Managing OSHA recordables

September 2, 2003
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The new OSHA Injury and Illness Recordkeeping rule (29 CFR 1904) has been in effect since January 1, 2002, and there have been substantial changes from the former OSHA recordkeeping rule. Some of those changes will cause you to have more OSHA recordable cases, while other changes in the standard allow you to have fewer - if those cases are properly managed. There are a number of legal and, I believe, ethical ways to avoid OSHA recordables. You can see our complete list on our Web site at www.ctjsafety.com. Here are ten of the most important:

1) Don't over treat.

Medical treatment makes a work-related injury or illness OSHA recordable; first-aid treatment does not. When medically prudent, limit treatment to first aid. In other words, don't over treat when less treatment will provide proper care.

For example, give the injured employee over-the-counter medication in an over-the-counter dose instead of prescription medication if medically appropriate.

For small cuts, use butterfly bandages when medically appropriate rather than sutures or dermal adhesive.

For chemical inhalation, don't give the employee oxygen unless it's medically necessary.

For sore arms, provide a support device for the arm rather than immobilize the arm.

For minor heat stress, limit the treatment to drinking fluids and avoid an IV administration of fluids.

There should be no intent to circumvent treatment that is necessary. But good management of treatments can avoid recordables.

2) Train care givers.

Your internal doctors, nurses, emergency medical technicians, and others who provide treatment for injured employees should receive training on what treatments cause OSHA recordables and which ones don't.

When feasible, make the doctors and nurses at the off-site private clinic that you use aware of the rules, too, so that they do not over treat one of your employees who has been injured or made ill on the job.

If feasible, educate local hospital emergency room doctors where you send your employees when on-site medical personnel aren't available about recordable versus non-recordable treatments.

3) Get a second opinion.

OSHA Standard 1904.7(b)(3), and the OSHA Recordkeeping Compliance Directive CPL 2-0.131, in Chapter 5, Question 7-10, both state that a more authoritative physician can override another opinion regarding lost workdays. When "contemporaneous" recommendations are given by two or more physicians, the employer can choose which opinion is more authoritative and record the case based on that opinion.

For example, if your employee is told to take the next day off by an emergency room doctor because of a work-related injury, your more authoritative physician who knows the job responsibilities and the tasks required better than the emergency room doctor may instruct that employee to continue working, but with restrictions from routine duties.

The more authoritative physician is normally your company doctor, a board-certified occupational physician or specialist. In the above scenario, you have avoided a day away from work case, and can record this case as restricted duty.

Your more authoritative physician may instruct the injured employee to continue all routine duties, but at a slower pace. A slowdown in production, by itself, does not make the case OSHA recordable. If this happens, you have avoided both a day away from work case and a restricted duty case.

4) Report off-the-job injuries.

Consider implementing a system so that employees inform your medical or safety staff of any significant off-the-job injuries or illnesses before they return to work on their next regularly scheduled shift, or of any prescription medications that they are taking.

If the employee hurts his back one evening in the city bowling league, comes to work the next day, doesn't tell anyone his back hurts and the job significantly aggravates his bad back, you've got yourself an OSHA recordable. But if you know about the bad back before the employee starts work, you could put him on light duty or not let him return to tasks that may aggravate the hurting back until it has healed up.

You've avoided a recordable, and even better, you've helped the employee by giving his back a chance to heal.

Consider having employees report all off-the-job injuries that require medical treatment, or a doctor's visit, or illnesses that result in at least one day of bed rest.

5) Report job injuries immediately.

OSHA Standard 1904.35(b)(1) requires employers to inform employees about how to report injuries and illnesses. Not only should you tell the employee how to report, but also when to report. Late reporting can cause recordables that you might be able to avoid. Once the employee has received medical treatment, the case is OSHA recordable. A more authoritative physician cannot override or rescind medical treatment given by another physician, or Licensed Health Care Provider, once the treatment has been given.

For example, your employee hurts his back one day at work, but it's not bad so he chooses to keep working and not tell anyone. That evening while at home, the back feels worse, so the employee goes to the local immediate care clinic to have it examined. The doctor at the clinic prescribes a pain medication. The prescription makes this case OSHA recordable, even if the employee chooses not to fill the prescription.

