Notice: Function _load_textdomain_just_in_time was called incorrectly. Translation loading for the acf-field-for-contact-form-7 domain was triggered too early. This is usually an indicator for some code in the plugin or theme running too early. Translations should be loaded at the init action or later. Please see Debugging in WordPress for more information. (This message was added in version 6.7.0.) in /home/workcareprod/public_html/wp-includes/functions.php on line 6114
Onsite Work Safety – WorkCare

Category: Onsite Work Safety

  • Uncovering Hidden Costs of Work-related MSDs

    Uncovering Hidden Costs of Work-related MSDs

    This is the first post in a series on workplace musculoskeletal disorders, their costs, and how to prevent and manage them.

    Musculoskeletal disorders (MSDs) are responsible for over 1 million workplace injuries annually in the U.S., costing employers an estimated $20 billion in workers’ compensation claims, according to the U.S. Bureau of Labor Statistics (BLS).  

    The National Institute for Occupational Safety and Health (NIOSH) has estimated that costs associated with work-related MSDs range from $13 billion to $54 billion annually. The direct cost of an MSD-related injury can range from $15,000 to $85,000 per case. Indirect costs (such as lost productivity and retraining) can double or triple this amount, according to government data. 

    MSDs have hidden costs that can far exceed medical care and insurance expenditures. Without preventive measures and early interventions to help relieve discomfort, improve mobility, and promote recovery, MSDs often result in productivity lapses that can be difficult for employers to measure in terms of monetary loss. 

    The potential for costly consequences occurs every time an employee experiences a strain, sprain, or other physical discomfort. In some cases, MSDs are acute injuries that may be caused by a vehicle accident, slip, trip or fall, or awkward movement while handling materials or tools. Other contributing factors may include repetition, advanced age, or underlying medical conditions. 

    MSDs Come in Different Forms 

    The BLS tracks and reports work-related injuries and illnesses on an annual basis. Due to their prevalence, the BLS has developed tables that cover a specific range of musculoskeletal disorders. These include

    • Pinched nerves and numbness 
    • Dislocations 
    • Hernias 
    • Strains, sprains, and tears 
    • Connective tissue disorders 
    • Carpal tunnel syndrome  

     The most commonly reported MSDs are sprains, strains, or tears associated with “overexertion.” (Refer to this interactive National Safety Council Injury Facts chart for details.) According to BLS data published in November 2024, MSDs in U.S. private industries during 2021-22 led to: 

    • 502,380 days away from work with an incident rate of 25.3 per 10,000 employees 
    • 473,700 days of restricted work activity or job transfer with an incident rate of 23.8 per 10,000 employees 
    • 14 median days off work and 20 days of restricted work or job transfer. 

    Sprains, strains, and tears accounted for 342,489 lost workdays and 359,000 restricted or job transfer days. Only injuries involving trauma to bones, nerves, or the spinal cord resulted in more lost time. 

    Hidden Costs Add Up 

    Hidden costs quickly accrue when injured workers are absent, assigned to temporarily modified jobs, or are at work but not fully engaged or productive (referred to as presenteeism). In some cases, replacement workers may have a higher-than-average risk for injury because they are not conditioned for the job, are expected to work overtime, or are not fully trained.  

    The Occupational Safety and Health Administration’s (OSHA) Safety Pays online calculator can be used to estimate the impact of MSDs on an organization’s profitability. Using a 3 percent profit margin as a factor in this example: 

    • The indirect cost of a work-related strain due to productivity loss and personnel reallocation is estimated at $35,225.  
    • Direct costs, such as medical treatment and workers’ compensation insurance coverage, are estimated at $32,023.  
    • A company would have to increase its sales by more than $1.1 million to cover indirect costs and $2.2 million to cover total costs for a single sprain.

    OSHA also estimates that workers’ compensation medical costs for MSDs range from $30,000 to $80,000 per case. Additionally, research from the Society for Human Resource Management (SHRM) indicates that injury-related absences lead to an average 36.6% drop in productivity, costing businesses approximately $3,600 per hourly worker each year due to absenteeism. 

