Injury

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Injury Illness Recording(Update 2007)

• Marianne McGee

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Work-Relatedness

• Cases are work-related if
• An event or exposure in the work environment
  either caused or contributed to the resulting
  condition
• An event or exposure in the work environment
  significantly aggravated a pre-existing injury or
  illness

1904.5
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Work-Related Exceptions

• Cases not work related

• Employee present as a member of the general
  public
• Non-work event or exposure (e.g. asthma or
  diabetes)
• Eating and drinking of food and beverages
• Voluntary Wellness Programs or Blood Donations
• Personal tasks outside of working hours.

1904.5(b)(2)
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Work-Related Exceptions

• Cases not work related

• Self grooming or self medication
• Common colds and flu
• Motor Vehicle Accidents
• In company parking lot/access road
• On commute to or from work
• Mental Illnesses

1904.5(b)(2)
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General Recording Criteria

• Requires records to include any work-related
  injury or illness resulting in one of the
  following
• Death
• Days away from work
• Restricted work or transfer to another job
• Medical treatment beyond first aid
• Loss of consciousness
• Diagnosis of a significant injury/illness by a
  physician or other licensed health care
  professional

1904.7(a)
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General Recording Criteria (continued)

• Medical treatment vs first aid
• Light duty or restricted work cases

Medical Treatment
First Aid
1904.7(b)(5)
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First Aid

• Using nonprescription medication at
  nonprescription strength
• Tetanus immunizations
• Cleaning, flushing, or soaking surface wounds

1904.7(b)(5)
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First Aid

• Wound coverings, butterfly bandages, Steri-Strips
• Hot or cold therapy
• Non-rigid means of support
• Temporary immobilization device used to transport
  accident victims

1904.7(b)(5)
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First Aid

• Drilling of fingernail or toenail, draining fluid
  from blister
• Eye patches
• Removing foreign bodies from eye using irrigation
  or cotton swab

1904.7(b)(5)
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First Aid

• Removing splinters or foreign material by simple
  means
• Finger guards
• Massages (non-therapeutic)
• Drinking fluids for relief of heat stress

1904.7(b)(5)
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Hearing Loss

• Requires employers to record standard threshold
  shifts (STS) in employees hearing if
• The hearing loss results in a total hearing loss
  of 10 db and is 25db above audiometric zero.
• Separate column on the OSHA form 300 to capture
  hearing loss cases

1904.10
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Fatalities

• All work-related fatalities must be reported to
  the local OSHA office (or 800-321-OSHA) within 8
  hours.
• Heart attacks included
• Vehicle accidents dont need to be REPORTED to
  OSHA (but may be recordable)

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Annual Summary

• Annual summary posted for three months
• Certification of the summary by a company
  executive

1904.32
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Retention Updating

• Keep current year plus previous 5 years data.
• OSHA 300 Log
• OSHA 301 Supplemental Form
• Privacy Case List (If Applicable)
• During storage period, you must update stored
  records.

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Where to get more informationwww.osha.gov
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Recordkeeping Webpage
Save the PDF file to your hard drive
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Use the find function to search the document
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Be flexible in your word choice
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Prescription Medication
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Would an injury be recordable if

• An employee suffered a recordable injury but the
  employee had a positive drug test and was fired?

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Yes Question 7-9

• When the employer conducts a drug test based on
  the occurrence of an accident resulting in an
  injury at work and subsequently terminates the
  injured employee, the termination is related to
  the injury. Therefore, the employer must estimate
  the number of days that the employee would have
  been away from work due to the injury and enter
  that number on the 300 Log.

22
Would an injury be recordable if

• An employee is working in the field and is
  assaulted by illegal immigrants?

23
Yes Question 5-2

• The Recordkeeping rule contains no general
  exception for purposes of determining
  work-relationship, for cases involving acts of
  violence in the work environment.
• Also, use the but for test. But for the fact
  the employee was working, he would not have been
  in that location for the incident to occur.

24
Would an injury be recordable if

• An employee is turning a wrench and it slips off
  and hits and breaks (or cracks) a tooth?

25
Yes Question 7-17

• Work-related fractures of bones or teeth are
  recognized as constituting significant diagnoses
  and, if the condition is work-related, are
  appropriately recorded at the time of initial
  diagnosis even if the case does not involve any
  of the other general recording criteria.

26
Would an injury be recordable if

• An employee damaged a prosthetic such as a leg or
  tooth?

27
NoLetter of Interpretation 4/30/2007

• Damage to artificial or mechanical devices, such
  as dentures, eye glasses, canes, or prosthetic
  arms or legs, would not be considered an injury
  or illness under Part 1904. Must be related to a
  person.

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Would an injury be recordable if

• An employee is injured and receives medical
  treatment,
• A second opinion is obtained and states medical
  treatment was not necessary?

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Maybe - Question 7-10a

• Once medical treatment is provided for a
  work-related injury or illness, or days away from
  work or work restriction have occurred, the case
  is recordable.
• If there are conflicting contemporaneous
  recommendations regarding medical treatment, or
  the need for days away from work or restricted
  work activity, but the medical treatment is not
  actually provided and no days away from work or
  days of work restriction have occurred, the
  employer may determine which recommendation is
  the most authoritative and record on that basis.
• In the case of prescription medications, OSHA
  considers that medical treatment is provided once
  a prescription is issued.

