Public Health Law Map - Beta 5 - Medical and Public Health Law Site

large employers contract out occupational medicine services, many private physicians
and clinics are providing regulated occupational medical services. These providers are
predominantly family physicians and general internists without specialty certification
in occupational medicine. This section discusses the OSHA rules that company and
contract physicians must follow in their occupational medicine practice.
1. Employee Medical Information
In 1980 OSHA promulgated rules governing access to and maintenance of employee
medical records (29 C.F.R. sec. 1910.20, Access to employee exposure and medical
records). (The following discussion omits citations to specific statutory language.)
Although directed at managing medical information, these regulations define the
scope of occupational medicine practice through their expansive definition of
workplace-related medical information. These rules were written for records
maintained in a company- based occupational medicine department, but they
specifically include nonemployee physicians and clinics that provide occupational
medical services. Any physician who treats workplace-related injuries or illnesses or
does preplacement or work fitness evaluations is subject to these regulations.
OSHA promulgated the rules to:
1. Ensure employees, their representatives, and OSHA access to the employees’
medical records.
2. Require employers to supply medical care providers sufficient information about
toxic exposures to allow the treatment and long- term evaluation of exposed
employees.
3. Create a way for medical care providers to report potential hazardous exposures to
OSHA without violating the employer’s trade secrets.
4. Ensure that employee medical records are maintained for a sufficient period (30
years after the termination of employment) to allow the monitoring of conditions
with long latency.
These rules are directed at employers rather than medical care providers. The
employer is expected to see that the medical care personnel follow the rules, and it is
the employer that is subject to administrative sanctions if the rules are not followed.
Physicians employed in a company occupational medicine department that does not
comply with the rules may be subject to sanctions as company representatives.
Nonemployee physicians may be subject to sanctions if they contractually accept the
responsibility for maintaining employee medical information. This can become a
problem if the employer goes out of business without arranging for an orderly
transition in responsibility for the employees’ medical information. An abrupt
termination of business may leave the physician with the duty and financial
responsibility to maintain the records or transfer them properly.
OSHA clearly intended these rules to supplement, rather than replace, traditional
practices: “Except as expressly provided, the rules do not affect existing legal and
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