrective As soon as 1, 9, and 17
If the incident is not one of the types listed above
action possible
(for example, it was a minor incident and there
was no risk of serious injury), you are not
required to investigate it.

Guide to Completing an Employer Incident Investigation Report (EIIR) page 1 of 6

 What to do following a workplace incident
Immediately Within 48 hours Within 3 days Within 30 days Ongoing

Notify Conduct If a worker Follow up to

Workplace WorkSafeBC preliminary was injured,
Complete full
investigation ensure
incident if the incident investigation submit Form 7– corrective
and prepare
occurs is one of the and prepare Employer’s report action is in
first six types report Report of place and
listed under Injury or effective
“When is an Occupational
investigation WorkSafeBC Disease Full report to
required?” may request WorkSafeBC

After producing After producing

report report

Undertake Undertake
corrective corrective
action as action as
required and required and
prepare report prepare report

Provide reports Provide reports

to workers* to workers*

If full investigation and corrective action can be completed

within 48 hours, you may combine the reports

* Provide to the joint health and safety committee or worker health and safety representative, as applicable.
If there is no joint committee or worker representative, post the report in the workplace.

Step 1: Preliminary investigation report investigation report to WorkSafeBC unless you

have been directed to do so by an officer.
When an incident occurs, you must conduct a
preliminary investigation to identify any unsafe Section 1: Employer information
conditions, acts, or procedures — as much as Provide the employer’s legal name, operating
possible — to identify and manage hazards in the name or trade name, address, contact number,
workplace. This helps ensure that work can be done email address, WorkSafeBC account number,
safely during the interim period between the incident and operating location number.
and the conclusion of the full investigation.
Section 2: Injured persons
When the preliminary investigation is complete, Provide the names and job titles of individuals
open the EIIR template and enter the incident injured or killed in the incident, even if they don’t
details in sections 1 to 14. Save the file as a work for the employer.
Microsoft Word or PDF file, indicating the date
of the incident, the injured worker’s name, and Section 3: Place, date, and time of incident
the type of report (preliminary investigation). For incidents in remote locations or away from the
Complete this report within 48 hours. employer’s mailing address, include whatever
identifying information is available. This may
Preliminary investigation reports must be initiated include GPS coordinates, mile markers, or street
immediately and must contain all information intersections.
specified by policy. Don’t submit your preliminary

Guide to Completing an Employer Incident Investigation Report (EIIR) page 2 of 6

Section 4: Type of occurrence followed the incident, such as first aid. Include
Use this section to indicate the type of incident you dates and times, if possible. Arrange the events in
are investigating. You are legally obligated to chronological order, from first to last. Don’t include
investigate and report certain types of incidents. things that should have happened but did not
If it’s a first aid-only injury and there was no risk of (for example, “worker did not use guard”).
serious injury, you are not required to investigate it.
Section 9: Unsafe conditions, acts, or
You are not required to investigate a vehicle
procedures that significantly contributed to
accident occurring on a public street or highway.
the incident
Section 10 of the template lists examples of Analyze the sequence of events. Ask why each
serious injuries. “A major release” is defined in event happened. Describe any unsafe conditions,
Policy D-10-172-1. acts, or procedures (for example, poor
housekeeping or failure to follow safety
Section 5: Report type procedures). Avoid stopping at personal factors,
Indicate whether this is a preliminary investigation, such as “worker was careless.” Consider possible
interim corrective action, full investigation, or full problems with factors such as training,
corrective action report. If you are using the EIIR equipment maintenance, standard work
template for multiple reporting obligations, select procedures, and environmental conditions.
all the report types that apply. For example, if you
have completed the preliminary investigation and Section 10: Nature of serious injury
identified and taken corrective action, select the You may use this section to indicate the nature of
“Preliminary investigation report” box and the the injury, if applicable. According to Guideline
“Interim corrective action report” box. G-D10-172-1, a serious injury “is any injury that
can reasonably be expected at the time of the
Indicate if this is a revision to a previously incident to endanger life or cause permanent
documented report. If this is a preliminary injury.” Serious injuries include traumatic injuries
investigation report requested by an officer, note such as fractures of the arms or legs, major cuts,
the officer’s name. burns and crush injuries.
Section 6: Witnesses Section 11: Brief description of the incident
Provide the names and job titles of any witnesses Summarize what happened based on the
to the incident, including workers or members of information in sections 8, 9, and 10.
the public.
Section 12: Corrective actions identified and
Section 7: Other persons whose presence taken to prevent recurrence of similar incidents
might be necessary for a proper investigation
Describe the corrective actions you have
Provide the names and job titles of anyone who identified to prevent similar incidents. Include the
is needed to conduct the investigation. This may action, the name and job title of the person
include workers who were on shift before the responsible for it, and the completion date or
incident, someone who maintained equipment anticipated completion date.
involved in the incident, or third-party
consultants. Section 13: Explanation of blank areas on
this preliminary report, if any
Section 8: Sequence of events that preceded
You are expected to take reasonable steps to
the incident
investigate the incident and identify unsafe
Identify significant events that led up to the conditions, acts, or procedures as much as
incident. You can also include relevant events that

