Work Injury Incident Report (Kenya)
WORK INJURY INCIDENT REPORT
Work Injury Benefits Act No. 13 of 2007 — Section 22 | Occupational Safety and Health Act No. 15 of 2007 — Section 26
To be filed with the Directorate of Occupational Safety and Health Services (DOSH) within 24 hours of the accident
Report completed by: [Report Completed By]
Date of report: [Report Date]
SECTION 1 — EMPLOYER DETAILS
Employer name: [Employer Name]
Business address: [Employer Address]
BRS registration number: [Employer BRS Number]
KRA PIN: [Employer KRA PIN]
Nature of industry: [Industry Type]
Total employees at this workplace: [Total Employees]
WIBA insurer: [WIBA Insurer]
WIBA policy number: [WIBA Policy Number]
SECTION 2 — INJURED WORKER DETAILS
Full name: [Worker Name]
NIC number: [Worker NIC Number]
Date of birth: [Worker DOB]
Gender: [Worker Gender]
Job title and department: [Worker Job Title]
Employment type: [Employment Type]
Date of commencement of employment: [Employment Start Date]
Normal monthly earnings: [Worker Monthly Earnings]
NSSF membership number: [Worker NSSF Number]
SECTION 3 — ACCIDENT DETAILS
Date of accident: [Accident Date]
Time of accident: [Accident Time]
Location within workplace: [Accident Location]
Task being performed: [Task At Accident]
Description of how the accident occurred:
[Accident Description]
Immediate cause: [Immediate Cause]
Root / underlying cause: [Root Cause]
Witnesses: [Witness Names]
SECTION 4 — INJURY AND MEDICAL TREATMENT
Part of body injured: [Body Part Injured]
Nature of injury: [Nature Of Injury]
Classification of injury (Second Schedule, WIBA): [Injury Classification]
Hospital / clinic: [Hospital Name]
Treating doctor (KMPDC Reg. No.): [Doctor Name]
Hospitalised: [Hospitalised]
SECTION 5 — IMMEDIATE ACTIONS AND CORRECTIVE MEASURES
Immediate actions taken:
[Immediate Actions]
Corrective actions to prevent recurrence:
[Corrective Actions]
SECTION 6 — DECLARATION
The undersigned declare that the information provided in this Work Injury Incident Report is accurate and complete to the best of their knowledge, and that this report has been filed with the Directorate of Occupational Safety and Health Services (DOSH) at [DOSH Regional Office] within 24 hours of the accident as required by Section 22 of the Work Injury Benefits Act No. 13 of 2007.
The WIBA insurer ([WIBA Insurer], Policy No. [WIBA Policy Number]) has also been notified of this accident simultaneously with this DOSH notification, in accordance with the terms of the WIBA policy.
Safety and Health Officer: [Safety Officer Name]
Authorised Employer Representative
________________
Signature
Safety and Health Officer
________________
Signature
What Is a Work Injury Incident Report (Kenya)?
A Work Injury Incident Report in Kenya organises the details a party must supply for the purpose it serves.
The Occupational Safety and Health Act No. 15 of 2007 (OSHA), also administered by DOSH under the Ministry of Labour and Social Protection, independently requires employers to notify DOSH of dangerous occurrences, near-misses, and occupational diseases under Section 26 of OSHA. An employer who operates a factory, construction site, mine, agricultural estate, or any other workplace with more than 20 employees must also have a registered Safety and Health Committee under Section 13 of OSHA, which is responsible for investigating accidents and preparing internal incident reports.
The dual reporting framework under the Work Injury Benefits Act No. 13 of 2007 and the Occupational Safety and Health Act No. 15 of 2007 means that a single serious workplace accident typically generates two distinct official reports: the WIBA Section 22 accident notification to DOSH (triggering the compensation process) and the OSHA Section 26 dangerous occurrence or disease notification (triggering the safety investigation process). A thorough Work Injury Incident Report addresses both requirements in a single document.
The Kenya National Industrial Training Authority (NITA) requires employers in certain sectors to maintain accident records as part of their training and safety management systems. The Factories and Other Places of Work Act Cap. 514, now substantially superseded by OSHA, historically required a register of accidents to be kept on premises — a requirement carried forward by OSHA regulations.