30
Would an injury be recordable if

• An employees suffers a cut and medical glue is
  used in lieu of stitches?

31
Yes - Question 7-5

• Surgical glue is a wound closing device. All
  wound closing devices except for butterfly and
  steri strips are by definition "medical
  treatment,"
• Wound closure devices are not on the all
  inclusive first aid list.

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Would an injury be recordable if

• An employees suffers a cut and Band-aid glue is
  used in lieu of a Band-aid?

33
No - Letter of interp. 8/8/2002

• Band-aid glue is a wound covering device not a
  wound closure device.

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Would an injury be recordable if

• An employee dies during surgery made necessary by
  a work-related injury?

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Yes - Question 7-3

• If an employee dies as a result of surgery or
  other complications following a work-related
  injury or illness, the case is recordable.

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Would an injury be recordable if

• An employee is involved a fatal vehicle accident
  in a foreign country?

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No Letter of Interp. 8/26/2004.

• Recordable only if the incident is in the
  jurisdiction of OSHA (US, DC, Puerto Rico, Virgin
  Islands, Outer Continental Shelf Lands)

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Would an injury be recordable if

• An employee is injured at work and the physician
  gives a prescription medication but the employee
  does not take the medicine?

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Yes Question 7-10a

• OSHA considers that medical treatment is provided
  once a prescription is issued
• Also see letter of interpretation 02/06/2007

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Would an injury be recordable if

• An employee is injured at work and the physician
  tells the employee to take an over-the-counter
  medicine
• The employee has a reaction and as a result has
  to take a prescription?

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Yes

• But for the fact the employee had a
  work-related injury they would not have taken the
  OTC.

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Would an injury be recordable if

• An employee was stung by a bee, and due to an
  allergic reaction the employee carries and
  administers an epi-pen?

43
Yes

• But for the employee being in the work
  environment he would not have been stung.

44
Would an injury be recordable if

• An employee is on-call and is injured while
  responding.

45
Yes

• Except for one commute.

46
Would an injury be recordable if

• At a drill site an employee sleeps in a trailer
  but would be expected to respond to an alarm.
• The alarm goes off and the employee strains his
  back getting out of bed and receives medical
  treatment.

47
Yes

• The employees job is to respond to the alarm and
  the moment the alarm sounds the employee is
  working.

48
Would an injury be recordable if

• An employee working on an offshore drilling rig
  is off duty and sustains an injury in the crew
  quarters.

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Yes LOI 2/6/2007

• The crew quarters is under the control of the
  employer thus not considered a home-away-from
  home.

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Would an injury be recordable if

• Volunteer fire brigade member goes for an annual
  physical.
• Phlebotomist is rough while drawing blood.
• The following day the ees arm has red streaks.
• The Doctor prescribes an RX.

51
Yes

• The participation on the fire brigade is
  voluntary but the medical evaluation is
  mandatory.
• The exception under 1904.5(b)(2) is for voluntary
  participation in a wellness or medical program.

52
Would an injury be recordable if

• An employee goes on break and goes to the vending
  machine to get a snack and strains his back and
  receives medical treatment?

53
Yes Letter of Interp. 3/10/2005

• The 1904(b)(2) exceptions do not apply to
  injuries that occur during breaks in the normal
  work schedule. Therefore the injury would be
  recordable.

54
Would an injury be recordable if

• An employee suffers an asthma attack, (not
  associated with the work environment) is
  transported to the hospital and later dies of a
  heart attack?

55
No

• The asthma attack was not caused by an event of
  exposure in the work environment, therefore not
  work-related. The resulting heart attack is also
  not work-related.

56
Would an injury be recordable if

• An employee suffers an injury and the doctor
  administers hot packs, stretching exercises,
  massage and TENS.

57
Yes

• Exercises that amount to self-administered
  physical therapy, and are normally recommended by
  a health care professional who trains the worker
  in the proper frequency, duration and intensity
  of the exercise. Physical therapy treatments are
  normally provided over an extended time as
  therapy for a serious injury or illness, and OSHA
  believes that such treatments are beyond first
  aid and that cases requiring them involve medical
  treatment.

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Would an injury be recordable if

• An employee loses time but later it is determined
  that the injury did not occur at work (fraud)?

59
No

• If the injury was not work-related the case would
  not be recordable.

60
Would an injury be recordable if

• An employee suffers an injury and is placed on
  restricted work but aggravates the injury AT HOME
  and now has time off work?

61
Yes

• Recordable as restricted work NOT days away.

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Would an injury be recordable if

• An employee is cut by machinery and is bleeding. 
  Another employee sees the blood and faints? 

63
Yes

• Loss of consciousness as a result of an event or
  exposure in the work environment.

64
Would an injury be recordable if

• An employee twists his ankle and doesnt want to
  go to the doctor so the employer decides to take
  it easy on him

65
YES (page 55 of the Blue Book)

• If the employee is kept from performing one or
  more of his normal duties it would be recordable.
  The restrictions can be given by the physician
  OR the employer

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Questions ??
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• Marianne McGee
• mcgee.marianne_at_dol.gov
• 361-888-3420 ext. 230