Guide to Completing an Employer Incident Investigation Report (EIIR) page 3 of 6

possible. Circumstances outside an employer’s Step 3: Full investigation report
control may restrict the investigation — for
In the full investigation, you must determine the
example, not being able to access the incident
causes of the incident. These causes could
scene because of an ongoing police investigation.
include underlying problems with supervision,
If you can’t complete the preliminary
training, preventative maintenance, or other
investigation you should still provide any
management systems.
information you have available.
When you have completed the full investigation,
Section 14: Persons who carried out or
open the interim corrective action report and
participated in the preliminary investigation
rename it (full investigation report). Check the box
Include the name and job title of anyone who
in section 5. Add information to sections 15 to
took part in the employer’s incident investigation.
19. Submit the report to WorkSafeBC within 30
days of the incident. Don’t submit attachments to
Step 2: Interim corrective action report the report, such as photos, videos, and drawings.
Interim corrective action reports must address Instead, keep them at the workplace.
the findings of the preliminary investigation. If all
interim corrective action was completed when Section 15: Determination of causes of
the preliminary report was written, you have incident
already completed the corrective action report Analyze the facts and circumstances of the
and can check both boxes in section 5 incident to identify the underlying factors that led
(preliminary investigation report and interim to it. What underlying factors made the unsafe
corrective action report). conditions, acts, or procedures possible? Identify
health and safety deficiencies.
If some actions still need to be done, open the
preliminary investigation report and rename the Section 16: Full description of the incident
file to indicate that this is the interim corrective Use the brief description from the preliminary
action report. Update the information in sections report as a starting point. Expand on it, as
9 and 12 with any new actions or dates. If some necessary.
actions still have not been done at the end of the
Section 17: Additional corrective actions
full investigation, ensure they are included in your
necessary to prevent recurrence of similar
full corrective action report.
incidents
Provide information about the corrective actions
The information you provide in sections 1 to you have identified to prevent similar incidents.
14 is sufficient to satisfy your legal obligation Include the action, the name and job title of the
to prepare both a preliminary incident person responsible for it, and the completion
investigation report and interim corrective date or anticipated completion date.
action report. You must provide these
Note: If all the corrective actions have been
reports to your joint occupational health
completed by the time you write the full report,
and safety committee (or worker health
this report can also serve as the full corrective
and safety representative, if applicable).
action report. In this case, remember to check
If there is no joint committee or worker
both boxes in section 5.
representative, the reports must be posted in
the workplace. Don’t send these reports to Section 18: Persons who carried out or
WorkSafeBC unless an officer asks for them. participated in the full investigation
Include the names and job titles of those who
took part in the employer’s incident investigation.

