Medical treatment and repeat cases on former OSHA injury logs

NOTICE: This is an OSHA Archive Document, and may no longer represent OSHA Policy. It is presented here as historical content, for research and review purposes only.

September 2, 1997

Velda Madison
Sr. Staff Assistant
OSHA Activity
NAO-Occupational Safety and Health
General Motors Corporation
General Motors Building
[Recipient address omitted]
Dear Ms. Madison:

Thank you for your letter of July 21, 1997, requesting an interpretation of recordkeeping requirements with regard to several situations occurring in your workplace. Please excuse the delay in our response. I will respond by restating each question and then answering it. I will cite the Recordkeeping Guidelines for Occupational Injuries and Illnesses by page and Q&A number(s) whenever possible unless another publication is specifically referenced, in which case, I will indicate the title.

1. If an employee receives a minor cut that requires first aid only, but the doctor prescribes antibiotics as a preventive against infection due to the object causing the cut (i.e. a rusty knife), would this be recordable solely due to the prescription being written?

Yes. The prescription of an antibiotic is considered medical treatment. If the minor cut is a work-related injury, then the case is recordable (F Deciding if work-related injuries are recordable, pages 42-43).

2. If an employee is diagnosed as having a sprain or strain and 6 months later complains that the pain is not any better and after further medical attention the doctor changes the diagnosis to cumulative trauma disorder, should this be considered a new case?

No. The obligation to make entries and update logs exists not only during the year that the injury or illness exposure took place, but also throughout the 5-year retention and maintenance period (B-5, page 30). The log in this case should be corrected to a diagnosis of cumulative trauma disorder using the same date of the original sprain or strain.

Question and Answer B-12 on page 31 of The Recordkeeping Guidelines states, "Employers are required to make new entries on their OSHA forms for each new recordable injury or illness. New entries should not be made for the recurrence of symptoms from previous cases (Emphasis added)."

When differentiating between a new cumulative trauma disorder (CTD) and the recurrence or further complication of a previously recorded CTD, the guidance found in Section c(1) on page 15 of the Ergonomics Program Management Guidelines For Meatpacking Plants should be used. This states, "A case is considered to be complete once there is complete resolution of the signs and symptoms. After resolution of the problem, if signs or symptoms recur, a new case is established and thus must be recorded on the OSHA-200 form as such. Furthermore, failure of the worker to return for care after 30 days indicates symptom resolution. Any visit to a health care provider for similar complaints after the 30-day interval implies reinjury or reexposure to a workplace hazard and would represent a new case." This 30-day rule applies only to CTDs. For all other injuries and illnesses, the guidance found in Q&A B-12 on page 31 of the Recordkeeping Guidelines must be used for determining a new case. New entries should be recorded when new events or exposures result in the aggravation of previous injuries and illnesses

3. Is the administration of oxygen considered first aid or medical treatment?

The administration of oxygen is considered to be first aid when it applies to an injury case. In the case of an illness, all occupational illnesses are recordable. Remember, the basic determinant in distinguishing between an injury and an illness is the single-incident concept. If the case resulted from an event or exposure that happened in one instant, it is classified as an injury. If the case resulted from an event or exposure that was not instantaneous, such as prolonged exposure to hazardous substances or other environmental factors, it is considered an illness (D, Distinguishing between injuries and illnesses, page 37 and D-3, page 38).

4. Is the administration of IV fluid considered medical treatment? The fluid is for hydrating purposes and contains no medication.

No, the administration of IV fluid is considered to be first aid when it applies to an injury case. See previous case for distinguishing between injuries and illnesses.

5. Are complications resulting from a personal injury recordable?

Example 1: An employee cuts his finger at home and the products he works with (oil cleaners, etc.) cause dermatitis over time.

Example 2: An employee breaks his ankle at home and has to have job. Should the days be counted as restricted work days?

The first criterion for determining recordability is whether or not the case results from a work accident or an exposure in the work environment (Chart 2, page 32). If the employee's symptoms surfaced on the employer's premises, a work relationship is presumed. Preexisting conditions usually do not affect determinations of recordability under the OSH Act. If it seems likely that an event or exposure in the work environment either caused or contributed to the case, the case is work related (B-15 and B17, pages 31-32).

Example 1 entails a chemical exposure on premises and is therefore considered a work related recordable illness. Example 2 is solely related to a nonwork related injury and therefore is not recordable.

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

Sincerely,

Bob Whitmore
Chief
Division of Recordkeeping Requirements