April 24, 1992

Mr. C. T. Sullinger
Manager of OSHA Records
Brown & Root, Inc.
Post Office Box 3
Houston, Texas 77001

Dear Mr. Sullinger:

Thank you for your letter of February 18, 1991, requesting interpretations for a series of injury and illness recordkeeping questions. I will address these questions by first restating each one and then answering it. Wherever possible, I will reference the enclosed Recordkeeping Guidelines for Occupational Injuries and Illnesses, 1986, by referencing the page number and question(s) that apply.

Many of the questions you have asked seem to be related to workers' compensation or insurance claims. Injuries and illnesses that are OSHA recordable may also be covered by either workers' compensation or private insurance. Regardless, as discussed on pages 45 and 46 of the Guidelines, the recording of occupational injuries and illnesses on the OSHA forms must be determined solely on the basis of the OSHA criteria.

Question 1. An employee receives a one time minor first aid treatment at the jobsite medical facility and returns to his/her normal duties. On a later date his/her job assignment is terminated due to a work force reduction. The employee, now out of work, develops some type of complications and requires additional medical care.

A. How does the jobsite classify and record this injury on the 200 log? B. If restricted duty is given how is it recorded? C. If medications are given, how is this recorded? D. If the ex-employee goes to a doctor other than the company doctor after he was terminated, and refuses to go to the Company Doctor for a second opinion, do we have to accept the call made by his/her Doctor?

Answer:

A. If the injury becomes recordable, the case should be recorded on the log for the job site within 6 working days after receiving knowledge that a recordable case has occurred. The date of the work accident which resulted in the injury should be used. (page 12, question A-3; page 23, question E-5)

B. If the termination of the employee results from the employee's injury or illness, the case should be recorded as a lost workday case (column 2) and an estimate should be made of the total number of restricted workdays (column 5) that would have been lost had the employee not been terminated. If the termination did not result from the employee's injury, the case should be recorded in column 6, injuries without lost workdays. (page 49 question B-11 and page 50, question B-14)

C. As stated in A. above, if the case results in the employee's treatment with prescription medications or other medical treatment, the case should be recorded in column 6, injuries without lost workdays. (pages 42 and 43, medical treatment)

D. Within 6 workdays after receiving information that an injury or illness has occurred, the employer must determine whether the case is recordable. Questionable cases should be entered on the log and lined out at a later date if they are found not to be recordable, Although medical verification is not required to record a case, in this situation you have received a doctor's opinion. Unless you receive additional information from another doctor, you will have to base your decisions on the best information available. (page 32, questions B-18 and B-19, page 40, question E-2, page 44, questions F-3 and F-4).

Question 2. An employee sustains an injury on the job and goes to the Doctor. The Doctor examines the employee, gives NO medical treatment, but tells the employee to work light (restricted) duty for a given period of time. The employee returns to work and says that he/she can work their regular duty and does not need, or want to work light duty.

A. How would this incident be recorded on the 200 log? B. What documentation would be needed to show that full duty was maintained instead of restricted duty?

Answer:

Restricted work activity focuses on the employees' ability to perform all normal duties associated with their job for the full work shift. The requirement to record restricted work activity then centers around whether the injury was serious enough that restricted work was actually provided or should have been provided. Cases should be recorded where restricted work was clearly required, but for one reason or another was not actually done. It is our interpretation that if a doctor prescribes work restrictions, then the restrictions are clearly required, until such time that the doctor removes the restrictions. Therefore, if a physician prescribes a restriction that affects the employee's normal job duties, then the case is to be recorded as a restricted workday case.

Question 3. An employee was injured while performing his/her assigned duty and was placed on restricted duty by the Doctor. The employee returns to the jobsite and placed on another duty or task that falls under the same job classification and description that the employee was hired to do.

A. Would this be a recordable or a first aid only? B. How similar must the assignments be to classify it as the same job as when injured? NOTE: many times these are short duration jobs and could be completed by a fellow employee while the injured employee is away at the medical facilities.

Answer:

This is a recordable injury based on the fact that the person has been transferred to another job, even though he or she has not been transferred to another job title, and because the employee has experienced a restriction of work. The concept of restricted work is based on three criteria as follows:

1. The employee was assigned to another job on a temporary basis, or

2. the employee worked at a permanent job less than full time, or

3. the employee worked at his or her permanently assigned job but could not perform all the duties normally connected with it.

If the restrictions apply only to the day of injury or onset of illness, then the injury should be recorded as a non-lost worktime case (columns 6 or 13). If the restrictions apply to any days beyond the day of injury or onset of illness, then the case is to be recorded as a restricted workday case. (columns 2 and 5 or columns 9 and 12)

The similarity of the assignments or the ability of a co-worker to complete the tasks is immaterial for recordkeeping purposes. The key question is whether the employee could perform all the duties normally associated with his or her job. We have interpreted the "normal job duties" to include any task or activity which the employee would perform during the calendar year. (page 47 and 48, lost workday cases; page 51 question B-20 and B-21; page 52 question C-2)

Question 4. An employee who is no longer employed by this company claims that he/she was injured while employed, but investigations reveal that no injury was reported to the safety department, site supervision, or anyone else.