Guide to Completing an Employer Incident Investigation Report (EIIR) page 4 of 6

Section 19: Other relevant workplace parties The Word template also has dynamic fields you can
Depending on the nature of your workplace, there type in. You may wish to customize the template by
may be other people, such as prime contractors or adding a company logo, more fields for tracking and
property owners, who have duties or categorizing incidents, or more rows in different
responsibilities for workplace safety. Identify any sections (for complex or large investigations).
other person actively involved in the incident, and
include the name and contact information for these Do I have to use the EIIR template?
other workplace parties, if applicable. Employers are not required to use the template.
You can choose to continue using your own
methods of recording incident investigations on
The information you provide in sections
your own forms.
1 to 19 is sufficient to satisfy your legal
obligation to prepare a full incident Regardless of the reporting format used, your
investigation report. You must provide this reports must contain the information required by
report to your joint occupational health Policy D10-175-1 and Policy D10-176-1 in order
and safety committee (or worker health to comply with sections 175(2)(a) and 176(2)(a) of
and safety representative, if applicable). the Act.
If there is no joint committee or worker
representative, the reports must be posted in If you are using your own form, please attach a
the workplace. cover sheet that includes any required information
that isn’t covered in your form. The cover sheet
should include:
•• Your WorkSafeBC account number and
Step 4: Full corrective action report operating location
If there are still outstanding, incomplete corrective •• The type of report you are submitting (full
actions when you write the full investigation investigation or other)
report, then you may be unable to complete the •• The type of incident (for example, a minor
full corrective action report at that time. When all injury, a near miss, or a serious injury)
the corrective actions have been completed, open
the full investigation report and rename it (full What are the timelines?
corrective action report). Add the completion
You must initiate the preliminary investigation
dates in section 17 (and section 9, if any).
immediately and complete a preliminary
You must provide this report to your joint investigation report within 48 hours of the
occupational health and safety committee (or worker incident. You must also initiate the full investigation
safety representative, if applicable). If there is no and submit the full investigation report to
joint committee or worker representative, you must WorkSafeBC within 30 days of the incident,
post the report in your workplace. Don’t send this unless WorkSafeBC grants an extension.
report to WorkSafeBC unless an officer asks for it.
Depending on the complexity of the incident, you
might be able to complete your full investigation
What formats is the EIIR template
report within 48 hours. (See “Can I combine
available in? reports?”)
The template is available in two formats: PDF and
Word. The PDF template is dynamic — you can The 48-hour period can be extended if it expires
type in the fields. However, it can’t be customized on a Sunday or other holiday, or it expires on a
with additional fields. day you are not normally open.

Guide to Completing an Employer Incident Investigation Report (EIIR) page 5 of 6

You must provide the corrective action report to When can I combine reports?
your joint occupational health and safety committee
Depending on the complexity of the incident
(or worker safety representative, if applicable) as
investigation, it may be possible to complete the full
soon as possible after the corrective action occurs.
investigation report and resulting corrective action
within 48 hours. In this situation, you may combine
How should I organize my one or more reports as long as you meet all the
investigation files? requirements and complete the reports within the
We recommend that when an incident occurs required time. Policy D10-176-1 describes what to
you open the template and save it as a Word or do when the incident investigation and resulting
PDF file with a name that indicates the date of the corrective action are completed within 48 hours.
incident, the injured worker’s name, and the type
of report. For example, you could save a file as: Who needs to conduct the investigation?
“2015-12-27 John Doe – Preliminary” Your incident investigation must be carried out by
If there was no injury, a near-miss incident could people who are knowledgeable about the type of
be saved as: work involved. The employer, or a representative
“2015-12-27 Near Miss – Preliminary” of the employer, and a worker representative
must participate if they are reasonably available.
When you move to step 2 (the corrective action That means each investigation will be carried out
report), open the preliminary report, rename it, and by at least two people, maybe more for complex
update the information. For example, rename the file investigations. For guidance on how to determine
“2015-12-27 John Doe – Interim” whether a worker representative is “reasonably
available” to participate in an employer incident
When you have completed the full investigation,
investigation consult Guideline G-D10-174-1
open the interim file, rename it, and complete the
Participation by worker representatives in
information in sections 15 to 19. For example,
incident investigations.
rename the file:
“2015-12-28 John Doe – Full” Participation in the investigation will include:
•• Viewing the scene of the incident with those
When you have completed all the corrective
carrying out the investigation
actions, it is time to complete the full corrective
•• Providing advice to the people carrying out the
action report. Open the full report, rename it, and
investigation
finalize the information in section 17. For example,
•• Any other activities prescribed by WorkSafeBC
rename the file:
“2015-12-28 John Doe – Corrective” People participating in the investigation must have
adequate training to be able to fulfill their
Naming and organizing your files in this way,
responsibilities. They should understand the
helps keep all reports together and minimizes
investigation process and be able to analyze the
re-entering data in the reports.
sequence of events to find all factors contributing
to the incident.
Can I hand write the full investigation
report?
Both the Word and PDF versions of the template
are formatted to be printed and may allow enough
space for you to write in the needed information.
You could then scan the print document as either
a PDF or JPG file and submit it online.

Guide to Completing an Employer Incident Investigation Report (EIIR) page 6 of 6