    The average cost to replace an absent worker with a newly hired employee is around $4,700, though some employers estimate the total cost to be three to four times the position’s salary, Edie Goldberg, founder of the talent management and development firm E.L. Goldberg & Associates, told SHRM in 2022. An employer seeking to fill a position that pays $60,000 may spend $180,000 or more to fill the role. 

    Meanwhile, other studies show that presenteeism (working while in pain or with limited function) can reduce productivity by 20 to 40 percent per affected worker, and the estimated cost of presenteeism for an employee with chronic pain from an MSD can range from $3,000 to $10,000 per year in lost productivity. 

    Some costs are truly hidden because no one knows for sure how many cases of work-related physical discomfort are not reported. The authors of a newly published American Journal of Public Health article on OSHA Injury Data: An Opportunity for Improving Work Injury Prevention estimate it is a significant number. Reasons for under-reporting vary. For instance, employers may feel pressured to reduce OSHA-recordable case rates to avoid fines and improve safety records. Injured employees may fear repercussions if they report an injury to their supervisor, or they may have an “I’ll just tough it out attitude” when early intervention would be in their best interest. 

    Prevention is Key 

    To help contain costs, many companies are investing in ergonomic interventions, workplace wellness programs, and injury prevention strategies to mitigate the financial burden of MSDs. Employers who prioritize MSD prevention report declines in rates of injuries and related costs and improved workforce well-being and morale.  

    Discover how WorkCare can help protect your workforce and your bottom line. Contact us for a consultation.  

    Join our April webinar to learn how one global power company client implemented a groundbreaking Total Employee Health program designed to prevent musculoskeletal disorders (MSDs) and improve workplace wellness.

  • Webinar Recap: Complying with OSHA Recording and Reporting Rules 

    Webinar Recap: Complying with OSHA Recording and Reporting Rules 

    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: 

    1. 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.  
    2. 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. 
    3. Understand medical restrictions and modified duty recommendations, some of which depend on authoritative medical guidance and may or may not be recordable.  
    4. Do not conflate OSHA-recordability with workers’ compensation compensability. They are related, but they are not the same thing. 
    5. 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. 
    6. 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.  
    7. 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. 
    8. 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.  
    9. 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. 
    10. 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. 

    Watch the webinar recording on-demand to learn more and read the Q+A from the session here to get answers to questions raised during and after the event. Reach out to WorkCare if you’d like more information on our services. 

  • Q+A from “Navigating OSHA Recordkeeping: Understanding the Differences Between Reportable and Recordable Incidents” Webinar

    Q+A from “Navigating OSHA Recordkeeping: Understanding the Differences Between Reportable and Recordable Incidents” Webinar

    The WorkCare team recently hosted a well-attended, informational webinar with our friends from Ogletree Deakins to discuss all things related to OSHA recordkeeping. In this session, our experts provided valuable insights into OSHA compliance and best practices for effective workplace health and safety recordkeeping. 

    Key Takeaways: 

    • Clarifying Recordable vs. Reportable Incidents – We explored the fundamental differences between OSHA recordable and reportable incidents, outlining when and how each must be documented. 
    • Real-Life Scenarios & Best Practices – Attendees engaged in discussions around complex workplace incidents, learning how to accurately determine reportability and recordability while avoiding common pitfalls. 
    • Ensuring Compliance Through Accurate Documentation – We reviewed OSHA’s recordkeeping requirements, emphasizing the importance of precise documentation to mitigate risks and ensure regulatory compliance. 

    As a follow-up to the webinar, we’ve provided answers to questions raised during and after the session. We hope you’ll find these useful.  

    If you missed the webinar, we invite you to watch it on-demand in its entirety at your leisure. 

    Webinar Q+A: 

    Do athletic trainers (ATs) have a large presence in the workers’ compensation field? Should providers be referring to physical therapists or ATs for care after an injury? 

