What this is
What is a lost time report?
What is a lost time report?
It is the record raised once a work injury keeps a worker away from work beyond the day it happened. It is completed jointly by the supervisor and HR, and it carries the case through days-away tracking, a workers' compensation claim where applicable, and into return-to-work planning. It supersedes the medical treatment record as the case's severity increases.
When does an injury become 'lost time' rather than 'medical treatment'?
The moment the worker does not return for their next scheduled shift because of the injury. A case can start as a medical treatment record and be escalated to lost time the day the absence is confirmed — the two are stages of the same case, not separate injuries.
Does the day of injury count as a lost day?
No. OSHA 1904.7(b)(3)(i) is explicit that the day the injury occurred is excluded from the days-away count. Counting begins with the next calendar day the worker was scheduled to work and did not.
Scope
When is a lost time report required?
This record exists for the point a case crosses from treated-and-back-at-work into genuinely away from work. Raising it too early inflates the lost time count; raising it too late leaves a case running with no formal tracking at all.
Use this template when
- A worker has not returned for their next scheduled shift because of a work injury, and the absence is confirmed rather than anticipated
- The case already exists as an incident or medical treatment record and now needs escalating because time away has begun
- A workers' compensation claim is being filed, or is being confirmed as not applicable
- Restrictions or an expected return date need tracking against a return to work notification
- An ergonomic or musculoskeletal component needs a linked assessment before the worker returns
Do not use it for
- Medical Treatment Report, which records an injury needing treatment beyond first aid where the worker is still at work.
- First Aid Report, which records a minor injury treated on site with no further medical care needed.
- Return to Work Notification, which formally clears the worker back once this case's return conditions are met.
- Incident Report, which records the original unplanned event before any severity determination is made.
- Anything outside KnowSafe, which belongs in the workspace that owns that process.
Compliance mapping
Which OSHA 1904.7 requirements does this satisfy?
The form exists to answer one question precisely enough to defend it later: how many days was this worker actually away, and what has to happen before they come back.
| Clause | Requirement | Where it lands |
|---|---|---|
| OSHA 1904.7(b)(3)(i) | Excludes the day of injury from the days-away count; counting begins the next scheduled day missed. | Lost time detail |
| OSHA 1904.7(b)(3)(ii) | Permits the count to be capped once it reaches 180 calendar days, with an estimate recorded rather than an indefinite tally. | Lost time detail |
| OSHA 1904.7(b)(1) | Confirms the case is work-related before any days-away determination applies. | Event |
| OSHA 1904.29(b)(3) | Records must be entered within seven calendar days of the employer learning the case is recordable. | Event |
| OSHA 1904.39(a) | Severe outcomes such as in-patient hospitalisation carry a faster, separate reporting duty distinct from ordinary lost time recording. | Immediate response |
| WCB reporting rules (jurisdiction-specific) | A claim must typically be filed within a fixed number of days of the employer learning of a lost time injury. | Lost time detail |
| Internal return-to-work policy | An expected return date and any restrictions must be tracked against a formal return to work notification before the case closes. | Lost time detail |
What it does not cover
- Days Away So Far left at its opening estimate for weeks, which hides the true, worsening severity of a case that is still open.
- Last Day Worked entered as the injury date itself, which miscounts the days-away total from the very first entry.
- Claim Submitted marked No with no reason recorded, which leaves it unclear whether the claim was missed, declined, or genuinely not applicable.
- Ergonomic Assessment Needed skipped on a musculoskeletal injury, which sends the worker back into the same task without the review that usually explains why the injury happened.
- Return To Work Notification ID never populated at case close, which means the worker's return was never formally confirmed against the conditions this case set.
Global
Lost Time Report requirements by country
Lost time sits at the intersection of federal injury recordkeeping and provincial or state compensation law, and the two run on separate clocks.
29 CFR 1904.7(b)(3)
Sets the mechanics of the days-away count itself — excluding the injury day, and permitting a capped estimate past 180 days — independent of any compensation claim.
