July 11, 2011

Deputy Chief Nicholas Campasano
Manchester Fire Department
Training Division
100 Merrimack St.
Manchester, NH 03101

Dear Deputy Chief Campasano:

Thank you for your letter to the Occupational Safety and Health Administration's (OSHA's) Directorate of Enforcement Programs. You requested a third review of a revised medical monitoring form developed by your department and asked if the form meets the requirements under OSHA's Hazardous Waste Operations and Emergency Response (HAZWOPER) Standard, 29 CFR 1910.120(f)(7). This letter constitutes OSHA's interpretation only of the requirements discussed and may not be applicable to any question not detailed in your original correspondence. Please excuse the delay in our response.

OSHA's Directorate of Technical Support and Emergency Management (DTSEM) office previously responded to you on March 20, 2009 and August 20, 2010, regarding a review of your department's draft medical monitoring form (i.e., examining physician's written opinion) under 29 CFR 1910.120(f)(7). DTSEM informed you that your draft, uncompleted medical form did not comply with §1910.120(f)(7), and provided information on the specific elements required of a written physician's opinion.

The standard does not mandate the use of a form for the physician's written opinion. While OSHA does not prohibit the use of a template or form for a physician's convenience in supplying the written opinion, the Agency simply cannot determine whether any blank form ultimately will result in compliance with the standard. A physician's written opinion can truly only be determined to be compliant or non-compliant with the standard after it has been completed and can be compared with the requirements listed in 29 CFR 1910.120(f)(7)(i).

Here are some recommendations for updating your form to make it more likely that a physician will complete it in compliance with §1910.120(f)(7):

1. Add a place for the physician to describe the results of the medical examination and tests if requested by the employee (per §1910.120(f)(7)(i)(C)).
    
2. Expand the language next to the third check box to say: "Has been notified of the results of this medical examination and any medical conditions that require further examination or treatment" (per §1910.120(f)(7)(i)(D)).
    
3. Add a note at the bottom of the form reminding the physician that the written opinion shall not include specific findings or diagnoses unrelated to occupational exposure (per §1910.120(f)(7)(ii)).

Whether or not the physician uses a form, an employer is in compliance with §1910.120(f)(7) only if the finished physician's written opinion contains all of the required information.

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 can consult OSHA's website at www.osha.gov. If you have any further questions, please feel free to contact the Office of Health Enforcement at (202) 693-2190.

Sincerely,



Thomas Galassi, Director
Directorate of Enforcement Programs