First aid and medical treatment are defined in ways unique to the OSHA recordkeeping standards and have been subject to hundreds of interpretations by the agency. If a medical provider administers first aid and a compensable claim exists, that does not mean the case is recordable for purposes of OSHA recordkeeping. If the employee receives only first aid from a medical professional who collects a fee for service, the employee sustained a compensable injury that is not recordable under the OSHA recordkeeping rules. Similarly, an incident that causes an employee to leave work early on the day of the incident for first aid is not recordable if the employee returns to work the next day. Though the employee had a compensable injury or illness due to the loss of income, it is not recordable because the loss of time on the day of the incident does not trigger a documentation obligation, as explained in section 7 of the recordkeeping standard. In contrast, if the incident results in work restrictions placed on the employee by an in-house medical provider but does not incur a loss of income as a result, the incident is recordable but not compensable as there is no medical expense or wage loss. Another reason compensability and recordability may not be aligned is a determination that medical treatment received by an employee, which served as the basis for the OSHA record, was not necessary or not work related. As employers only have seven days to place a case on their OSHA records, decisions about whether to record an incident are often made with limited or incomplete information. Likewise, a workers’ compensation carrier may deny a claim, but if it meets recordkeeping criteria, that denial has no impact on the employer’s obligation to record the incident. A last example relates to the way certain states handled COVID-19 during the pandemic. While several states passed emergency regulations that made any case of COVID-19 in the workplace a compensable work-related illness, that did not necessarily create an obligation to document the illness on OSHA records. OSHA instructed employers to determine whether it was likely that an employee contracted the illness because of a work-related exposure. Many of the cases that were considered compensable were not recordable. THE OEHS PROFESSIONAL’S ROLE The OEHS professional is tasked with determining whether an incident meets OSHA recordkeeping requirements. Often, there is pressure from leadership to determine that the incident is not recordable. Chances are that few company leaders are knowledgeable about OSHA’s recordkeeping requirements. It’s essential for OEHS professionals to understand these requirements, ensure compliance, and provide knowledgeable guidance to management. Sometimes the determination of recordability is straightforward, as in the case of a laceration from a sharp edge that requires treatment beyond first aid. Questions arise when no incident is identified, as when an injury results from cumulative trauma. This scenario reveals the importance of conducting a thorough incident investigation and understanding the work task, including job safety and job hazard analyses, operating instructions, and risk evaluations. This information should be used to determine whether the work caused or contributed to the injury. The final piece of the puzzle is evaluation by a healthcare professional. If an incident results in treatment beyond first aid, work restrictions, or time away from work, it is recordable. Although the opinion of a medical professional is sought, the determination of work relatedness rests with the employer. According to section 5 of the recordkeeping standard, employers “must evaluate the employee’s work duties and environment to decide whether or not one or more events or exposures in the work environment either caused or contributed to the resulting condition or significantly aggravated a preexisting condition.” Whether the determination of recordability is straightforward or requires further evaluation, the OEHS professional should document the rationale used to determine compensability. This documentation must be kept with the record of the incident and readily available to the organization. The most sustainable option is embedding the documentation into injury and illness recordkeeping software. The bottom line is the totality of the situation governs the determination of recordability. The decision should be based on the information noted in this article along with sound professional judgment. OEHS professionals should take the opportunity to engage and educate leaders wherever they are challenged about the recordability of an incident. The goal should be to develop a safety culture that focuses resources on identifying root causes and sustainable corrective actions rather than debating recordability. LORRAINE SEDLAK, CIH, CSP, FAIHA, is a senior EHS consultant at Bright Talent located in Tustin, California. JOHN D. SURMA is a shareholder in the Ogletree Deakins Houston office whose practice is focused on workplace health and safety and environmental matters. Send feedback to The Synergist.
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