The OSHA 300 log entry and the workers' compensation claim are governed by different rules and can disagree on the exact day count; both need tracking, not just one.
Provincial workers' compensation legislation
Each province sets its own claim-filing deadline, wage-replacement rules and return-to-work obligations, and these run alongside — not instead of — any federal recordkeeping duty.
Claim Submitted and Claim Reference need to reflect the specific provincial board the worker falls under, since the filing deadline and required forms differ by province.
Local injury and illness reporting frameworks (e.g. RIDDOR in the UK for over-seven-day incapacity)
Days-away thresholds and reporting duties are defined differently outside North America; the OSHA 180-day cap and WCB claim mechanics do not transfer directly.
Use the days-away figures captured here as an operational record, but confirm the applicable local reporting threshold separately before relying on this form for a statutory filing.
How to complete it
How to complete a lost time report, step by step
The fields are straightforward to fill once the facts are known. The defensibility of the case rests on a smaller set of calls that are easy to get casually wrong.
The injury day itself is excluded by rule. Last Day Worked should record the last day the worker actually worked, and the count of Days Away So Far should begin from the next scheduled day missed, not from the date of the incident.
Not eligible and No look identical on a summary report but mean very different things — one is a policy determination, the other is a gap. The distinction only holds if whoever enters it actually checked eligibility rather than defaulting to No when unsure.
A worker who is medically restricted but performing modified duty on site is not the same as a worker who is fully away — conflating the two either overstates or hides the lost time count depending on which way the error runs.
For a musculoskeletal injury, deferring the ergonomic assessment until after return to work usually means the worker goes back into the exact task that caused the injury with nothing changed. The assessment earns more from being opened while the case is still active.
What auditors find
Most common lost time report findings
Auditing closed lost time cases against payroll and the linked health case tends to surface the same handful of gaps.
| Finding | Clause | What fixes it |
|---|---|---|
| Days Away So Far unchanged from the case's opening entry despite the worker still being off weeks later. | OSHA 1904.7(b)(3)(i) | Require a periodic revisit of the days-away figure on any case still open past a set number of days. |
| Last Day Worked recorded as the same date as the injury, undercounting the true absence. | OSHA 1904.7(b)(3)(i) | Validate Last Day Worked against the incident date and flag same-day entries for review. |
| Claim Submitted marked Not eligible with no supporting reason on file. | WCB reporting rules | Require a short reason whenever the eligibility determination is anything other than a straightforward Yes. |
| Investigation Level left at a lighter tier despite the case being lost time by definition. | Internal investigation policy | Default lost time cases to a minimum investigation tier rather than leaving the level field open to judgement. |
| Ergo ID never populated on cases with Ergonomic Assessment Needed marked Yes. | Internal return-to-work policy | Block case closure until the linked ergonomic assessment reference exists. |
| Return To Work Notification ID blank on cases already showing an Expected Return Date in the past. | Internal return-to-work policy | Surface an overdue flag once the expected return date passes without a linked notification. |
Case in point
Case in point: the estimate that never moved
A worker strained their back lifting a tote in the chill store and was expected to be off for roughly a week — that estimate went into Days Away So Far the day the case was opened, and the case sat there through the supervisor's next few weeks of shift changes and holiday cover.
Six weeks later, HR pulled the case while reconciling workers' compensation payments and found the worker was still off, the claim had been running the entire time, and the ergonomic assessment that should have looked at the lifting task had never been opened. The days-away figure on the case bore no relation to the days-away figure the compensation board had on file, and reconciling the two took longer than the original investigation would have.
The template
The template, field by field
The form exactly as it installs. Every field, option, score and conditional rule is editable, and the links to other templates come with it.
7 sections
- Reference
- SAF-005
- Archetype
- Record
- Record ID
- CASE-2026-000
- Scoring
- Actual severity
- Direction
- High is bad
- Singleton
- No
- Basis
- OSHA 1904.7, WCB reporting
- Links
- Feeds RCA, Return to Work
- Tags
- Incident, Lagging
- Sections
- 7
- Fields
- 52
- Follow up fields
- 14
- Repeating sections
- 0
- Links out
- 9
Event
6 fieldsCase ID*
Auto sequence. Format CASE-2026-00000.