    The use of athletic trainers continues to gain popularity in the U.S. as a proactive, cost-effective way to prevent and manage workers’ compensation cases. WorkCare’s Industrial Athlete Program team includes certified athletic trainers who are Injury Prevention Specialists focused on managing work-related musculoskeletal cases at a first-aid level. While physical therapy may be classified as a recordable treatment, first-aid level care is not recordable. However, referral to an AT or PT may be recordable under certain circumstances. OSHA states: “If an employee exhibits symptoms of a work-related injury or illness, the recommendation to conduct exercise/stretching, either at work or at home, to treat a work-related injury or illness makes the case recordable regardless of the professional status of the person making the recommendation.” 

    Can you clarify the recordability of vehicle incidents and injuries that occur while an employee is driving for work? 

    Recordability depends on the circumstances of the incident. If an employee is operating a company vehicle while performing work duties, such as traveling between job sites, a motor vehicle accident (MVA) would likely be considered work-related. However, if the employee is commuting to or from work in a company vehicle they are permitted to keep at home, the situation becomes less clear. Additionally, state workers’ compensation laws may impact the determination, so it’s important to review specific regulations when assessing recordability. 

    If an employee reports an injury but there is no identifiable event that caused it, is the employer required to assume it is work-related? If there is no evidence of an incident outside the workplace, does it still need to be recorded as work-related? 

    Before recording the injury, a medical evaluation should be conducted to assess work-relatedness. If there is no clear mechanism of injury, work-relatedness may be in question. In occupational medicine, this scenario is a red flag; further investigation may be needed. A thorough clinician will evaluate the employee’s job duties, discuss any activities outside of work, and compare clinical findings to determine whether the injury should be classified as work-related. See Compliance Reference. 

    If an employee independently purchases and uses a rigid splint without a healthcare provider’s recommendation, does this make the injury recordable? 

    For OSHA recordkeeping purposes, rigid splints that immobilize body parts are classified as medical treatment beyond first aid. However, OSHA generally does not consider self-treatment or self-medication by an employee to constitute medical treatment. For an injury to be recordable, the treatment must be directed by the employer or a healthcare professional. To avoid any misinterpretation, employers should refrain from providing wrist braces or similar devices. Additionally, when triaging employees, it’s important not to inadvertently condone the use of a rigid brace, as this could be misconstrued as a medical recommendation. 

    What does it mean to be “in the work environment as a member of the public?” Would traveling on a commercial flight for work fall under this category? 

    If an employee is on a required work trip and sustains an injury, such as straining their back while lifting their luggage into the overhead bin, the injury would likely be considered work-related because the employee is traveling for work, not for personal reasons.  This scenario does not fall under OSHA’s exception for injuries occurring “as a member of the public.”

    However, if an employee is engaging in personal activities within the workplace, such as playing basketball in the company gym outside of an official team-building exercise, they would be considered “in the work environment as a member of the public,” meaning any injury incurred may not be considered work-related. 

    What happens when a workers’ compensation review determines an incident is not work related? 

    If a review concludes that an incident is not work-related, it should simply be removed from the OSHA log, and no further action is required

    Why is a laceration resulting in a tetanus vaccine not considered recordable but an animal bite resulting in a rabies vaccine or a tick bite resulting in a prophylactic antibiotic are considered recordable? 

    OSHA considers tetanus vaccines as a preventive measure intended to reduce the risk of infection rather than to treat an existing condition. In contrast, treatment following an animal bite —such as immunoglobulin therapy and a rabies vaccine —is considered medical treatment due to the potential severity of rabies. Similarly, any prescription medication, such as antibiotics given after a tick bite, qualifies as medical treatment, making it recordable. However, if a veterinarian is required to receive a rabies vaccine as a preventive measure before potential exposure, it is not recordable. 

    If an employee calls 911 for himself and the ambulance takes him to the hospital as a precaution, do we need to report? 

    It depends on the reason for the hospital visit. If the employee is being transported due to a work-related injury, such as a crushed hand, reporting may be required. However, if the visit is for a personal medical condition, such as chest pain related to pre-existing heart disease and not caused by a workplace incident, reporting is generally not necessary. 

    Would it be a recordable incident in this scenario involving a “minor” injury? An employee bumps a knee but feels fine and continues working without reporting it to their supervisor. The employee develops knee pain, seeks treatment days later, and is put on restricted duty or given time off from work.

