OSHA’s Recordkeeping Part 1: Injury & Illness Classification

The process of determining recordability can sometimes be very taxing—both professionally and emotionally.  If you’re like most EHS professionals, it’s one of the more stressful parts of your job, especially when you have to tell a member of management that they’ve had a recordable injury. 

When incentive bonuses are tied to incident rates and when leadership teams are more focused on keeping something from being a recordable rather than on preventing recurrence, that can often be a signal of a safety culture that is in need of improvement.

In this two-part series, we will try to lessen the burden of making recordability determinations and provide a simplified explanation of what you need to know about revisions to the recordkeeping standards where your 300 forms and electronic reporting are concerned.

The Importance of Injury & Illness Data

First things first!  Let’s talk about injuries and illnesses and how they are classified by OSHA.  How OSHA differentiates between “first aid” injuries and “recordable” injuries is not that complicated however, it’s one of the most misinterpreted standards.  As a result, many injuries that should be recorded aren’t.  This is a problem because injury and illness data have several important functions and uses. 

The most basic function of injury and illness data is to help employers understand where their hazards are so they can be corrected.  In addition, injury and illness data helps OSHA determine whether regulatory intervention is needed or whether a current federal standard needs to be revised.  Some of the most prolific updates to federal safety standards in the past 20 years have been the result of injury and illness data.  Finally, this data is what the Bureau of Labor Statistics (BLS) uses to generate important national statistics on safety in the workplace. 

Injuries & Illnesses: Two Classifications

When an injury or illness occurs in the workplace, a determination must be made whether it’s a first aid injury/illness or it’s a recordable injury or illness and must be entered on the 300 Log.  In some cases, a recordable injury might also be a “reportable” injury—but we’ll get to that later. 

How an injury or illness is classified is really based on three key pieces of information: work relatedness, the severity of the injury or illness and how the injury was treated.  In some cases, the type of injury plays a part as well.  To help understand how an incident should be classified, OSHA created an interactive recordkeeping advisor that asks a series of questions about an incident, providing you with their best suggestion regarding recordability.   

Work Relatedness

The first piece of information needed when making a recordability determination is whether the injury or illness is considered “work related”.  Some employers believe that what constitutes “work related” is up to their discretion or to the discretion of their Workers Compensation provider—but it’s not.  Of course, Workers Compensation is free to decide what they feel is compensable and what isn’t—but that has no bearing on recordability (which we’ll discuss later in more detail).

OSHA considers an injury or illness to be work related if an “event or exposure in the work environment either caused or contributed to the resulting condition or significantly aggravated a pre-existing injury or illness.” 

There are several exceptions to this which can be found in the standard however, OSHA makes it very clear that worked relatedness is “presumed” for injuries and illnesses that happen from events or exposures that take place in the work environment. 

First Aid Injuries

For an injury or illness to be classified as a first aid, the treatment received must fit into the list of treatments below.  OSHA was very specific about this list being “all inclusive” so if the injury or illness treatment an employee received is not on this list—it’s not a first aid injury!

• Using a non-prescription medication at nonprescription strength. (Using a non-prescription medication (Advil, Tylenol, Aleve, etc.) the way the instructions on the bottle indicate.)
• Administering tetanus immunizations
• Cleaning, flushing or soaking wounds on the surface of the skin
• Using wound coverings such as bandages, Band-Aids™, gauze pads, etc.; or using butterfly bandages or Steri-Strips™ and the use of eye patches
• Using hot or cold therapy—such as ice packs and/or heat packs
• Using any non-rigid means of support such as elastic bandages & wraps (Ace bandage, Kerlix wrap) and non-rigid back belts, etc.
• Using temporary immobilization devices while transporting an accident victim (e.g., splints, slings, neck collars, back boards, etc.)
• Drilling of a fingernail or toenail to relieve pressure, or draining fluid from a blister
• Removing foreign bodies from the eye using only irrigation or a cotton swab
• Removing splinters or foreign material from areas other than the eye by irrigation, tweezers, cotton swabs or other simple means
• Using finger guards
• Using massages (to relieve muscle cramps)
• Drinking fluids for relief of heat stress

Recordable Injuries

What constitutes a recordable injury or illness is a little more complicated.  For the purpose of making this a bit easier to understand, we’ve divided what situations constitute a “recordable” into four sections: 

• Section 1:  Automatics
• Section 2:  Significant Injuries & Illnesses – Professionally Diagnosed
• Section 3:  Special Situations
• Section 4:  Medical Treatment Beyond First Aid

The first section are the “automatics”.  Anytime a workplace injury or illness results one or more of the following situations, the injury is automatically classified as a recordable.

• Death
• Days away from work
• Restricted work or transfer to another job
• Loss of consciousness

A note about “restricted work”: Not all work restrictions constitute “restricted work”.  Only those work restrictions preventing an employee from performing one or more routine job functions (activities performed regularly at least once per week) and/or that prevent an employee from working their full workday—whether they are given directly or recommended by a licensed medical professional—constitute “restricted work”. 

