Case Study: How To Identify a Workplace Injury

Imagine the following situation and ask yourself if you know exactly why or why not the employer should log the injury as work related.

An employee, while walking up 80 feet of steps at work, had their left knee suddenly “pop” and couldn’t place weight on it, requiring first aid. After being taken to a hospital, the employee was diagnosed with a strained/sprained knee.

Then, four days later, a second physician says the knee condition is non-occupational — citing the exception in 1904.5(b)(2)(ii) that says employers don’t need to report an injury that happened solely from a non-work related event, even if the symptoms occurred while at work — because there were no obvious aggravating factors at the workplace that contributed to the knee injury.

This was the situation put to OSHA that they addressed February 2014 in a clarification of its recordkeeping regulations: 1904.5 Determination of Work-relatedness” and 1904.7 General Recording Criteria”.

OSHA first made it clear it is the employer’s responsibility to make the correct decision whether a specific injury or illness is work related, even though the employer may use the guidance of a health care professional.

Also, a work event doesn’t have to be the only, or even main, cause of a work injury. The injury doesn’t even have to be caused by a unique or “out-of-the-normal” event like a fall.

Question: Is walking up 80 feet of steps at work an identifiable event or exposure, even without a slip, trip, or fall?

OSHA Response: Yes, normal body movements like walking, bending down or sneezing can be an event that makes it related to work if these actions can be identified as the cause of an injury.

Question: If a physician determines the injury is a reoccurrence and not a new case, is the employer relieved from the requirement to determine the injury is recordable?

OSHA Response: 1904.6(b)(3) says employers must follow the health care professional’s determination of whether an injury is a new case or reoccurrence, but that’s when the employee has a recorded similar workplace injury. Without any previous OSHA recorded left knee injuries, the employee’s case is new and a health care professional’s evaluation isn’t necessary.

Question: If two health care professionals come to different conclusions about whether an employee’s injury is work related, do you use the first one or second one?

OSHA Response: OSHA’s recordkeeping regulation allows advice from multiple health care professionals to determine if an injury or illness is work-related. But it is the employer’s responsibility to make the correct decision.

When two or more health care professionals make conflicting determinations, the employer must base its decision on the most authoritative — best documented, best reasoned, or most persuasive — evidence or recommendation — 1904.6(b)(3).

2014 Interpretations

In addition to creating new and updating current regulations, OSHA publishes interpretations and answers to questions about existing rules. Here is what has been released in 2014:

• Construction’s Electrical Power Regulations Final Rule
• Cranes and Derricks Near Power Lines
• Recordkeeping for Multiple Business Establishments
• How to Decide It’s a Workplace Injury
• Safety Data Sheet (SDS) Reporting of Petroleum Streams
• Combustible Dust Labeling Requirements in Hazard Communication Standard (HCS)
• OSHA Definition of A HNOC Clarified for the HCS
• General Duty Clause Covers All Impalement Hazards
• Employer Responsible for Determining Qualified Rigger Status