If your employee had been instructed to report the injury immediately at work when he felt the pain, or to contact a company doctor from his home that evening, over-the-counter medication and rest for the remainder of the day may have been medically appropriate. If that was the end of the treatment, a recordable could have been avoided.

6) Give healing a chance.

If an employee is injured and is sent home or placed on light duty for the remainder of the shift, or sits in the medical office at the work location for the remainder of the shift for observation, the case is not recordable - as long as the employee can return to routine duties the next calendar day.

But there must not be any medical treatment given or needed; there can be no loss of consciousness; no bone or tooth was broken, cracked or chipped; and no contaminated sharps injury was involved. And the injury or illness must not be one of the significant injuries and illnesses that are always recordable.

Remember, it's not the next scheduled work shift any more, it's the next calendar day because under the new rules, we must count calendar days for days away from work and restricted duty.

We can use that day of the injury to let the employee heal and recuperate by sending him/her home for rest or providing light duty for the rest of the shift. This time may be enough to allow the employee to recuperate and you have avoided a potential OSHA recordable.

7) Document the doctor's opinion.

Let's imagine that the employee has a sore back from shoveling dirt at work yesterday and doesn't want to come to work today. Your company physician says that the employee is well enough to work his full duties and can go back to work. The employee stays at home anyway. Now, do you have a day away from work case?

No, because OSHA standard 1904.7(b)(3)(iii) states that recordability is not based on what the employee does, but what the doctor says he can do. All that is necessary is to document in the medical record that the doctor's opinion was that the employee was capable of working full duties.

8) Keep job descriptions updated.

With the new standard, restricted duty occurs when an employee cannot perform all routine duties of the job - now defined as duties that are performed once per week or more often. So, if the employee climbs ladders only once per month, this is not a restricted duty case.

Ensure that your job descriptions are current in describing all routine duties so that you can make decisions quickly about what may be restricted duty and what may not be restricted duty.

9) Educate employees.

Voluntary recreation on the premises is not work-related; horseplay on the premises is work-related. Ensure that your employees know what is acceptable in this area and what is not.

Recreational activities are those activities that you sanction, such as the use of a walking trail on company property, or maybe you let employees play basketball during their breaks at a net set up in an area of the warehouse. Injuries and illnesses that occur during these activities are not OSHA recordable.

Horseplay would be activities that you prohibit or should prohibit, such as trying to squirt a co-worker with a fire extinguisher, or throwing sharp objects while at work. Injuries and illnesses that occur during these activities are work-related and may be recordable if the recordability criteria (medical treatment, loss of consciousness, etc.) apply.

10) Don't drive reporting underground.

Avoid incentives that are based on whether or not a work-related injury or illness occurs. This type of incentive plan can drive minor injuries and illnesses underground - employees may not want to report them for fear of losing a reward. If these minor injuries and illnesses are not reported early, they can get worse and become OSHA recordable. Incentive or recognition programs should be based on positive activities.

Bottom line

Don't lose sight of the best way to reduce OSHA recordables. The best way is to implement safety and health management systems that include management leadership and commitment, employee participation and acceptance, and hazard recognition and control so that injuries and illnesses don't occur. Your time is better spent going the distance in implementing and improving proper safety and health management systems rather than trying to avoid OSHA recordables based on the recordkeeping rules.

SIDEBAR: Did you know. . .

  • Medical treatment makes a work-related injury or illness OSHA recordable; first-aid treatment does not.
  • When "contemporaneous" recommendations are given by two or more physicians, the employer can choose which opinion is more authoritative and record the case based on that opinion.
  • A slowdown in production, by itself, does not make the case OSHA recordable.
  • A prescription makes a case OSHA recordable, even if the employee chooses not to fill the prescription.
  • Recordability is not based on what the employee does, but what the doctor says he can do.
  • Routine duties of the job are now defined as duties that are performed once per week or more often.
  • Voluntary recreation on the premises is not work-related; horseplay on the premises is work-related.

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