    Many injuries may seem minor at first but can worsen over time. For example, shoveling snow may not feel problematic in the moment, but stiffness and pain can increase overnight as the body cools down and rests. Employees are encouraged to report incidents, even those that seem minor, as soon as possible to ensure appropriate care. While a hospital visit may not always be necessary, and since emergency rooms often place employees on work restrictions automatically seeking treatment at a local clinic might be more appropriate in some cases. It would be considered recordable if the employee is officially taken off work due to the injury.

    Additional General OSHA Recordkeeping Q+A 

    How does OSHA classify mental health conditions, such as work-related stress or post-traumatic stress disorder (PTSD) in recordkeeping requirements?

    Context: OSHA typically requires recording of physical injuries and illnesses, but work-related mental health conditions can be recordable under certain circumstances. 

    Compliance Reference: According to 29 CFR 1904.5, an illness is recordable if it is work-related, results in days away from work, restricted duty, or medical treatment beyond first aid. However, mental illnesses, including PTSD, must be diagnosed by a licensed healthcare professional and determined to be work-related for OSHA recordability. 

    Example: If an employee is diagnosed with PTSD after witnessing a workplace fatality and a physician attributes it to the event, it could be recordable. 

     

    If an employee suffers an injury at a company-sponsored event like a team-building activity or tradeshow, is it considered recordable?

    Context: Work-sponsored events blur the line between work-related and non-work-related activities. 

    Compliance Reference: Per 29 CFR 1904.5(b)(2)(iii), an injury occurring during a company-sponsored social or recreational event is not work-related if the employee is there voluntarily and not performing work-related duties. 

    Example: If an employee sprains an ankle while voluntarily playing in a company softball game, it is not recordable. However, if they are required to participate, or the injury occurs during a work presentation at the event, it could be recordable. 

     

    Are injuries sustained during an employee’s break, lunch, or while commuting on company property recordable? 

    Context: Employees often get injured while walking to their cars, using company break areas, or commuting on work property. 

    Compliance Reference: If an injury occurs in a company-controlled break area or cafeteria, it is recordable (1904.5(b)(1)). If an injury occurs in the company parking lot while commuting to or from work, it is not recordable (1904.5(b)(2)(vii)). 

    Example: If an employee slips on ice inside the building’s break room, it is recordable. If they slip in the parking lot on their way to work, it is not recordable. 

     

    How should near-miss incidents be documented? Do they ever factor into OSHA recordkeeping requirements?

    Context: Near misses are not recordable but are essential to address for safety reasons. 

    Compliance Reference: OSHA does not require near-miss reporting under 29 CFR 1904, but 29 CFR 1910.119(h)(6), but it encourages documenting and investigating near-misses. 

    Example: When a worker nearly falls from scaffolding it is not recordable but should be documented for hazard mitigation. 

     

    If an employee experiences a delayed onset injury (e.g., back pain weeks after lifting a heavy object), when does the OSHA recordability clock start?

    Context: Some injuries don’t immediately show symptoms. 

    Compliance Reference: Per 1904.5(b)(3), the injury becomes recordable when a licensed medical professional diagnoses it as work-related and results in treatment beyond first aid, restricted work, or lost time. 

    Example: An employee who lifts heavy boxes and reports back pain a week later is recordable only if medical treatment beyond first aid or lost work time occurs. 

     

    How do recordkeeping rules apply to temporary workers or contractors? Who is responsible for maintaining their records, the host employer or staffing agency?

    Context: Responsibility depends on who directly supervises the worker. 

    Compliance Reference: Per OSHA’s Temporary Worker Initiative (TWI), the host employer is responsible for recordkeeping if they control the worker’s day-to-day activities (29 CFR 1904.31). 

    Example: If a temp worker under an employer’s supervision gets injured, the employer must record it, not the staffing agency. 

     

    Are adverse reactions to flu shots or other vaccinations provided at work covered under OSHA’s recordkeeping requirements? 

    Context: Employees sometimes experience reactions to employer-provided flu shots. 

    Compliance Reference: Per 1904.5(b)(2)(iii), an adverse reaction to a voluntary flu shot is not recordable, but if the vaccine is mandatory, it is recordable. 

