Medical treatment choices and injury-recording incentives

OSHA archive notice: "This is an OSHA Archive Document, and may no longer represent OSHA Policy. It is presented here as historical content, for research and review purposes only."

December 10, 1999

Michael Patellos, MD MPH

Corporate Medical Director

Methodist Occupational Health Centers, Inc.

[Recipient address omitted]

Dear Dr. Patellos:

Thank you for your letter dated December 2, 1999, requesting clarification of an issue regarding the OSHA occupational injury and illness recordkeeping requirements.

In your letter you cite a September 2, 1997 letter from Mr. Bob Whitmore to the Central Plains Clinic of Sioux Falls, SD which discusses the recordkeeping requirements in relation to the use of prescription and over-the-counter medications. You further state that this letter has been presented to physicians in the context of deciding what treatment an injured employee should receive. I want to make it clear, and in no uncertain terms, that the OSHA recordkeeping requirements should not be regarded as acceptance or recommendation of a medical practice by OSHA. Furthermore OSHA objects to situations where the recordability of an injury or illness would enter into the decision making process of the proper treatment of an injured employee.

When OSHA issues a letter of interpretation, in most cases we are responding to a certain set of facts presented by a person requesting interpretation. As can be seen from the September 2, 1997 letter, we were specifically asked by the Central Plains Clinic to evaluate scenarios involving the use of OTC medications beyond the FDA recommended dose. When making interpretations of the injury and illness recordkeeping requirements, we rely upon 29 CFR Part 1904 and the Recordkeeping Guidelines for Occupational Injuries and Illnesses. It is clear from page 43 of the Recordkeeping Guidelines that use of nonprescription medication does not make an injury recordable. Our answer to the Central Plains Clinic was made solely in this context. It was not an acceptance or recommendation of the practice.

In response to your specific questions:

Q1. Does OSHA find it acceptable, recommend or encourage physicians to prescribe medications outside the FDA's recommendations?

A1. No. OSHA does not find it acceptable, recommend or encourage physicians to prescribe medications outside the FDA's recommendations.

Q2. Does OSHA find it acceptable, recommend or encourage the use of over-the-counter (OTC) medications to be written in prescription doses to avoid making an injury a recordable?

A2. No. OSHA does not find it acceptable, recommend or encourage the use of over-the-counter (OTC) medications to be written in prescription doses to avoid making an injury a recordable.

I hope you find this information useful. If you have any further questions, please contact the Division of Recordkeeping Requirements on (202) 693-1702.

Sincerely,

Cheryle A. Greenaugh

Director

Directorate of Information Technology