The record's own ID. Other templates point at this value.
Status*
Drives who this goes to next.
- Planned2 pts
- In progress2 pts
- Complete3 pts
- Deferred0 pts
- Open0 pts
- Closed3 pts
- Overdue0 pts
Date and Time of Event*
Date Reported*
A gap between these two is worth understanding on its own.
Reported By*
Person ID*
Format PER-0000.
Links to FDN-003 Person ID
Where
4 fieldsSite*
Site ID*
Format SITE-000.
Links to FDN-001 Site ID
Area*
The area within the site.
Exact Location
Drop a pin for anything hard to find.
What happened
7 fieldsDescription*
Facts only. What happened, in the order it happened.
Photographs
Wide shots and close ups, before anything is moved.
Equipment Involved*
Asset
Asset ID
Format AST-0000.
Links to FDN-002 Asset ID
Was Machine Running
Guard Or Control In Place
- Yes, correctly fitted2 pts
- Yes, but bypassed0 pts
- No0 pts
Lost time detail
13 fieldsInjured Person*
Person ID*
Format PER-0000.
Links to FDN-003 Person ID
Body Part*
Injury Type*
Last Day Worked*
Days Away So Far*
Expected Return Date
Return To Work Notification ID
Links to SAF-011 Notification ID
Claim Submitted*
- Yes3 pts
- Not eligible2 pts
- No0 pts
Claim Reference
Health Case ID
Links to HLT-016 Case ID
Ergonomic Assessment Needed
Almost always yes for a musculoskeletal injury.
Ergo ID
Links to ERG-006 Assessment ID
Severity and potential
6 fieldsSeverity Guidance
Lost time is always investigated at level 3 or above. Potential still matters, because the same event could have been far worse.
Actual Severity*
- No injury4 pts
- First aid3 pts
- Medical treatment2 pts
- Lost time1 pt
- Fatality0 pts
Maximum Potential Loss*
The worst credible outcome had circumstances been slightly different.
- Minor4 pts
- Moderate3 pts
- Serious2 pts
- Fatal or catastrophic0 pts
Investigation Required*
Set by potential outcome, not by what actually happened.
- No3 pts
- Yes0 pts
Investigation Level
RCA ID
Format RCA-2026-00000.
Links to FDN-013 RCA ID
Immediate response
8 fieldsImmediate Action Taken*
What was done to make the area safe before anyone left.
Area Made Safe*
Scene Preserved
Work Stopped
Reportable To Regulator*
- No3 pts
- Yes0 pts
Regulator
Notification Reference
Links to SAF-010 Notification ID
Notification Made
Follow up
8 fieldsAction Required*
Raise the action record, then enter its reference here.
- No2 pts
- Yes0 pts
Priority
- High0 pts
- Medium1 pt
- Low3 pts
CAPA ID
Format CAPA-2026-00000.
Links to FDN-014 CAPA ID
Action Owner
Supervisor*
Signature*
Site Manager*
Second Signature*
SAF-005 · record IDs look like CASE-2026-000 · Feeds RCA, Return to Work
Open in KnowellaRun it with agents
From a document you fill in to a programme that runs itself
The single days-away number is easy to enter once; keeping it current, and keeping the claim and return-to-work threads moving in step with it, is the part that actually slips over a multi-week case.
Holds the lost time case against the incident it escalated from, flags cases whose days-away figure has gone stale, and keeps the investigation and RCA links intact.
Tracks the linked health case and restrictions through to the return-to-work date, reconciling it against what actually happens on the ground.
Runs the linked ergonomic assessment for musculoskeletal cases, so the task that caused the injury gets reviewed before the worker returns to it.
Coordinates the crew across KnowSafe, KnowHealth and KnowErgo, surfaces overdue return-to-work and claim gaps in one view, and holds every write for your approval before it touches a record.
