During a Feb. 8, 2025, webinar hosted by WorkCare, a WorkCare occupational health physician and two attorneys with Ogletree Deakins, a leading employment law firm, provided expert guidance to help employers comply with OSHA Criteria for Recording and Reporting of Occupational Injuries and Illnesses. Their primary message: Be meticulous about recordkeeping and prompt about reporting. At the same time, take steps to prevent work-related injuries and illnesses and proactively manage cases for optimal workplace health outcomes and safety performance.
The webinar panelists:
- WorkCare Associate Medical Director Isabel Pereira, D.O., M.P.H., M.S.A., a board-certified occupational medicine physician and clinical lead for WorkCare’s telehealth (Incident Intervention) and telemedicine (TeleMD) services.
- Kevin Bland, an attorney with 25 years of experience in workplace health and safety, including federal Occupational Safety and Health Administration (OSHA) and state plan regulatory compliance.
- Mike Clarkson, an attorney whose expertise includes federal OSHA compliance, workplace drug testing rules and regulations, and employer representation in employment-related lawsuits
Recordkeeping Refresher
According to attorneys Bland and Clarkson, compliance assurance starts with an understanding of the differences between first aid (not recordable) and medical treatment (recordable) and knowing when a recordable case must be reported OSHA. (Refer to standard sections in 1904.7(b)(5) for OSHA’s definitions of medical treatment and first aid.)
To comply with federal OSHA regulations, covered employers should accurately record employees’ work-related injuries and illnesses when they occur and immediately report those that meet certain criteria as part of their comprehensive employee health and safety programs. A pattern of failure to record or report is a red flag for OSHA inspectors and can result in substantial fines, especially for willful or repeated violations.
The attorneys said the best legal defense is to immediately record all incidents that require medical treatment and report serious injuries or fatalities as soon as they occur rather than wait for details to emerge and then report them to authorities. In states with their own enforcement agencies, employers are advised to review recording and reporting criteria because they may be more stringent than those enforced by federal OSHA.
However, even with the risk of OSHA citations, some employers hesitate to record cases because they may affect the modification rates used to establish workers’ compensation insurance premiums. Similar to insurance rates that increase due to multiple accidents or traffic tickets, the more cases that are recorded, the greater the liability risk, the higher the insurance cost. Consequently, there may be pressure applied to keep an injury at the first-aid level when medical treatment is warranted.
What is Recordable?
OSHA-recordable incidents are events or exposures that occur in the work environment that are found to cause or contribute to an injury of illness, or that significantly aggravate an existing medical condition. Work-relatedness is presumed unless an exception applies. (Refer to 1904.5(b)(2)).
By comparison, when a workers’ compensation claim is filed, work-relatedness is not an automatic presumption. Medical records and an expert medical opinion may be needed to help determine “causation” – whether an injury or illness arose out of and during the employee’s course of employment – for a covered employee to receive benefits.
“If you’re going to say it’s not work-related, make sure you’ve got a well-documented, supported rationale,” Clarkson advised.
Federal OSHA recordkeeping regulations apply to employers with at least 10 employees (with limited exceptions) in most industries. Covered employers must complete the following OSHA forms:
- 300: Log of work-related injuries and illnesses
- 301: Incident report for each recordable case
- 300A: Annual summary of work-related injuries and illnesses
Form 300A requirements apply to designated industries with at least 250 employees at any time during the previous calendar year and workplaces with 20 to 249 employees that are classified as high-hazard industries, such as agriculture, construction, manufacturing, and utilities. The deadline for employers to electronically submit form 300A for 2024 to OSHA is March 2, 2025. Since Jan. 1, 2024, establishments with 100 or more employees in designated high-hazard industries are also required to electronically submit forms 300 and 301 as part of agency efforts to make reporting more efficient and transparent. (Refer to OSHA’s Injury Tracking Application.)
In addition to medical treatment beyond first aid, the following are recordable:
- Fatalities
- Injury or illness that results in loss of consciousness, days away from work, restricted work, or transfer to another job.
- Any work-related diagnosed case of cancer, chronic irreversible disease, fractured or cracked bones or teeth, and punctured eardrums.
There are special recording criteria for work-related cases involving needlesticks and sharps injuries, medical removal, hearing loss, and tuberculosis.
What is Reportable?
These criteria apply to incidents that must be reported to OSHA with a phone call or via its online portal within a specific timeframe:
- Any fatality within eight hours of occurrence
- Any fatality that occurs within 30 days of the initial incident
- Severe injuries (hospitalization, amputation, or loss of eye) within 24 hours (excludes observation or diagnostic testing)
When Questions Arise
The webinar panelists noted that while recording and reporting criteria are relatively straightforward, confounding factors often add complexity. They encouraged attendees to record an incident if they are in doubt because you’re better off having the documentation than not. Questions about specific situations may require additional guidance from medical, regulatory, and legal experts to help ensure OSHA compliance. Teams should be trained to ask for guidance when in doubt.
