Health and Safety at Work etc Act 1974
The Reporting of Injuries, Diseases and Dangerous Occurrences Regulations 2013

Report of an Occupational Disease

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About you and your organisation




About where the affected person usually works

Affected person details

In which local authority are the premises where the affected person usually works?  

Please indicate the local authority area in which the site is located. You need to select the Country first, then the geographical area (England only), and finally the local authority.
Selecting the local authority will help ensure that the appropriate Enforcing Authority (EA) for that area receives the notification.
For local authorities in England, each is allocated to a geographical area. The information is available on gov.uk 'Find your local council' opens in new window




What type of work was being carried out (generally the main business activity of the site where the affected person usually works)?

Enter information on the industry to which the disease should be classified. In most cases this will be the main activity underway at the site where the affected person usually works.
The categories on this form are based on Standard Industrial Classification (SIC 2007). To see which detailed activities are available under each main industry, these are available in an Excel Spreadsheet opens in new window

About the affected person




Affected person's employment status

Provide details of the affected persons employer if you have indicated that they are employed by someone else.
Or provide details if the affected person is on a training scheme.


About the disease and work that led to the disease



Please provide further relevant information. For example:
  • further details about the operation or activity
  • the environmental conditions
  • the name of any substances involved
  • the name and type of any machinery involved
  • the events that led to the disease
  • the part played by any people (if relevant)
  • action taken (if any) to prevent similar cases occurring.

Thank you for submitting your RIDDOR form

Your form has been received and has been assigned the Notification number . If you wish to keep a copy of the form, please download it using the button below. YOU WILL NOT RECEIVE ANY OTHER CONFIRMATION.

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