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Collection of personal and health information
WorkSafe Victoria (WorkSafe) is a body corporate established under Victorian workers compensation legislation. To obtain the contact details of
your nearest WorkSafe oce, visit our website at www.worksafe.vic.gov.au Personal and health information collected in connection with this
notication will be used for the purpose of monitoring, assessing and investigating workplace incidents. The information may also be used for the
purpose of administering and enforcing legislation administered by WorkSafe, administration and evaluation of the WorkSafe’s programs generally
and legal proceedings. Subject to Section 10 of the Occupational Health and Safety Act 2004, WorkSafe may disclose such information to its
contractors and agents, to other regulatory agencies, to a court or tribunal and to any person or organisation authorised by the individual to whom it
relates, or by law, to obtain it. Collection of this information is required by the Occupational Health and Safety Act 2004 and other legislation
administered by WorkSafe. If you do not provide any of this information, you may be subject to a penalty. Individuals have rights of access to personal
and health information WorkSafe holds about them: contact the WorkSafe Freedom of Information Ocer. You can access WorkSafe’s Privacy Policy
at www.worksafe.vic.gov.au.
Notice of an incident
This information is a summary of the incident notication provisions and should be read in conjunction with the legislation.
Part 5 of the Occupational Health and Safety Act 2004 requires an
employer or self-employed person to notify WorkSafe immediately after
becoming aware of an incident at a workplace which results in—
• the death of any person; or
• a person requiring medical treatment within 48 hours of exposure to a
substance; or
• a person requiring immediate treatment as an in-patient in a hospital;
or
• a person requiring immediate medical treatment for—
– the amputation of any part of his or her body; or
– a serious head injury; or
– a serious eye injury; or
– the separation of his or her skin from underlying tissue
(such as de-gloving or scalping); or
– electric shock; or
– a spinal injury; or
– the loss of a bodily function; or
– serious lacerations
Notice of incident that exposes a person to risk
An employer or self-employed person must notify WorkSafe
immediately after becoming aware of an incident at a workplace which
exposes a person in the immediate vicinity to an immediate risk to the
person’s health and safety through—
a. the collapse, overturning, failure or malfunction of, or damage to, any
plant that the regulations prescribe must not be used unless the plant
is licensed or registered; or
b. the collapse or failure of an excavation or of any shoring supporting an
excavation; or
c. the collapse or partial collapse of any part of a building or structure; or
d. an implosion, explosion or re; or
e. the escape, spillage or leakage of any substance including dangerous
goods as dened in the Dangerous Goods Act 1985; or
f. the fall or release from a height of any plant, substance or object; or
g. the following incidents in a mine:
i. the overturning or collapse of any plant; or
ii. the inrush of water, mud or gas; or
iii. the interruption of the main system of ventilation
In addition to immediate notication, the employer/self-employed
person must provide a written record of the incident to WorkSafe within
48 hours of becoming aware of an incident.
1. to notify WorkSafe immediately, call 132 360
2. for written notication send this incident notication form to WorkSafe
within 48 hours:
• electronically via the web or
• by post to PO Box 279, Geelong, VIC 3220 or
• by facsimile to (03) 9641 1091 or
• by post or delivery to WorkSafe at 1 Malop Street,
Geelong, VIC 3220
3. keep a copy of the written record for at least 5 years
Site preservation
The site of a notiable must not be disturbed until an inspector arrives or
until directed by an inspector except to protect the health and safety of a
person; or provide aid to an injured person involved in the incident; or to
take essential action to make the site safe or prevent a further incident.
Part 9 of the Equipment (Public Safety) Regulations 2017 requires a
person in charge of prescribed equipment at an equipment site to notify
WorkSafe immediately after becoming aware of an incident involving the
equipment which results in—
• the death of any person; or
• a person requiring medical treatment within 48 hours of exposure to a
substance; or
• a person requiring immediate treatment as an in-patient in a hospital;
or
• a person requiring immediate medical treatment for—
• the amputation of any part of his or her body; or
• a serious head injury; or
• a serious eye injury; or
• the separation of his or her skin from underlying tissue (such as
de-gloving or scalping); or
• electric shock; or
• a spinal injury; or
• the loss of a bodily function; or
• serious lacerations
Notice of a dangerous occurrence
A person in charge of prescribed equipment at an equipment site must
notify WorkSafe immediately after becoming aware of an incident
involving the equipment which exposed a person in the immediate
vicinity to an immediate risk to that person’s health and safety through—
a. the collapse, overturning, failure or malfunction of, or damage to, any
item of plant listed in 45 of the Equipment (Public Safety) Regulations
2017 and the Australian Standards referred to therein; or
b. an implosion, explosion or re.
In addition to immediate notication, a person in charge of prescribed
equipment must provide a written record of the incident to WorkSafe
within 48 hours of becoming aware of the incident.
Site preservation
The site of an incident must not be disturbed until an inspector arrives or
until directed by an inspector except to protect the health and safety of a
person; or provide aid to an injured person involved in the incident; or to
take essential action to make the site safe or prevent a further incident.
