What Should a Small Business Do When a Worker Is Seriously Hurt?

By Bill Stilwell · Last reviewed October 17, 2026

The short answer

When someone is seriously hurt, get emergency help first. Then, if the person is your employee, federal law says you must report a work-related death to the Occupational Safety and Health Administration (OSHA) within 8 hours, and an in-patient hospital stay, amputation, or loss of an eye within 24 hours. After that, write down what happened, keep the evidence, and call your workers’ compensation or liability insurer.

What this means

The outline asks for four parts: emergency response, documentation, insurance, and reporting.

Emergency response: call 911, give first aid if trained, keep others safe, and stop the work that caused the injury.
Documentation: record who, what, when, where, and how, with photos and witness names.
Insurance: tell your workers’ compensation carrier if an employee is hurt, or your general liability carrier if a customer or visitor is hurt.
Reporting: report to OSHA, or your state’s safety agency, when the rules require it.

Made-up example: A crew member at Summit Tree Care falls from a ladder and is admitted to the hospital overnight. The crew lead calls 911, stops all ladder work, and calls the owner. The owner reports the hospitalization to OSHA by phone that afternoon, well inside 24 hours. She fills out an incident report, saves photos of the ladder, and calls her workers’ compensation carrier to open a claim.

Why it matters

Deadlines are short. OSHA’s 8-hour and 24-hour clocks start when you learn of the event.
Small employers still have to report. OSHA says even employers exempt from routine injury records must report these severe events.
Late claims cause problems. Workers’ compensation rules set deadlines for reporting injuries. These vary by state.
Evidence fades fast. Equipment gets moved and memories change. Photos and statements taken the same day matter.

Who this applies to

Every business. OSHA reporting applies when the injured person is your employee. If a customer, vendor, or visitor is hurt, OSHA reporting doesn’t apply, but your liability insurer still needs to know. Solo owners with no employees should still have the emergency and insurance steps ready.

Many states run their own OSHA-approved safety programs. OSHA says their rules must be at least as effective as federal rules, and some differ. Check whether your state runs its own plan.

How to do it

Prepare now:

Post a response card near the first aid kit and in every work vehicle. Include 911, the address of the job site or shop, your workers’ comp carrier, your liability carrier, and OSHA’s 24-hour line, 1-800-321-6742.
Train people on what to do first, who to call, and how to stop work safely (see 11.4.2 Safety Training and 11.4.7 Stop-Work Procedure).
Keep a blank incident report form ready (see 11.4.5 Incident Reports).
Know your state rules for workers’ compensation claims and safety reporting (see 10.3.7 Workers’ Compensation).

If it happens:

Get help. Call 911. Give first aid only if trained. Keep others away from the hazard.
Stop the work that caused the injury until it’s safe.
Call the owner or manager right away.
Report to OSHA if required. A work-related death within 8 hours. An in-patient hospitalization, amputation, or loss of an eye within 24 hours. Call the nearest OSHA office, the 24-hour line, or use OSHA’s online form. OSHA says voicemail, fax, and email don’t count. Emergency room treatment alone isn’t reportable.
Document it. Fill out the incident report, take photos, list witnesses, and save the equipment or materials involved.
Call your insurer. Workers’ compensation for employees, general liability for others.
Support the injured person and their family. Stay in touch, and keep personal health details private.
Find the cause and fix it before the work starts again.
Talk to your attorney before making public statements if a claim is possible.

What proof to keep

The completed incident report
Photos of the scene and equipment
Witness names and written statements
OSHA report confirmation or the name of the person you spoke with and the time
Insurance claim numbers
Records of what you changed afterward

Store these in a restricted folder. Keep health details separate from general files.

Common mistakes

Thinking a small business doesn’t report. The severe injury reporting rule still applies.
Leaving a voicemail for OSHA. It doesn’t count as a report.
Waiting to see how bad it is. If someone is admitted to the hospital, the 24-hour clock is running.
Cleaning up the scene too fast. Take photos first, unless leaving it creates more danger.
Posting about it online or replying to reviews in detail. Stay brief and private (see 14.6.3 Review Responses).
Treating a customer injury as no big deal. Tell your liability insurer, even if the person says they’re fine.

When to get help from a pro

Insurance agent: to open the claim and learn what the carrier needs. Employment attorney: if the injury is serious or a claim is likely. Safety consultant: to find and fix the cause. Questions to ask:

Does this injury need to be reported to OSHA or our state safety agency, and by when?
What does our workers’ compensation carrier need from us this week?
What should and shouldn’t we say to the injured worker’s family and to the public?

Bill’s note

[Bill: add a short note. For example, a lesson from a client in the trades about how they handled a serious injury, or why SiteSmarty keeps a printed response card even as a mostly office business.]

How I did this for SiteSmarty

[Date I did this:]
[What I actually did, step by step: the response card, first aid kit location, and insurer contacts for SiteSmarty]
[What it cost and how long it took:]
[What surprised me or what I’d do differently:]
[Screenshot or photo to add, with private info blurred: the posted response card]
[Result so far:]

Questions people ask

When do I have to report a work injury to OSHA? A work-related death within 8 hours. An in-patient hospitalization, amputation, or loss of an eye within 24 hours.

Does a small business have to report injuries to OSHA? Yes, for these severe events. OSHA says employers exempt from routine injury records must still report them.

Do car crashes on public roads count? OSHA says injuries from a motor vehicle accident on a public street or highway aren’t reportable to OSHA, except in a construction work zone. See 11.9.7 Vehicle Accident for the other steps.

Who do I call if a customer is hurt on my property? 911 if needed, then your general liability insurer.

Audit check

Question: Does the business have a written severe injury plan that covers emergency response, documentation, insurance, and OSHA reporting deadlines?
Pass looks like: A posted response card with OSHA’s number and both insurers, incident report forms on hand, trained staff, and known state rules.
Fail looks like: No plan, no one knows the reporting deadlines, insurer numbers buried in email.
Evidence to collect: The response card, blank and completed incident reports, training records, and insurance policy contact pages.

Where this fits

Do this first: 11.4.1 Hazard Identification, 11.4.2 Safety Training, 11.4.5 Incident Reports, 10.3.7 Workers' Compensation

Do this next: 11.9.7 Vehicle Accident

Sources

Occupational Safety and Health Administration, "Report a Fatality or Severe Injury" (checked October 17, 2026)
Occupational Safety and Health Administration, 29 CFR 1904.1, partial exemption for employers with 10 or fewer employees (checked October 17, 2026)

This page explains general rules and Bill's own experience. It is not legal, tax, or insurance advice. Talk to a qualified professional about your situation.