BC Incident Investigation Report Template

What a BC incident investigation report is for

When a worker is hurt, or nearly hurt, in a British Columbia workplace, the Workers Compensation Act does not just ask the employer to fill in a form. It requires an investigation in two stages, carried out by people who know the work, with a worker representative taking part, and it sets fixed deadlines for each written report. The reports are the employer's evidence that the investigation happened properly and that the hazards it found were fixed. WorkSafeBC officers ask for them after serious incidents, and they are often the first documents reviewed when a claim, an inspection order or a penalty is in question.

This template turns those obligations into one working file. It starts with a checklist for the first hour, tracks every deadline, and then walks the investigators through the preliminary report, the interim corrective actions, the full investigation and the final corrective action report in the order the Act sets out. Supervisors, safety coordinators, joint committee members and small business owners can use it without having read Division 10 of the Act first, because the requirements are built into the headings.

When to use it

Start a new copy immediately after any incident listed in section 69: one that must be reported to WorkSafeBC immediately, any injury that needs medical treatment beyond first aid, and any near miss or minor injury that could have caused a serious injury. Major structural failures, hazardous substance releases and fires or explosions with serious potential are included even when nobody was hurt.

You do not need it for a first-aid-only injury with no potential for serious harm, or for a vehicle collision on a public road. Psychological injuries, including bullying and harassment complaints, follow your bullying and harassment procedure instead; WorkSafeBC only wants an incident report for those if an officer asks for one.

What's inside

The full list of sections and fields in this template, in the order they appear.

1. First Hour Checklist

   • Immediately reportable incident types
   • Immediate notice record
   • Scene protection
   • First aid and lockout
   • Committee notified
   • Witnesses held
   • Form 7 reminder

2. Deadline Tracker

   • 48-hour preliminary report
   • Delivery to committee or posting
   • Interim corrective action report
   • 30-day full report to WorkSafeBC
   • Full corrective action report
   • Extension

3. Employer Information

   • Legal name
   • WorkSafeBC account number
   • Workplace address
   • Supervisor at the time
   • Investigation contact

4. The Incident

   • Exact location
   • Date
   • Time
   • Work being done
   • Type of occurrence
   • Report types covered

5. People Involved

   • Injured workers and injuries
   • Witness names
   • addresses and phones
   • Other people needed for the investigation

6. Investigation Team

   • Employer representative
   • Worker representative
   • Person knowledgeable about the work
   • Participation and signatures
   • Explanation if a representative was unavailable

7. Preliminary Investigation

   • Sequence of events
   • Unsafe conditions
   • acts or procedures
   • Nature of serious injury
   • Brief description
   • Interim corrective actions table
   • Incomplete areas
   • Sign-off and delivery

8. Full Investigation

   • Scope
   • Evidence gathered
   • Immediate causes
   • Underlying factors by area
   • Root cause worksheet
   • Updated findings
   • Recommended corrective actions with control type
   • Incomplete areas

9. Full Corrective Action Report

   • Action taken
   • Person responsible
   • Date completed
   • Effectiveness check
   • Outstanding actions

10. Distribution and Submission Record

    • Committee or representative copy
    • Posting
    • WorkSafeBC submission method and confirmation

11. Sign-off

    • Employer representative
    • Worker representative
    • Approving manager

12. Witness Statement

    • Witness details
    • Five structured questions
    • Signature

13. Evidence and Photo Log

    • Item number
    • Description
    • Collected by
    • Date and time
    • Storage location

