April 8, 1994

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

Dear Brad:

Thank you for your letter dated March 23, requesting interpretations concerning several OSHA injury and illness recordkeeping issues. I will address each issue by first repeating the question and by referring to the appropriate Q&A and page numbers in the Recordkeeping Guidelines for Occupational Injuries and Illnesses.

Q1. An employer has an employee who showed symptoms of a CTD in October, 1993 due to the repetitive nature of her work. She lost no time from work and had no restriction and no medical treatment. The employee was diagnosed with a cumulative trauma disorder in March of 1994 and has lost time from work. The date for column B of the Log, which determines what year the case is recorded in, is supposed to be the date of diagnosis or the date of onset of the illness. Specifically, what constitutes the onset of illness? The bluebook states "for occupational illnesses, enter the date of initial diagnosis of the illness (which was March of 1994 even though the employee had problems before this) or if absence occurred before diagnosis, enter the first day of absence attributed to the illness. This implies that onset means absence from work. Is this correct? If so, then the date of recording for this case should be in March of 1994.

A1. A cumulative trauma disorder is recordable if there is at least one physical finding OR at least one subjective symptom combined with 1) medical treatment, 2) lost workdays (includes restricted work activity), or 3) transfer/rotation to another job. Examples of physical findings include positive Tinel's, Phalen's, or Finkelstein's tests; or swelling, redness or deformity; or loss of motion. Subjective symptoms include pain, numbness, tingling, aching, stiffness, or burning.

For cases involving cumulative trauma disorders, the date the case becomes recordable using the above criteria should be used for the entry in column B. The case as described above should be recorded using a March 1994 date if the symptoms the employee showed between October and March were subjective symptoms. The case would not be recordable until the diagnosis was made in March. If her symptoms were physical findings, the case should be recorded using the date that the physical findings first appeared.

For OSHA recordkeeping purposes, if days away from work or days of restricted work activity occur before an illness is recognized or diagnosed, then the first lost workday is considered the onset of the illness.

Q2. On page 15 (of the Ergonomics Program Management Guidelines) there is a paragraph that states that a CTD case is considered complete once there is complete resolution of signs and symptoms. After resolution, if signs or symptoms recur, a new case is recorded. I have spoken with Bob about resolution in the past and he indicated the following for injuries (e.g., back sprains) and for CTDs: if a person has returned to their regular job and is working full-time without any restrictions--even for a day--and then the person goes out of work again then a new case should be recorded. Is this still correct? The Ergonomics Guidelines also state that failure of the worker to return for care after a 30 day interval indicates symptom resolution. Reinjury or reexposure to a workplace hazard would represent a new case. My understanding is that this does not mean that employees with CTDs must be resolved of problems for 30 days (i.e., working full-time without restrictions) before another CTD case may be recorded. Is this correct? What then does the 30 day interval rule suggest? Does this mean the case and hence the count of days for a worker on lost time or restricted worktime stops if he does not go to the doctor for 30 days?

A2. If and when an employee who has experienced a recordable CTD becomes symptom free (including both subjective symptoms and physical findings), any recurrence of symptoms should be evaluated as a new case. Furthermore, the 30-day rule is only one indication of symptom resolution and the 30 day count applies only to the worker seeking medical care (not the number of days he or she is symptom free). This means that symptom resolution can be for a period of less than 30 days to indicate case resolution.

If an employee is experiencing days away from work or days of restricted work activity due to a CTD case, than that case is not considered resolved and would not be until the employee returns to his or her full duties and is symptom free. Furthermore, the application (or count) of the 30-day rule would not start until the employee returned to full duty.

Please be aware that the 30-day rule applies only to cases involving CTDs. For all other cases, differentiation between new incidents and recurrences is addressed in Q&A B- 12 on page 31 of the Guidelines.

Q3. A ski area called inquiring about establishments and the number of logs they had to keep. They have under one management, one set of books and one payroll the following functions: the ski area, two hotels, a restaurant, a waste water treatment facility, and rental service and housekeeping for condos. Each of these by themselves would be different Standard Industrial Classifications and different operational procedures. Please let me know how many different sets of records you expect. Certain SICs are exempt from recordkeeping. If taken separately, the restaurant and the rental service would be exempt. What if you determine that only one set of records is needed. Do cases occurring in the restaurant need to be recorded?

A3. When distinct and separate economic activities are performed at a single physical location, each activity may represent a separate establishment. Each distinct and separate activity should be considered an establishment when (1) no one industry description (Standard Industrial Classification, 1987) includes such combined activities, and (2) the employment in each such economic activity is significant, and (3) separate reports can be prepared on the number of employees, their wages and salaries, sales or receipts, or other types of establishment information.

All of the separate functions listed above fall under SIC 7011 using the line item "Ski Lodges and Resorts" and therefore do not meet criteria number 1. The organization in question should not maintain separate logs for separate functions. It may be required, however, to maintain separate logs for separate establishments if they are physically separate from each other and not located in proximity to one another (Q&A A-1, page 19).

Recordable injuries and illnesses occurring to employees in any one of the functions of the company (e.g., restaurant, rental service, etc.) must be entered into the OSHA records.

I hope you find this information useful. If you have any further questions, please call us at Area Code: (202) 219-6463.

Sincerely,



Robert Whitmore
Chief
Division of Recordkeeping Requirements