The Work Injury Benefits Act No. 13 of 2007 Section 5 requires employers to insure all employees with a WIBA-compliant insurance policy authorised by the Insurance Regulatory Authority (IRA). When an accident occurs and is reported to DOSH, the employer must simultaneously notify the WIBA insurer to trigger the claims process. Most WIBA insurers require a copy of the employer's Work Injury Incident Report as part of the claims documentation.
The National Environment Management Authority (NEMA), established under the Environment Management and Co-ordination Act No. 8 of 1999, may also require notification of incidents involving hazardous substances or environmental damage — relevant for chemical spills, industrial fires, or accidents at extractive industry sites. A well-prepared Work Injury Incident Report that documents the full facts of the accident assists the employer in responding to all relevant regulatory authorities from a single source of truth.
The Employment and Labour Relations Court (ELRC) has held in several decisions that an employer's prompt, accurate, and complete incident reporting demonstrates reasonable conduct — while delayed, incomplete, or falsified reports can be treated as evidence of negligence or bad faith in contested WIBA or common law proceedings.
When Do You Need a Work Injury Incident Report (Kenya)?
A Work Injury Incident Report in Kenya is required by law within 24 hours of any workplace accident that results in death, permanent disablement, temporary disablement of more than 3 days, or the contraction of an occupational disease listed in the Third Schedule to the Work Injury Benefits Act No. 13 of 2007.
A Work Injury Incident Report is needed when a worker on a road construction site in Mombasa is struck by a reversing vehicle and sustains a broken pelvis. The employer must file the DOSH notification within 24 hours under Section 22 of the Work Injury Benefits Act No. 13 of 2007, simultaneously notify the WIBA insurer, and initiate an internal safety investigation under the Occupational Safety and Health Act No. 15 of 2007.
A Work Injury Incident Report is required when a laboratory technician in a Nairobi hospital suffers a needlestick injury during a blood sample procedure. Even if the injury appears minor, the risk of blood-borne disease transmission means DOSH notification is required under both WIBA and OSHA, and the hospital's infection control and occupational health procedures must be activated.
A Work Injury Incident Report is needed when a security guard employed by a private security firm is assaulted and injured while on duty at a client's premises. The Security Industry Act No. 14 of 2013 and the WIBA both apply, and the employer — the security firm, not the client — must file the incident report and the WIBA notification.
A Work Injury Incident Report is required when an employee in a tea-processing factory in Kericho is diagnosed with occupational hearing loss after years of exposure to machinery noise exceeding 85 decibels. Occupational diseases under the Third Schedule to the Work Injury Benefits Act No. 13 of 2007 must be reported to DOSH on diagnosis, even where the causative exposure occurred over a prolonged period.
A Work Injury Incident Report is needed when a software developer who works from home under a remote work arrangement falls and fractures a wrist while walking from their workstation during working hours. The Work Injury Benefits Act No. 13 of 2007 covers accidents arising out of and in the course of employment, and there is developing DOSH guidance on home-working accidents — employers should report and let DOSH assess whether the accident falls within the Act's scope.
A Work Injury Incident Report is required when a fatal accident occurs at an agricultural estate, mine, or industrial plant — triggering not only the 24-hour DOSH notification under WIBA Section 22 but also a potential investigation by the Directorate of Criminal Investigations (DCI) and a coroner's inquest under the Inquests Act Cap. 68.
What to Include in Your Work Injury Incident Report (Kenya)
A Kenya Work Injury Incident Report compliant with the Work Injury Benefits Act No. 13 of 2007 Section 22 and the Occupational Safety and Health Act No. 15 of 2007 must contain the following essential elements.
Employer Identification: Full legal name of the employer; business address and physical location of the workplace where the accident occurred; Business Registration Service (BRS) registration number; KRA PIN; nature of the industry or business; total number of employees at the workplace; name, designation, and contact details of the person completing the report; and WIBA insurance policy number and insurer name as required by Section 5 of the Work Injury Benefits Act No. 13 of 2007.