14. Scene Sketch

    • Positions
    • Equipment
    • North arrow
    • Measurements

Preview pages

How to complete the report

1. Work through the First Hour Checklist. Decide whether the incident must be phoned in to WorkSafeBC immediately, record the call, and protect the scene. Note who was told and which witnesses were asked to stay.
2. Fill in the Deadline Tracker. Write the exact 48-hour and 30-day dates as soon as you know the incident time, so nobody has to calculate them later.
3. Record the employer, incident and people involved. Capture the exact location and the task under way. Write down every witness's address and phone number; the Act requires you to record them.
4. Name the investigation team. Include an employer representative, a worker representative and someone who knows the work. If a representative was not reasonably available, say why.
5. Complete the preliminary investigation within 48 hours. Build the sequence of events, identify the unsafe conditions, acts or procedures that significantly contributed, and assign interim corrective actions with names and dates. Explain anything you could not yet find out.
6. Share the preliminary report. Give it to the joint committee or worker representative as soon as it is done, or post it if there is neither. Send it to WorkSafeBC only if asked.
7. Finish the full investigation within 30 days. Gather the evidence listed in Part 6, work through the underlying factors by area, use the root cause worksheet, and recommend corrective actions, preferring controls that remove the hazard over warnings and PPE.
8. Submit and distribute the full report. Send it to WorkSafeBC and give it to the committee or worker representative within 30 days of the incident. Log both in Part 8.
9. Close out the corrective actions. Complete Part 7 as each action is finished, check that it worked, and report it to the committee.

Example: a completed preliminary excerpt

A fictional distribution company in Kelowna had a near miss when a pallet of bottled water fell from a racking shelf beside a picker:

Type of occurrence: No injury, but with potential for serious injury. Sequence of events: 06:40 night shift restocks aisle 7 and places a pallet overhanging the beam by about 20 cm. 07:55 forklift reverses into the upright at aisle 7, bay 4. 08:10 picker Jordan Ames works below bay 4. 08:12 the overhanging pallet falls 3.2 m and lands 1 m from Ames. Unsafe conditions and acts: Pallet overhanging the beam beyond the posted limit; upright struck by a forklift and not reported; no exclusion zone during picking. Interim corrective actions: Aisle 7 closed and the upright tagged out (Warehouse Supervisor, done 08:30); all overhanging loads in aisles 5 to 9 restacked (Shift Lead, done 11:00); forklift operators reminded to report any racking contact (Operations Manager, done before the next shift).

The preliminary report was finished at 14:00 the next day, inside the 48 hours, and handed to the joint committee co-chairs that afternoon. The full investigation then looked past the forklift contact to the underlying factors: no racking inspection schedule, and a night-shift restocking procedure that never mentioned beam overhang.

British Columbia rules to know

These requirements come from Part 2, Division 10 of the Workers Compensation Act and WorkSafeBC's Prevention Policies. Check the OHS Regulation for any additional incident types in your industry.

• Immediate notice (section 68). Serious injury or death, major structural failure or collapse, major release of a hazardous substance, fire or explosion with potential for serious injury, and incidents named by regulation must be reported to WorkSafeBC immediately. The scene must not be disturbed except to help the injured, prevent further harm or protect endangered property.
• Incidents to investigate (section 69). Everything reportable under section 68, injuries requiring medical treatment, and near misses with potential for serious injury. Public-road vehicle accidents are excluded.
• Who investigates (section 70). People knowledgeable about the work, with an employer representative and a worker representative if reasonably available. Witnesses must be made available, and their names, addresses and phone numbers recorded.
• Preliminary investigation (section 71). Start immediately; complete the report within 48 hours; give it to the joint committee or worker representative, or post it; take interim corrective action without undue delay and report on it.
• Full investigation (section 72). Determine the causes, submit the report to WorkSafeBC within 30 days, share it the same way, then report on the corrective action taken. WorkSafeBC may extend the 30 days.
• Report contents (Prevention Policy items P2-71-1 and P2-72-1). Your own format is acceptable if it contains the required information.
• No discouraging claims (section 73). An employer or supervisor must not discourage a worker from reporting an injury or hazard, or from claiming compensation.

Mistakes that weaken an investigation

The most common weakness is a report that stops at "worker did not pay attention". WorkSafeBC expects investigators to ask why the unsafe act or condition existed: missing training, an unclear procedure, equipment that was never inspected, production pressure. Other frequent problems are missing the 48-hour deadline because the preliminary report waited for the full facts, leaving out the worker representative, not recording witness contact details, and corrective actions with no named person or date. Each part of this template is set up so those gaps are visible before the report is signed.