Contractor Safety Questionnaire Form Page 2

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Injury and Illness Rate calculations
Total Case Incident Rate (TCIR) = Total number of OSHA recordable injuries per 100
employees
Total Recordable Cases X 200,000 =
TCIR
Total hours worked
Days Away, Restricted, and/or Transferred (DART) Case Incident Rate = Total Recordable
Cases with Days Away, Restriction, and/or Transfer per 100 employees
Total number of cases with days away from work
+ Total number of cases with job transfer or restriction
Total Recordable Cases with Days Away, Restriction, and/or Transfer
Total Recordable Cases with Days Away, Restriction, and/or Transfer X 200,000 = DART
Total hours worked

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