OSHA Recordkeeping Handbook - Msabc.net

the Guidelines stated that “the aggravation of a previousinjury almost always results from some newincident involving the employee * * * [w]hen workrelated,these new incidents should be recorded asnew cases on the OSHA forms, assuming they meetthe criteria for recordability * * *” (Ex. 2, p. 31).However, the Guidelines also stated that “certain illnesses,such as silicosis, may have prolonged effectswhich recur over time. The recurrence of thesesymptoms should not be recorded as a new case onthe OSHA forms. * * * Some occupational illnesses,such as certain dermatitis or respiratory conditions,may recur as the result of new exposures to sensitizingagents, and should be recorded as new cases.” ……In the final rule, OSHA has decided against theproposed approach of determining case resolutionbased on a certain number of days during which theinjured or ill employee did not lose time, receivetreatment, have signs or symptoms, or be restrictedto light duty. OSHA agrees with those commenterswho argued that the proposed approach was too prescriptiveand did not allow for the variations that naturallyexist from one injury and illness case to thenext. Further, the record contains no convincing evidenceto support a set number of days as appropriate.OSHA thus agrees with those commenters whopointed out that adoption of a fixed time intervalwould result in the overrecording of some injury andillness cases and the underrecording of others, andthus would impair the quality of the records.Further, OSHA did not intend to create an “injuryfree” time zone during which an injury or illnesswould not be considered a new case, regardless ofcause, as . . . suggested. Instead, OSHA proposedthat a case be considered a new case if either conditionapplied: the case resulted from a new event orexposure or 45 days had elapsed without signs,symptoms, or medical treatment, restricted work, ordays away from work. There are clearly cases wherean event or exposure in the workplace would because for recording a new case. A new injury maymanifest the same signs and symptoms as the previousinjury but still be a new injury and not a continuationof the old case if, for example, an employeesustains a fall and fractures his or her wrist, and fourmonths later falls again and fractures the wrist in thesame place. This occurrence is not a continuation ofthe fracture but rather a new injury whose recordabilitymust be evaluated. The final rule’s approach torecurrence/new case determinations avoids this andother recording problems because it includes no daycount limit and relies on one of the basic principlesof the recordkeeping system, i.e., that injuries or illnessesarising from events or exposures in the workplacemust be evaluated for recordability.In response to those commenters who raisedissues about inconsistency between the OSHA systemand workers’ compensation, OSHA notes thatthere is no reason for the two systems, which servedifferent purposes (recording injuries and illnessesfor national statistical purposes and indemnifyingworkers for job-related injuries and illnesses) to usethe same definitions. Accordingly, the final rule doesnot rely on workers’ compensation determinations toidentify injuries or illness cases that are to be considerednew cases for recordkeeping purposes….…OSHA has not included any provisions in thefinal rule that require an employer to rely on a physicianor other licensed health care professional or thattell a physician or other licensed health care professionalhow to treat an injured or ill worker, or whento begin or end such treatment. In the final ruleOSHA does require the employer to follow any determinationa physician or other licensed health careprofessional has made about the status of a newcase. That is, if such a professional has determinedthat a case is a new case, the employer must recordit as such. If the professional determines that thecase is a recurrence, rather than a new case, theemployer is not to record it a second time. In addition,the rule does not require the employee, or theemployer, to obtain permission from the physician orother licensed health care professional before theemployee can return to work. OSHA believes that theemployer is capable of, and often in the best positionto, make return-to-work decisions….…”A recurrence of a previous work-related injuryor illness should only be considered a new case whenthe injury or illness has completely healed. Severemuscle and nerve damage can take many weeks ormonths to properly heal.” The final rule takes suchdifferences into account, as follows. If the previousinjury or illness has not healed (signs and symptomshave not resolved), then the case cannot be consideredresolved. The employer may make this determinationor may rely on the recommendation of a physicianor other licensed health care professional whendoing so. Clearly, if the injured or ill employee is stillexhibiting signs or symptoms of the previous injuryor illness, the malady has not healed, and a new casedoes not have to be recorded. Similarly, if work activitiesaggravate a previously recorded case, there is noneed to consider recording it again (although theremay be a need to update the case information if theaggravation causes a more severe outcome than theoriginal case, such as days away from work)….§1904.6OSHA RECORDKEEPINGHANDBOOK41