Note to Review - 2012 Form Updates

Note to Reviewer - SOII forms changes 2012.docx

Survey of Occupational Injuries and Illnesses

Note to Review - 2012 Form Updates

OMB: 1220-0045

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August 31, 2012



MEMORANDUM FOR : Reviewer of 1220-0045


FROM : Beth Rogers, Chief

Division of Safety and Health Statistics

Office of Compensation and Working Conditions

Bureau of Labor Statistics


SUBJECT : Changes to Collection Forms for the Survey of
Occupational Injuries and Illnesses



In January 2013, the Bureau of Labor Statistics (BLS) will begin using revised collection forms for the Survey of Occupational Injuries and Illnesses (SOII). Minor changes were made to collection forms to clarify instructions for reporting.


The changes made to the SOII IDCF mailing are described below:


  • Reworded the reference on the use of Workers’ Compensation forms to clarify instructions;

  • Changed the “example” image to accurately reflect the front of the form (with an updated logo, password format, and displayed establishment information). Also changed the telephone and fax numbers in the example (to 555-555-5555) from an actual telephone number


We also corrected several typos on the SOII IDCF mailing form and one typo on the Spanish Data Collection Booklet.


Copies of relevant forms have been included with this note to the reviewer. These changes are not expected to have an impact on respondent burden. If you have any questions about this request, please contact Beth Rogers by telephone at 202-691-5098 or by e-mail at [email protected].

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File Typeapplication/vnd.openxmlformats-officedocument.wordprocessingml.document
File TitleOutline of the Incentive Experiment
AuthorJames R. Walker
File Modified0000-00-00
File Created2021-01-29

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