New Brunswick incident report template

New Brunswick rules for this report

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

• The employer notifies the Commission immediately if an employee suffers an injury resulting in loss of consciousness, an amputation, a fracture other than to fingers or toes, a burn that requires medical attention, loss of vision in one or both eyes, a deep laceration, admission to hospital as an in-patient, or death, and immediately tells the committee or health and safety representativeOccupational Health and Safety Act, S.N.B. 1983, c. O-0.2, s. 43 (1), (2)
• The employer also notifies the Commission immediately of an accidental explosion or an accidental exposure to a biological, chemical or physical agent at the place of employment, whether or not anyone is injured, and of a catastrophic event or catastrophic equipment failure that results, or could have resulted, in an injury (not for vehicle accidents on public roads)Occupational Health and Safety Act, s. 43 (4), (5)
• Unless an officer orders otherwise, no one disturbs the scene of an accident that results in serious injury or death, except to attend to the injured or dead, prevent further injury, or protect endangered propertyOccupational Health and Safety Act, s. 43 (3)
• On the Commission's form, the employer reports the accident and its nature, the day and time, the injured worker's name and address, the place, and the attending physician or surgeon, within three days after a worker suffers an injury that may entitle them to compensation or medical aid (first aid by the employer excluded), a worker is diagnosed with an occupational disease, or the employer first learns of the accident from the worker's notice; late reports can bring an administrative penaltyWorkers' Compensation Act, R.S.N.B. 1973, c. W-13, s. 44 (4), (4.1), (4.2)
• Every employer has a procedure requiring workers to tell the employer of an accident the employer must report; a worker's notice gives their name and address, the cause of the injury in ordinary language, and where it happenedWorkers' Compensation Act, s. 44 (5.1), (7)
• An employer with 20 or more employees has a written health and safety program that includes a system for the prompt investigation of hazardous occurrences to find their causes and the actions needed to prevent them happening again; the joint health and safety committee may take part in all investigations, in particular of the occurrences reportable under s. 43Occupational Health and Safety Act, ss. 8.1 (1), 15 (j)

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 12, 2026. Read the full New Brunswick incident report requirements.