    Example: If an employer requires flu shots and an employee suffers an allergic reaction requiring medical treatment, it must be recorded. 

     

    If an injured worker seeks medical care but later declines treatment, is the incident still recordable?

    Context: Employees sometimes refuse treatment for personal reasons. 

    Compliance Reference: Per 1904.7, if a healthcare provider recommends medical treatment beyond first aid, work restrictions, or lost time, the case is recordable—even if the worker refuses treatment. 

    Example: Declining care does not change whether a case is reportable or recordable. Obviously, without care the employee will not receive a prescription, restrictions, or medical treatment. For example, if an employee has an incident for which they initially seek medical care, then decides to forego a clinic visit but instead goes to a pharmacy and gets a rigid brace, that’s still recordable. In another example, if an employee loses consciousness buts feel fine afterward, it’s still recordable.
     

    How should safety managers document workplace violence incidents, including those involving third parties or customers?

    Context: Workplace violence is a growing safety concern. 

    Compliance Reference: Per OSHA’s General Duty Clause (Section 5(a)(1)), employers must provide a safe workplace. Under 29 CFR 1904.5, injuries caused by workplace violence must be recorded if they meet general recording criteria (e.g., medical treatment beyond first aid). 

    Example: If a customer assaults an employee, leading to hospitalization, this must be recorded. 

     

    Does OSHA consider injuries caused by an employee’s pre-existing medical condition (e.g., seizure, heart attack) recordable if it occurs in the workplace?

    Context: Some medical events happen at work but are unrelated to work. 

    Compliance Reference: Per 1904.5(b)(2)(ii), an injury or illness is not recordable if it results solely from a pre-existing condition and is not aggravated by work. 

    Example: If an employee has a heart attack at their desk with no workplace-related cause, it is not recordable. If a pre-existing condition is aggravated by work (e.g., asthma triggered by workplace fumes), it is recordable. 

    Wrap-up: 

    Maintaining accurate OSHA records is critical for workplace safety and compliance. If missed the webinar, you can view it on-demand. If you have additional questions or need further guidance, our experts are here to help. 

    Stay tuned for future sessions where we’ll dive into other occupational health and safety best practice topics! 

  • Avoid Injury After a Break from Physical Activity

    Avoid Injury After a Break from Physical Activity

    As segments of the country reopen during the COVID-19 pandemic, many employees are returning to physically demanding jobs, gyms and group sports activities after taking a break from their usual work and fitness routines.

    There are ways for them to ease back into physical activity and reduce injury risk.

    Normally active men and women who have been sheltering in place are likely to notice signs of physical deconditioning, such as declines in their cardiovascular fitness, muscle strength and tone.  Physical inactivity also lowers mood and energy levels because rigorous exercise induces positive chemical reactions at the cellular level.

    When not exercising, the average adult loses 1-3 percent of muscle strength per day, with noticeable strength loss occurring within three weeks. A break from aerobic exercise is apparent with an increase in resting heart rate – four to 12 beats per minute higher a month. Meanwhile, after a month of cardio inactivity, maximal oxygen (VO2) gains achieved in the past two months are lost. (Vo2 is used to measure the amount of oxygen a person uses during intense exercise and assess energy production levels at the cellular level.)

    Slower metabolism and burning fewer calories may also lead to unhealthy weight gain. Did you know that for every extra pound gained, four pounds of pressure are exerted on the knees?

    Injury Prevention

    Bryan Reich, a certified athletic trainer and director of WorkCare’s Industrial Athlete Program, recommends the following to reduce employees’ injury risk after a hiatus:

    1. Allow time for reconditioning. Don’t expect endurance levels to be the same as they were at the beginning of the pandemic when workplace and workout routines were disrupted. Allow employees to start slowly and build back up.
    2. Remind employees to warm up and gently stretch before doing any physical activity, and cool down and stretch afterward.
    3. Evaluate levels of exertion required for certain activities and job functions. As feasible, adjust expectations until conditioning is restored.
    4. If job rotation is an option, use it to switch off between strenuous and less strenuous tasks. This principle also applies to fitness activities such as weight training and contact sports.
    5. Eat a nutritious diet, stay well-hydrated (drink half your body weight in ounces of water per day) and get quality sleep to boost your immune system and stay healthy.
    6. Advise employees to get professional advice if they want to start a new exercise program, reduce their caloric intake and lose some weight, or feel anxious or depressed.