Here are two examples: 

• Scenario 1: An office employee cuts their hand open with a letter opener.  The wound is cleaned and bandaged using butterfly bandages.  The treating physician recommends the employee not lift more than 35 pounds with that hand—but the employee doesn’t ever lift more than maybe 10 pounds.  These restrictions would not be considered “restricted work” because they don’t prevent this employee from performing one or more routine job functions.
  
  
• Scenario 2: A warehouse employee strains their lower back and is given a lifting restriction of “no lifting more than 5 pounds”.  This employee routinely has to lift 50 pounds.  In this case, the lifting restriction would be considered restricted work because it prevents the employee from performing from performing one or more routine job functions.

The second section deals with significant workplace injuries and illnesses that are diagnosed by a licensed medical professional and include (but are not limited to) things like workplace related cases of cancer, chronic irreversible diseases, fractured or cracked bones or teeth and punctured eardrums.  Sometimes these types of injuries and illnesses will not result in medical treatment, or the medical treatment will be delayed—but they are still considered recordable injuries because of the severity. 

The third section deals with special situations such as work-related cases involving needlesticks and sharps, medical removal, hearing loss cases and cases of tuberculosis.  If you’re not familiar with the term “medical removal”, this means anytime an employee is medically removed under the medical surveillance requirements of an OSHA standard.  These cases usually involve standards dealing with specific chemicals such as lead, benzene, formaldehyde, etc. 

The fourth section deals with injuries and illnesses where medical treatment beyond first aid is provided or should have been treated.  These treatments include:

• Chiropractic manipulation
• Exercises recommended by a healthcare professional who trains the worker in the proper frequency, duration and intensity of the exercise
• Physical therapy
• Sutures (stitches), staples, surgical glue
• Surgical debridement (cutting away dead skin)
• Inoculations such as gamma globulin, rabies, etc. given to treat a specific injury or illness, or in response to workplace exposure
• Using anything other than irrigation and/or a cotton swab (Q-Tip) to remove foreign bodies from the eye
• Foreign bodies which require more than simple means to remove because of their location, depth of penetration, size, or shape
• Using casts and/or devices with rigid stays or other systems designed to immobilize parts of the body
• Draining of bruises by needle
• Cold compression therapy
• Oxygen administered to an employee exposed to a substance who exhibits symptoms of an injury or illness
• Medication:
  • Application of prescription antiseptic or a non-prescription antiseptic at prescription strength
  • Prescription medication, whether given once or over a longer period of time
  • Prescription medication-regardless of if the prescription is filled and/or used
  • Treatment of infection with prescription meds on any visit

One of the most hotly debated and misunderstood types of medical treatment beyond first aid from the list above is the use of prescription medications.  OSHA addresses most of these misconceptions in a very thorough letter of interpretation from February of 2007 which ultimately states once a medical professional writes a prescription to treat an injury or illness, it’s a recordable injury—regardless of whether that prescription is filled, used or declined and regardless of whether a company doctor or another doctor reviews the case and decides the prescription wasn’t necessary. 

The reason for OSHA’s response goes back to what we originally discussed in this article—recordable injuries and illnesses are generally determined by their severity and how they are treated—regardless of whether the treatment is accepted by the employee or not. 

Temporary Workers

There is often a lot of confusion about injury and/or illness reporting when it comes to temporary workers.  The key to understanding who is responsible for reporting injuries and/or illnesses of temporary workers comes down to one thing:  supervision. 

Per 29 CFR 1904.31, the employer that provides the day-to-day supervision of temporary workers (also called the “host” employer) is responsible for reporting these injuries and/or illnesses to OSHA.  The host employer should also be including any injuries and/or illnesses that are considered “recordable” to their 300 Log. 

Workers Compensation & OSHA Recordability

Now let’s talk about Workers Compensation and how it applies to recordability.  The simple answer is that it doesn’t.  When trying to determine whether an injury or illness is a considered “recordable” or not, whether the case is considered compensable and covered by Workers Compensation is not a consideration.  There are situations where injuries and illnesses may fit into the criteria of being a recordable but aren’t compensable under Workers Compensation and vice versa. 

Some companies believe that if a Workers Compensation carrier decides that a specific injury or illness is “not compensable” because they don’t believe it to be work related that this somehow affects recordability—but don’t fall into this trap.  These two things are not related and if you’re relying on your Workers Compensation provider to make work relatedness determinations before you determine whether an injury or illness is a recordable, you’re setting yourself up for a serious penalty—especially if the injury or illness is not entered onto your 300 Log within seven calendar days after you receive information that a recordable work-related injury or illness has occurred.  The only benefit that a denied Workers Compensation claim can provide is as supporting evidence if a 300 Log entry is “redlined” or based on a thorough investigation, the injury or illness no longer meets the criteria to be considered a recordable.

In part 2 of this two-part series, we will talk about 300 forms and outline the recent revisions to the recordkeeping standards to include a discussion about electronic reporting.