When First Aid is Appropriate
Based on WorkCare’s decades of experience assessing and managing work-related injuries at onset, Dr. Pereira said the most commonly occurring work-related conditions, such as sprains and strains, minor burns, shallow cuts, and skin rashes, can be safely managed with first aid and care guidance from a WorkCare occupational health provider. This approach allows employees to safely self-administer non-recordable, OSHA-approved remedies such as ice and over-the-counter medications that allow them to safely remain at work during recovery, in turn reducing recordable case rates, workers’ compensation claims, and related costs.
“WorkCare’s 24/7 telehealth triage team helps employers and employees manage work-related injuries by maximizing first-aid options and preventing unnecessary clinical visits, as clinically appropriate,” she said. “Many of our cases are managed at the OSHA first-aid level by our occupational nursing team, and when appropriate or if a patient requests it, the employee can consult with a WorkCare occupational medicine physician.
“For many employees, just talking with an occupational physician can be very reassuring with regard to self-care or first aid, and of course our nurses always follow up with the employee. Our physicians also reach out through peer-to-peer conversations with the treating provider when an employee visits a local clinic.” The peer consultation may touch on issues such as feasible return-to-work pathways, specific functional work restrictions (not just “light duty”), and work-relatedness determinations.
“With peer-to-peer conversations, we can help reduce lost workdays by ensuring appropriateness of care and work restrictions or avoiding work restrictions altogether if they are not necessary. We really do believe in providing the right care, at the right time, in the right setting,” said Dr. Pereira, who described situations in which early diagnosis and treatment averted serious health consequences.
Avoiding Common Mistakes
Before wrapping up the webinar, the panelists were asked for tips to help employers avoid recording and reporting pitfalls. Here are some of their suggestions:
- There isn’t time to fix logs when an OSHA inspector is at the door. Designate a captain to be responsible for OSHA log accuracy and thoroughness. The captain should also track and update the status of recorded cases as they evolve so the company can report them to OSHA, as necessary.
- For multiple sites, have someone in a central office conduct OSHA recordkeeping and reporting audits to help identify injury trends and ensure compliance across the enterprise. When doing audits or holding recordkeeping inspection weeks, consider doing them under attorney-client privilege to keep sensitive information private and not subject to disclosure in the event of a lawsuit.
- Understand medical restrictions and modified duty recommendations, some of which depend on authoritative medical guidance and may or may not be recordable.
- Do not conflate OSHA-recordability with workers’ compensation compensability. They are related, but they are not the same thing.
- Interview injured employees and witnesses. Their observations may help identify the cause of an injury and reduce recordable injury rates. When a close-call decision is made that a recorded case is not work-related, write a memo to explain why the determination was made. This may help prevent OSHA inspector from issuing a costly willful citation. It is legal to remove a recorded case from the log when there is evidence to confirm it is not related to work.
- Encourage employees to immediately report incidents (without fear of retribution). The sooner an injury is reported, the sooner it can be triaged and managed. Make reporting simple. Do not have programs or offer incentives that discourage reporting, such as rewards for complying with zero-accident policies.
- Be prepared to provide evidence to OSHA that the company has a safety culture, such as new-hire training programs, toolbox talks, efforts to engage employees in healthy and safe work practices, and disciplinary actions for unsafe behaviors.
- Pay attention to first aid and medical treatment nuances. For example, there are differences between a non-prescription and prescription dose of an over-the-counter medication; methods used to close lacerations (e.g., Steri-Strips versus stitches); preventive vaccinations and medication injections; and the use of ace wraps, knee sleeves, neoprene, or wrist supports (first aid) as opposed to outdated rigid or hinge braces (recordable). Referrals to chiropractors or physical therapists are both recordable.
- When completing the OSHA log, be specific about the cause of an injury, for example, do not simply say an employee broke her wrist when she slipped and fell; describe how and where the incident occurred.
- Retain providers who with training in occupational medicine to assess wounds, musculoskeletal complaints, and illnesses and help triage employees appropriately. The right level of care is the best care.
Finally, the panelists encouraged employers to remember that maintaining OSHA logs is not just a recordkeeping task. Information on the logs can be used to spot trends, introduce solutions to reduce accidents, injuries, illnesses, and fatalities, and as a tool to avoid OSHA citations and other problems down the road. Recordkeeping and reporting are essential aspects of safe and healthy workplaces.
