Sample Standard OSHA Settlement Agreement

In the matter of: Complainant v. Respondent

Case No. 1-2345-08-001


The undersigned Respondent and the undersigned Complainant, in the settlement of the above-captioned matter and subject to the approval of the Occupational Safety and Health Administration ("OSHA"), hereby agree as follows:

Compliance with Acts. Respondent will not discharge or in any other manner discriminate against Complainant or any other employee because of activity protected by the whistleblower provision of the [insert name of statute], [insert statutory cite].

Posting of Notice. Respondent will post in conspicuous places in and about its premises, including all places where notices to employees are customarily posted, including electronic posting, where the employer communicates with its employees electronically. and maintain for a period of at least 60 consecutive days from the date of posting, copies of the Notice attached hereto and made a part hereof, said Notice to be signed by a responsible offıcial of Respondent organization and the date of actual posting to be shown thereon.  [For employers who communicate with their employees electronically, Respondent shall e-mail this notice to all employees at [insert establishment] or post this notice on its intranet].

Compliance with Notice. Respondent will comply with all of the terms and provisions of said Notice.

General Posting. Respondent will permanently post in a conspicuous place in or about its premises, including all places where posters for employees are customarily posted, including electronic posting, where the employer communicates with its employees electronically. [select appropriate poster [OSHA 3165-12-06R ("Job Safety and Health: It’s the Law!"); OSHA 3113 ("Attention Drivers"); FAA-WBPP-Ol ("Whistleblower Protection Program"); 29 CFR Part 24, Appendix A ("Your Rights Under the Energy Reorganization Act"); OR the applicable OSHA Whistleblower Rights Fact Sheet(s)]].

Reinstatement. Respondent has offered [or shall offer as soon as possible] reinstatement to the same or equivalent job, including restoration of seniority and benefits, that Complainant would have earned but for the alleged retaliation.  Complainant has [declined/accepted] reinstatement.  [OR Reinstatement is not an issue in this case.  Respondent is not offering, and Complainant is not seeking, reinstatement.]

Monies. Respondent agrees to make the Complainant whole by payment of $_____in back pay (less normal payroll deductions).  Respondent shall submit appropriate documentation to the Social Security Administration allocating back pay to the appropriate calendar quarters [OR to the Railroad Retirement Board allocating back pay to the appropriate months].  [OR Respondent agrees to pay Complainant a lump sum of $ _____.] Complainant and Respondent agree to comply with applicable tax laws.  Any check shall be made payable to the Complainant and mailed to the OSHA [Area/Regional] Office [give address].

Personnel Record.  Respondent shall expunge any references from Complainant’s personnel records relating to the adverse action and shall not make any references relating to the adverse action in any future requests for employment references.

Inquiries Concerning Complainant.  Should any third parties, including prospective employers, inquire as to the employment of Complainant with the Respondent, Respondent agrees to refrain from any mention of Complainant’s protected activity.  Respondent agrees that nothing will be said or conveyed to any third party that could be construed as damaging the name, character, or employment of Complainant. If a third party submits a Freedom of Information Act ("FOIA") request, OSHA will disclose settlement agreements in accordance with the FOIA, unless one of the FOIA exemptions applies.

Performance.  Performance by both parties of the terms and provisions of this Agreement shall commence immediately after the Agreement is approved.

Enforcement of Settlement.  [For all cases other than Section 11(c) of the OSH Act, AHERA, or ISCA] This settlement constitutes the Secretary’s findings and preliminary order under [insert name of statute and cite to provision on issuance of findings and preliminary order].  The parties’ signatures constitute a failure to object to the findings and order under that statute.  Therefore, this settlement is a final order under that statute and is enforceable in an appropriate United States district court. [For Section 11(c) of the OSH Act, AHERA, and ISCA cases] Failure to comply with this settlement may constitute a violation of the whistleblower provision of [insert statute], [insert cite] for which the Secretary of Labor may seek redress by filing a civil action in an appropriate United States district court under [insert cite for whistleblower provision].  A violation of this settlement agreement is also a breach of contract for which Complainant may seek redress in an appropriate court.

Non-Admission.  Respondent’s signing of this Agreement in no way constitutes an admission of a violation of any law, standard, or regulation enforced by OSHA.  Nothing in this Agreement may be used against either party except for the enforcement of this Agreement’s terms and provisions.

Notification of Compliance.  Respondent agrees that within ten (10) days of receiving a fully executed and approved copy of this Agreement, Respondent will notify the OSHA Regional Administrator in writing of the steps it has taken to comply with the terms and conditions of this Agreement.

Closure of Complaint.  Complainant agrees that acceptance of this Agreement constitutes settlement in full of any and all claims against respondent arising out of Complainant’s complaint filed with OSHA on [insert date] and will cause the complaint to be closed.

This Agreement has been obtained and entered into without duress and in the best interests of all parties.














Regional Supervisory Investigator