October 30, 1992

Mr. Bradford Brown
Planning & Research Associate
II Department of Labor
Bureau of Labor Standards
Research and Statistics Division
State House Station #45
Augusta, Maine 04333-0045

Dear Brad:

Thank you for your letter dated October 14, requesting interpretations on several injury and illness recordkeeping issues. I will restate each question and address it in the order presented. Whenever possible, I will cite the Recordkeeping Guidelines for Occupational Injuries and Illnesses by page and Q&A number.

Q1 An employee is injured on the job (recordable injury). The individual goes out of work and is compensated through Workers' Compensation. The employee goes through months of treatment but is not permanently restricted. The employee accepts a lump sum payment from the employer's insurance company. As part of the lump sum agreement, the employee had to tender his resignation. The employee is still not able to do his previous job. How should the count of the lost workdays be recorded? Include a best estimate of future lost workdays?

A1 Termination of employment may stop the count of lost workdays only if unrelated to the employee's injury or illness. Because the employee's resignation was part of an agreement relating to his injury, the lost workday count should not be stopped. An estimate should be made of the total number of workdays that would have been lost had the employee not been terminated. (Q&A B-11, page 49)

Q2 Employee has a right knee injury (work related) and loses many workdays. He is brought back to work with restrictions. A job was created to accommodate his restrictions. He is doing the full duties of the new job and the same knee is injured. The employee once again loses time from work. If the original injury resulted in permanent transfer, you would stop the count of lost workdays and record a new case for the second injury to the knee. What if the original transfer was not a permanent one?

A2 The aggravation of a previous injury almost always results from some new incident involving the employee. Consequently, when work related, these new incidents should be recorded as new cases on the OSHA forms when they meet the recordability criteria. In the situation described above, a new case should be recorded. The lost workdays should be counted on the second case until it is resolved. If days continue to be lost at that point, assign them to the original case once again. (Q&A B-12, page 31)

Q3 Exposure incidents (needlesticks, lacerations, etc.) resulting in the recommendation of specific vaccinations, even as a precaution are recordable. What if a hepatitis B vaccination is given as a benefit to the employee as a preventative measure and, after receiving the shot, the employee is out for 3 days with flu like symptoms (a common reaction to the shot). Is this case recordable as an injury?

A3 If the shot was given on the employer's premises, work relationship would be presumed. Unless the employee was there as a member of the general public, work relationship is established. If given off premises, the shot would be considered work related if the employee received it as a condition of his or her employment. If the case is determined to be work related, it should then be evaluated as an injury case. The original exposure (the injection) was an instantaneous event. Because the employee experienced lost workdays due to a reaction to the vaccine, the case should be recorded if it is work related. (Section C, pages 32 & 35)

Q4 Is a case recordable if the medical staff at a plant authorizes medical treatment but the treatment is performed by the employee at work but not in the medical department?

A4 We will assume that the medical treatments being used are: 1) done under standing orders issued by the medical department/employer to use as needed and 2) are provided by the employer. Given the above, it should be interpreted as medical treatment being provided on the second or subsequent visit to medical personnel. A work related injury should then be recorded. Guidance can be found in the Ergonomic Program Management Guidelines for Meatpacking Plants on page 14. An example would be hot wax treatments located near the employees' work stations to be used when they are feeling discomfort.

Q5 Removal of foreign bodies by irrigation are not recordable. Removal of embedded foreign bodies are recordable. What about removal of a non embedded foreign body by cu-tip which is unable to be irrigated?

A5 When addressing the subject of removal of foreign bodies for injury and illness recordkeeping purposes, a distinction is made between removal from the eye and removal from other parts of the body. Removal of non-embedded material from the eye by means of irrigation or cotton swab is considered first aid. Removal of non-embedded material from the eye by any other means is medical treatment. Removal of a foreign body from a wound (other than to the eye) by complicated means because of depth of embedment is medical treatment. Removal by simple means is first aid. (page 42)

Q6 Lost workday cases include cases with restricted workdays. Question B-1 on page 48 seems to contradict C-2 on page 52. Do we count restrictions only on the day of the injury?

A6 Question B-1 on page 48 of the Guidelines is addressing lost workday cases. Question C-2 on page 52 is addressing non-lost workday cases. If there is a restriction on the day of injury or illness only, it is a non-lost workday case (C-2). If there is a restriction beyond the day of injury or illness, it is a lost workday case (B-1).

I hope you find this information useful. If you have any further questions or comments, please call Bob Whitmore or Dave Schmidt at (202) 219-6463.

Sincerely,



Stephen A. Newell
Director
Office of Statistics