If your company had 10 or fewer employees for the last full calendar year, you do not need to record and keep OSHA injury and illness records.*

If you had 11 or more employees last year, this guidance applies to you. Failing to record injuries/illnesses is a citable offense, and while it typically doesn’t come with a monetary penalty, it will likely invite more OSHA scrutiny into other areas of your business. Please read on.

All employers covered by the OSH Act must report to OSHA any work-related incident that results in a fatality, the in-patient hospitalization of one or more employees, an employee amputation or an employee loss of an eye. Failing to report an incident is a violation, with monetary penalties ranging in the thousands of dollars.

When is an incident recordable?
According to federal OSHA, a work-related injury or illness must be recorded if it results in one or more of the following:

• Death.
• Days away from work – you begin counting days away on the day after the injury occurred or the illness began.
• Restricted work or transfer to another job.
• Medical treatment beyond first aid.
• Loss of consciousness.
• A significant injury or illness diagnosed by a physician or other licensed health-care professional.

What is “work related”?
OSHA’s approach to the “work-relatedness” of a recordable incident reflects two important principles.

The first principle is that work need only be a causal factor for an injury or illness to be work related. An employee illness/injury is work related any time an event or exposure in the work environment either caused or contributed to the resulting condition or significantly aggravated a pre-existing condition. The regulation requires neither precise measurement of the occupational cause nor an assessment of the relative importance of occupational versus non-occupational causal factors. If work is a tangible, discernible causal factor, the injury or illness is work related.

The second principle is that a geographic presumption applies for injuries and illnesses caused by events or exposures that occur in the work environment. In other words, if it first occurs at work, it is work related, unless one of the following exceptions apply:

• The injury or illness involves signs or symptoms that surface at work but result solely from a non-work-related event or exposure that occurs outside the work environment.
• The injury or illness results solely from voluntary participation in a wellness program or in a medical, fitness or recreational activity such as blood donation, physical examination, flu shot, exercise class, racquetball or baseball.
• The injury or illness is solely the result of an employee eating, drinking or preparing food or drink for personal consumption (whether bought on the employer’s premises or brought in). For example, if the employee is injured by choking on a sandwich while in the employer’s establishment, the case would not be considered work related.
• Note: If the employee is made ill by ingesting food contaminated by workplace contaminants (such as lead) or gets food poisoning from food supplied by the employer, the case would be considered work related.
• The injury or illness is solely the result of an employee doing personal tasks, unrelated to their employment, at the establishment outside of the employee’s assigned working hours.
• The injury or illness is solely the result of personal grooming, self-medication for a non-work-
  related condition, or is intentionally self-inflicted.
• An injury is caused by a motor-vehicle accident in a company parking lot or on a company access road while the employee is commuting to or from work.
  The illness is the common cold or flu. This exception applies whether the employee contracted illness in the work environment or outside of work.
• Note: Contagious diseases such as tuberculosis, brucellosis or hepatitis A are considered work related if the employee is infected at work.
• Mental illness is not considered work related unless the employee voluntarily provides the employer with an opinion from a psychiatrist, psychologist, psychiatric nurse practitioner, etc., stating that the employee’s mental illness is work related.

The geographic presumption encompasses cases in which an injury or illness results from an event at work that is outside the employer’s control, such as a lightning strike, or involves activities that occur at work but are not related to production, such as horseplay.

Injuries and illnesses that occur to an employee who is on travel status are considered injury or illness if the employee was engaged in work activities “in the interest of the employer.” For example, travel to and from customer contacts, conducting job tasks and entertaining or being entertained to transact, discuss or promote business are all activities done “in the interest of the employer.”

When is it “medical treatment,” and when is it “first aid”?
OSHA requires employers to record work-related injuries and illnesses that result in medical treatment beyond first aid. OSHA defines medical treatment broadly as “the management and care of a patient to combat disease or disorder,” but does not include “first aid” as defined by any one of the following:

• Using non-prescription medication at non-prescription strength. For medications available in both prescription and non-prescription
  form, a recommendation by a physician or other health-care professional to use a non-prescription medication at prescription strength is considered medical treatment.
• Administering tetanus immun-izations. Other immunizations, such as Hepatitis B or rabies vaccinations, are considered medical treatment.
  Cleaning, flushing or soaking wounds on the surface of the skin.
• Using wound coverings such as bandages, Band-Aids, gauze pads, etc., or using butterfly bandages or Steri-Strips. Other wound-closing devices such as sutures, staples, etc., are considered medical treatment.
• Using hot or cold therapy.
• Using any nonrigid means of support, such as elastic bandages, wraps, nonrigid back belts, etc. Devices with rigid stays or other systems designed to immobilize parts of the body are considered medical treatment.
• Using temporary immobilization devices while transporting an accident victim, e.g., splints, slings, neck collars, back boards, etc.
• Drilling of a fingernail or toenail to relieve pressure or draining fluid from a blister.
• Using eye patches.
• Removing foreign bodies from the eye using only irrigation or a cotton swab.
• Removing splinters or foreign material from areas other than the eye by irrigation, tweezers, cotton swabs or other simple means.
• Using finger guards.
• Using massage to treat an injury. Physical therapy or chiropractic treatment are considered medical treatment.
• Drinking fluids to relieve heat stress.

For further information …
If you need more detail, you can use this link, www.osha.gov/laws-regs/regulations/standardnumber/1904/, to go directly to 29 CFR §1904, the federal OSHA recordkeeping rule. You will want to review §1904.7, General Recording Criteria, which OSHA wrote in question-and-answer format to make it easier to understand. You also can review and download OSHA’s Form 300, Form 300A and instructions for recording and posting work-
related illnesses and injuries from www.osha.gov.

* The Bureau of Labor Statistics occasionally collects employer illness and injury data via a survey. If you are informed in writing to provide information to BLS, then you must share illness/injury data with them, regardless of the size of your business.

Peter Gerstenberger is senior vice president of industry support at TCIA. He’s been involved with the development or revision of most TCIA training programs and has served on the ANSI Z133 Committee for 22 years.