A. How should this be recorded? B. What type of documentation do we need to allege this injury?

Answer:

Within 6 workdays after receiving information that an injury or illness has occurred, the employer must determine whether the case is recordable. Questionable cases should be entered on the log and lined out at a later-date if they are found not recordable. If an employer doubts the validity of an employee's alleged injury or illness and there is no substantive or medical evidence supporting the allegation, the employer need not record the case. (Page 32, B-18 and B-19)

Question 5. A Doctor prescribes a prescription medication for an injured employee. This employee makes the decision to refuse to take the medication.

A. The prescription was not filled, is this case recordable? B. The prescription was filled, BUT not taken. Is this a recordable or not.

Answer:

The requirement to record medical treatment cases focuses on whether the injury was serious enough that medical treatment was actually provided or should have been provided. Cases should be recorded where medical treatment was clearly required, but for one reason or another was not actually done. It is our interpretation that if a doctor prescribes medical treatment, including prescription medications, then the treatment is clearly required. Therefore, if a physician prescribes a prescription medication beyond a single dose for minor pain or discomfort, then the case is to be recorded.

Question 6. An employee chips a tooth, goes to a physician/Dentist but requires no treatment.

A. Would simple buffing of the cap or tooth be recordable? B. Are all chipped or broken teeth recordable even though treatment was not required?

Answer:

The distinction between medical treatment and first aid depends not only on the treatment provided, but also on the severity of the injury being treated. First aid involves treatment of only minor injuries. Injuries are not minor if they result in damage to the physical structure of a non-superficial nature. Our interpretation is that all fractures are non-minor injuries. Therefore, any broken or chipped tooth, if work related, would be a recordable injury. (page 42, page 44 question F-8)

Question 7. An employee breaks his bridge, or false teeth, while performing his/her assigned duties.

A. The false teeth, or bridge is taken in for repair but in no way did the employee require medications, restricted duty, or suffer in any way. Is this case recordable?

Answer:

If the case does not result in medical treatment beyond first aid, loss of consciousness, restriction of work or motion, or transfer to another job, the injury is not recordable.

Question 8. An employee is working a fast pace, short term assignment with many hours and produces very good work. At the end of the assignment as he/she is being terminated they tell you that they were injured on the job but did not say anything because they needed the money and they were afraid they would be taken off the job by the doctor. Now they want to go to the doctor. They tell the doctor they hurt so bad that they can NOT work. NOTE: No witnesses, never reported, no complaints, good worker, no sign of injury.

A. Would this be a recordable injury? B. If recordable, how do you determine restricted days, or even worse, days away from work? C. What documentation would we need to allege this injury?

Answer:

A. See questions 1 and 4.

B. Lost workdays (restricted days or days away) include those days the employ would have worked but could not because of the job-related injury or illness. No lost workdays are counted if he or she would not have worked because of a strike, work stoppage, weather, end of the job, etc. The termination of employment also stops the count of lost workdays, if the termination is unrelated to the employee's injury or illness. (Page 48 question B-4, Page 49 question B-11)

C. If a questionable or disputed case is unrecorded (or recorded and later removed) it is advisable to document the decision. Such documentation would consist of a description of the decision, the reason or rationale for making that decision, and any supporting evidence (medical opinions, etc.) that support the decision made.

Question 9. An employee had worked for BROWN & ROOT for many years. He/she leaves BROWN & ROOT for a job elsewhere and after a period of time we get a call from a doctor's office for authorization of medical treatment of a back injury the exemployee WAS treated for while with BROWN & ROOT. Investigation shows that he/she had a return to full duty and had worked without any problems until he/she left this company.

A. Would this case be a recordable?

Answer:

See questions 1, 4 and 8. It appears likely that this injury was recorded while the employee was working for Brown & Root. If so, the injury should not be recorded twice. If not, and the treatment is due to complications from the original injury and meets the criteria of medical treatment beyond first aid, the case is to be recorded on the log for the year when the work accident occurred.

Question 10. An employee breaks a prosthetic device but does not suffer any other injury while performing his/her assigned duties.

A. The employee is not limited or restricted in any way in the performance of his/her duties, would this be a recordable injury?

B. If the employee has another prosthetic device at home, and available for use, would this be a recordable even if no medical or restriction are there?

Answer:

Generally, damage to prosthetic devices is recordable if it involves either some form of medical treatment or restriction of work or motion. It is important to remember that restricted work activity limited to the day of injury can make a case recordable as a non lost worktime injury. I suspect that in many of these cases, even if the employee has a replacement device at home, damage to a prosthetic device often results in restricted work activity on the day of the injury. (page 43 part 3. Restriction of work or motion, page 44 question F-9, and page 52, question C-2) I hope this information will answer your questions about the OSHA injury and illness recordkeeping requirements. If you have further questions please contact my staff at (202) 523-1463.

Sincerely,



Stephen A. Newell
Acting Director
Office of Statistics

Enclosure