    Remember, while there may be a temporary decline in performance compared to previous fitness levels, there is risk of injury caused by expecting someone to do too much too soon.

  • New Employees Who Get Injured More Likely to Have Recurrences

    New Employees Who Get Injured More Likely to Have Recurrences

    A study at an academic medical center found that employees who experienced a work-related injury within their six months of employment were more than twice as likely to have three or more lost-time injuries for the duration of their tenure.

    Findings from the study, Do Work-Related Lost-Time Injuries Sustained Early in Employment Predict Multiple Lost-Time Injuries Throughout Employment? published in the October 2019 edition of the Journal of Occupational and Environmental Medicine, are based on 5,906 injuries followed from 1994 to 2017, or 1,046,218 person years.

    Researchers found that the odds ratio of having three or more lost-time injuries was 2.12 for employees having their first lost-time injury within the first six months of employment versus those injured after that, controlling for demographics and employment duration. For each increasing year before the first lost-time injury, the probability of having three or more lost-time injuries decreased by 13 percent.

    The authors concluded that employment duration before the first lost-time injury may be used to predict future lost-time injuries without detailed information of underlying risk factors.

    What’s the Significance?

    WorkCare’s Executive Chairman and Chief Medical Officer Peter P. Greaney, M.D., says a number of factors can contribute to the occurrence of an injury early in a person’s employment. For example, there may be a poor match between the employee and essential job functions, insufficient training or misalignment between the employee’s personal characteristics and the company’s culture.

    According to Dr. Greaney, a board-certified occupational physician, a training or cultural issue is usually the byproduct of a systemic employer approach that rarely gets fixed, in turn increasing the likelihood of an initial injury and a recurrence. Once a person becomes injured, he or she learns how the system works and identifies perceived benefits derived from that condition – such as monetary, days away from work, job accommodation, medications (possibly including opioids), and attention (positive or negative) from supervisors and managers, friends and family. The bottom line is that some needs are met.

    As life crises emerge, the employee reverts to behavior that was positively reinforced from earlier experiences. An injury event does not have to be contrived. It may be all subconscious and driven by pain mechanisms.

    Related Research

    Related research supports the use of preventive interventions, including training, to address correlations between early employment and injury risks. Here are three examples:

    • 1. Among 58,271 workers who experienced 10,260 injuries, those with job tenure of less than six months showed higher relative injury risk compared to employees with job tenure of more than two years. Relative injury risk was 41 percent higher among workers under age 30 and 22 percent higher among people over 40. Authors’ conclusion: “If institutions don’t adopt appropriate prevention policies, injury risk is likely to increase, especially among young people.”
    • 2. A 10-year study of the association between job tenure and lost-time claim rates found significantly higher rates among workers with shorter job tenure. Authors’ conclusion: Elevated risk among new workers suggests the need to improve training, reduce exposures, promote permanent employment, and monitor work injury trends and risk factors.
    • A 2014-15 study of Tennessee construction workers found 44.5 percent of reported injuries were sustained by workers with tenure of one year or less. The three most common types of injuries (strain, laceration and contusion) accounted for 62 percent of the top ten types of injuries. Authors’ conclusion: The importance of new employee “on-boarding” orientation cannot be over emphasized. Contents should include injury incidence data and training for temporary workers.
    A WorkCare Solution

    WorkCare’s Incident Intervention® program supports immediate reporting of non-emergency work-related injuries and early telehealth intervention by occupational physicians and nurses, optimally within the “golden hour” following onset. About 75 percent of the time employees elect to follow self-care guidance at the first-aid level and are able to safely go back to work in a full or temporarily modified capacity. Those who choose to visit a clinic or are referred to a local provider by a WorkCare clinician are positioned to receive the right care, at the right time, in the right setting. Only a small percentage of incidents result in lost work time.

    In all cases, a positive initial injury care experience helps improve outcomes and reduce the likelihood of injury recurrence.