This template lives in KnowSafe — safety and compliance. Incidents, hazards, permits, inspections and the critical controls behind them.
Meet KnowSafe→Glossary
Lost Time Report definitions and key terms
- Days away from work
- OSHA's count of calendar days a worker was unable to work due to a recordable injury, excluding the day of the injury itself.
- WCB
- A workers' compensation board — the provincial or state body administering injury claims, wage replacement and return-to-work obligations.
- Restricted work case
- A case where the worker is medically limited in duties but still performing modified work, distinct from a full lost time case.
- Return to work notification
- The formal confirmation that a worker has met the conditions to resume normal duties, closing out the lost time case.
- Ergonomic assessment
- A task-level review of the physical demands behind a musculoskeletal injury, used to change the task before the worker returns to it.
FAQ
Frequently asked questions about lost time report
Who completes the lost time report?+
The supervisor together with HR, once it is confirmed the worker will not return for their next scheduled shift because of the injury. It is typically an escalation of an existing incident or medical treatment case rather than a fresh report.
Does the day of the injury count as a lost day?+
No. OSHA excludes the injury day itself from the days-away count. The count starts with the next calendar day the worker was scheduled to work and did not.
Is a lost time case always investigated?+
Yes, as a rule — lost time cases carry enough actual and potential severity that they are treated as requiring at least a formal investigation, with the level set by potential outcome rather than how the case actually resolved.
What if the workers' compensation claim is declined?+
The lost time record stays as-is; Claim Submitted should reflect what actually happened, and a declined or not-eligible claim is recorded with its reason rather than left ambiguous alongside a genuine No.
Why does this form ask about ergonomic assessment?+
Musculoskeletal injuries are the largest single category behind lost time, and returning a worker to an unchanged task without reviewing it tends to reproduce the same injury.
How does this case close?+
Once the worker meets the conditions to return, a return to work notification is issued and linked back to this case by ID, and the expected return date is reconciled against what actually happened.
Keep going
Related templates and programmes
Industries this is written for
Programmes this belongs to
Used together in Incident and Investigation
Root Cause Analysis
Finds out why something happened rather than who was involved
Corrective and Preventive Action
The single action record used everywhere
Finding
Records a single deficiency picked up during an audit, inspection or check
Effectiveness Verification
Checks whether an action actually worked, some time after it was put in place
Just Culture Determination
Separates a system problem from a genuine choice to take a risk, using a consistent set of questions
Extent of Condition Review
Asks two questions after an investigation: where else does this same condition exist, and where else could this same cause bite us
More in Incidents
Incident Report
Records any unplanned event that caused harm, damage or loss
Near Miss Report
Records something that could have caused harm but did not
First Aid Report
Records a minor injury treated on site with no further medical care needed
Medical Treatment Report
Records an injury needing treatment beyond first aid
Property Damage Report
Records damage to equipment, buildings or stock where nobody was hurt
Vehicle Incident Report
Records a collision or vehicle event on site involving forklifts, yard trucks or visiting vehicles
Written and reviewed by
Siddarth Singh
Founder & Chief Executive Officer, Knowella
Certified Safety Professional and industrial and systems engineer with more than a decade inside food supply chain, freight and manufacturing operations. This page was written against the current text of the standards it cites, not against secondary summaries of them.
- Certified Safety Professional (CSP), Board of Certified Safety Professionals
- MBA, University of Chicago Booth School of Business
- MS and BS, The Ohio State University, Industrial and Systems Engineering
- Six Sigma Black Belt
Sources and last review. Reviewed 16 August 2026 against:
- OSHA 29 CFR 1904.7(b)(3) — Recording days away from work
- OSHA 29 CFR 1904.29 — Forms and completion timing
- OSHA 29 CFR 1904.39 — Reporting fatalities, hospitalisations, amputations and loss of an eye
- Provincial workers' compensation board (WCB) reporting requirements
This page is general guidance, not legal advice. Confirm requirements with your jurisdiction’s regulator.