Injured Worker Details: Full name; National Identity Card (NIC) number; date of birth; gender; job title and department; type of employment (permanent, casual, seasonal, or apprentice); date of commencement of employment; normal monthly earnings (used to calculate WIBA compensation under the Second Schedule); and NSSF membership number.
Accident Details: Exact date and time of the accident; precise location within the workplace (building, floor, workstation, open yard, or road); task being performed by the worker at the time of the accident; sequence of events leading to the accident described in chronological order; the immediate cause of the accident (equipment failure, human error, environmental hazard, or other); and the underlying or root cause where ascertainable at the time of initial report.
Injury Description: Part of the body injured; nature of the injury (fracture, laceration, burn, crush injury, chemical exposure, or occupational disease); classification of the injury — fatal, permanent total disablement, permanent partial disablement, or temporary total disablement as defined in the Second Schedule to the Work Injury Benefits Act No. 13 of 2007; name of the hospital or clinic where the worker was treated; name and KMPDC registration number of the treating medical practitioner; and whether the worker was hospitalised.
Witness Information: Names, job titles, and contact details of all witnesses to the accident. Witness statements should be taken as soon as practicable and attached to the report.
Immediate Actions Taken: First aid administered, emergency services contacted, unsafe area cordoned off, damaged equipment isolated, and any other immediate corrective measures taken after the accident.
Root Cause Analysis and Corrective Actions: Preliminary assessment of the factors contributing to the accident — inadequate training, absence of personal protective equipment (PPE), machinery malfunction, failure to follow the Safe Work Procedure (SWP), or lack of adequate supervision. Corrective actions proposed or already implemented to prevent recurrence, with responsible persons and target dates.
Declaration: The employer's authorised signatory declares that the information is accurate and complete to the best of their knowledge, and that the report has been filed with the DOSH regional office within 24 hours of the accident as required by Section 22 of the Work Injury Benefits Act No. 13 of 2007. The Safety and Health Officer's countersignature should appear where the employer has a registered Safety and Health Committee under Section 13 of OSHA. The forms-legal.com Kenya Work Injury Incident Report template meets all DOSH mandatory fields and includes guidance notes on each section to help employers complete the report accurately under time pressure.
Additional compliance elements for a Work Injury Incident Report (Kenya) used in Kenya include: Under the Employment Act No. 11 of 2007, the Employment and Labour Relations Court (ELRC) adjudicates workplace disputes in Kenya. Section 35 of the Employment Act 2007 governs termination of employment. The National Social Security Fund Act No. 45 of 2013 mandates employer contributions to NSSF. The Social Health Insurance Fund (SHIF) replaced NHIF in 2024. The Kenya Revenue Authority (KRA) administers PAYE under the Income Tax Act (Cap. 470). Forms-legal.com provides this template as a starting point for Kenya-compliant documentation.
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Reference this free template in an article, syllabus, or research note:
Forms Legal. (2026). Work Injury Incident Report (Kenya) (Kenya) [Legal document template]. Forms Legal. https://forms-legal.com/kenya/employment/health-safety/work-injury-incident-report-kenya
"Work Injury Incident Report (Kenya) (Kenya)." Forms Legal, 2026, https://forms-legal.com/kenya/employment/health-safety/work-injury-incident-report-kenya.
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year = {2026},
howpublished = {\url{https://forms-legal.com/kenya/employment/health-safety/work-injury-incident-report-kenya}},
note = {Free legal document template}
}Frequently Asked Questions
Section 22 of the Work Injury Benefits Act No. 13 of 2007 requires an employer to report any accident that results in death or disablement of an employee to the nearest DOSH regional office within 24 hours of the accident. This is an absolute obligation with no discretion — even if the full facts of the accident are not yet known, a preliminary report must be filed within 24 hours, and a supplementary detailed report can follow. The Occupational Safety and Health Act No. 15 of 2007 Section 26 similarly requires prompt notification of dangerous occurrences. Employers who fail to report within 24 hours face criminal prosecution under the Work Injury Benefits Act, with penalties including fines and imprisonment. The employer must also notify the WIBA insurer within the timeframe specified in the insurance policy — typically 24 to 48 hours — to preserve the insurer's ability to investigate the claim.
