December 5, 2007

Mr. Frank A. White
ORC Worldwide
1800 K Street NW
Washington, DC 20006-2226

Dear Mr. White:

Thank you for your May 5, 2006 letter to the Occupational Safety and Health Administration (OSHA), Directorate of Enforcement Programs, requesting clarification on the requirement for a written opinion from an examining physician. This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any questions or situations not delineated within your original correspondence.

As you stated in your letter, there are a number of expanded health standards that require the employer to provide the employee with a medical examination and "obtain a written opinion from the examining physician." In each of these standards, OSHA considers the physician supervising the medical examination to be the "examining physician." A healthcare professional person who works under the supervision of a licensed physician and performs a medical examination may write a medical opinion for the physician, but the physician must review the opinion, concur with the opinion, and assume responsibility for the opinion. Therefore, the signature on the opinion must be the physician's signature.

Recent standards allow for written opinions from other healthcare professionals (PLHCPs), but only when they are legally permitted by their professional license to independently conduct the type of medical evaluation required. In many cases, however, the required signature on the opinion would still be the physician's. This can vary state by state according to their licensing laws and what scope of practice is permitted for each healthcare professional.

Thank you for your interest in occupational safety and health. We hope you find this information helpful. OSHA requirements are set by statute, standards, and regulations. Our interpretation letters explain these requirements and how they apply to particular circumstances, but they cannot create additional employer obligations. This letter constitutes OSHA's interpretation of the requirements discussed. Note that our enforcement guidance may be affected by changes to OSHA rules. Also, from time to time we update our guidance in response to new information. To keep apprised of such developments, you may consult OSHA's website at http://www.osha.gov. If you have any further questions, please feel free to contact the OSHA Office of Health Enforcement at (202) 693-2190.

Sincerely,



Richard E. Fairfax, Director
Directorate of Enforcement Programs