An employer in Kenya who fails to report a workplace accident to DOSH within 24 hours as required by Section 22 of the Work Injury Benefits Act No. 13 of 2007 commits a criminal offence. The penalty under the Act is a fine, imprisonment, or both. Additionally, a WIBA insurer may use late notification as grounds to resist or reduce a claim, though the insurer cannot rely on the employer's breach of duty to defeat the injured employee's statutory right to compensation entirely. The Occupational Safety and Health Act No. 15 of 2007 provides separate penalties for failure to report dangerous occurrences under Section 26. In fatal accident cases, failure to report may also attract scrutiny from the Director of Public Prosecutions (DPP) and the Directorate of Criminal Investigations (DCI) as potential evidence of an attempt to conceal a criminal offence. DOSH conducts post-accident inspections and has power under OSHA Section 31 to issue improvement notices and prohibition notices if unsafe conditions that caused the accident have not been remedied.
The employer is legally responsible for completing and filing the Work Injury Incident Report under Section 22 of the Work Injury Benefits Act No. 13 of 2007. In practice, the report is typically prepared by the Safety and Health Officer (SHO) appointed under Section 13 of the Occupational Safety and Health Act No. 15 of 2007, the Human Resources Manager, or another designated representative of the employer. Where the workplace has a registered Safety and Health Committee, the Committee's secretary typically assists in compiling witness statements and documenting the accident scene. The employer's authorised signatory — typically a director, operations manager, or HR manager — must sign the report before it is submitted to DOSH. In construction sites, the site foreman or site manager typically has delegated authority to complete and file the initial 24-hour notification, with the main contractor's management following up with the detailed report.
The Work Injury Benefits Act No. 13 of 2007 Section 22 reporting obligation is triggered by accidents resulting in actual injury, disease, or death — it does not extend to near-misses where no person was harmed. However, the Occupational Safety and Health Act No. 15 of 2007 Section 26 requires employers to notify DOSH of dangerous occurrences — defined as incidents that had the potential to cause serious injury or death but did not, such as a scaffold collapse with no workers in the area, a chemical release that was contained before exposure, or a crane failure. Best practice under OSHA and international occupational health standards (referenced by Kenya's National Occupational Safety and Health Policy 2012) is for employers to investigate and document all near-misses as part of their safety management system, even where DOSH notification is not legally required. Near-miss records demonstrate a proactive safety culture and can be critical evidence in defending negligence claims if a similar incident later causes injury.
An injured employee in Kenya has a legitimate interest in accessing the Work Injury Incident Report relating to their accident. Under the Access to Information Act No. 31 of 2016, any person may request access to records held by public bodies, and DOSH is a public body — an employee may therefore request the DOSH copy of the employer's accident notification. The Employment Act No. 11 of 2007 implies a duty of good faith between employer and employee, and an employer who withholds the incident report from an injured employee seeking to file a WIBA claim may be found to have breached this duty. In WIBA proceedings before DOSH or appeals before the Employment and Labour Relations Court (ELRC), both parties are entitled to disclose and rely on the incident report as documentary evidence. Employers should be consistent between the internal report, the DOSH notification, and any report provided to the WIBA insurer, as inconsistencies will be scrutinised.
A Kenya employer should retain Work Injury Incident Reports for a minimum of 5 years from the date of the accident, consistent with the general limitation period under the Limitation of Actions Act Cap. 22 for personal injury claims and the WIBA claims limitation period under Section 23 of the Work Injury Benefits Act No. 13 of 2007. For fatal accidents, the limitation period for dependants' claims runs from the date of death, and records should be retained for at least 7 years. The Occupational Safety and Health Act No. 15 of 2007 regulations require employers to maintain an accident register at the workplace for inspection by DOSH Safety and Health Officers under Section 31 of the Act. Where the accident involves an occupational disease with a latency period — such as mesothelioma or silicosis — the employer's exposure records and incident reports may be relevant decades later, and indefinite retention is advisable for hazardous industries. Digital records stored securely in compliance with the Data Protection Act No. 24 of 2019 are legally acceptable.
This template is provided for informational purposes only and does not constitute legal advice. Laws vary by jurisdiction and change over time. Consult a qualified attorney for advice specific to your situation.Full disclaimer
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