HealthQuest Medical FAQ's
An OSHA recordable is an injury, illness, or death that OSHA deems to be recordable under its record keeping regulations.
The answer to your question is that giving a medication, dose or a treatment that “requires a prescription” makes an injury “recordable” under OSHA guidelines. Therefore a “prescription” for 200mg ibuprofen is not recordable unless you tell the patient to take 3 pills at a time (a prescription dose of a non prescription medication.) Now, 400mg ibuprofen is not a prescription dose but is not available over the counter so likely would be considered a “prescription” medication. Confusing, huh?
So when you gave that injured worker 400mg of ibuprofen that night that did not cause the injury to be listed as recordable but prescribing the antibiotic did. (I hope it was more than a scratch.)
Next, duty status: Restricting duty will usually make an injury recordable under OSHA guidelines but not in all cases.
First you may restrict the workers duty for the balance of his shift on the “day of injury” without incurring recordability. The “day of injury” is defined by OSHA as well and occasionally subject to interpretation. If the injury results from trauma, the day of injury is the day of the trauma and the subsequent shift. So our night workers who are injured before midnight may be restricted after midnight without penalty if the restriction is limited to the current work shift.
The TX DWC 73 form in this case would have both the restricted and unrestricted boxes checked with the appropriate dates clearly noted. It is a good idea to write “balance of shift only” in the notes section of restrictions.
A worker who reports his traumatic injury occurred on a prior date establishes that date as the “date of injury” and may not be restricted balance of shift without triggering recordability. (Remember that this worker may have been doing full duty up to the time of the visit and may deserve a trail of treatment without restrictions initially.) Be aware that we all will use the date of injury for identification and tracking so it should be consistent with the employers and insurers records as well so document the incident carefully. You may be asked to defend your choice of DOI.
When a worker reports symptoms that have appeared gradually and the medical determination is that the injury is a result of “cumulative trauma” the date of the first medical visit and diagnosis becomes the “date of injury.” Work related soreness is not always “an injury” but when an employee is brought to us it becomes an injury. Be sure to counsel workers that when the work is hard, soreness can be a daily fact of life especially during an adjustment period when the work or the pace is changing.
Restrictions that do not impact the “essential functions” of an employee’s job do not trigger recordability. For example, a secretary who is told not to lift 50 pounds would not generally trigger recordability. Putting that restriction onto her duty slip might trigger an unpleasant response from her safety supervisor if he does not understand OSHA very well (and many do not.)
“Lost time” under OSHA results when restrictions are so consequential that the employee should not be at work. This is rarely a medical determination with the injuries we treat and applies more to patients that have required hospitalization or surgery.
Even so, many workers can undergo day surgeries and return to restricted duties without lost time if the consultants understand how to work with the system. Employees may even be in a safer and more supervised environment than they would be at home.
“Death” in the workplace is the highest level of recordability and usually OSHA will be onsite within 24 to 48 hours to investigate the circumstances surrounding these tragedies.
Utilization review places another level of review between the provider of health care (e.g., a doctor or hospital) and the payer (e.g., the health care plan insurer). Providers must consult with the utilization review service either before a course of treatment is instituted (a precertification review), or on an ongoing basis as the treatment is being conducted (a concurrent review). The utilization review service reviews the program of treatment to make sure it does not include procedures that are either unnecessary or of questionable effect.
In addition, utilization review sees to it that when care is necessary, it is provided in the most cost-effective way. If the program falls within the standards that guide the utilization review reviewer in making his determination, the treatment will be approved.
However, if the treatment is not approved, either on initial review or on appeal, it does not mean the patient will be denied the care, it simply means the payer will not foot the bill. The patient is always free to pay for the care without being reimbursed by the plan.
Depending on the state generally post accident drug screen results can only be admissable or permitted if “a doctor or employer has a reasonable suspicion that the employee’s work injury was caused by the employee’s use of alcohol or a controlled substance.”
Your employer must be able to demonstrate that not only were you impaired at the time of the accident but that impairment caused the accident. Reasonable suspicion cannot be presented as just simply the fact an accident occurred.
Your employer must be able to present that you were not only impaired at the time of the accident but also show that it was THE reason the accident occurred.
Your employer must also have other reasoning within the documentation such as observation of unusual obvious behavior, slurred speech, trouble walking, dilated pupils, loss of coordination etc.
Just one of these items would not necessarily constitute reasonable suspicion, it generally would require a combination observed by a supervisor trained in reasonable suspicion. The information cannot be here-say, it must be first hand observation by the trained supervisor. On this basis alone it would be very difficult for a drug test to be admitted into a post accident evidentiary case directly related to your workman’s compensation claim. There are some exceptions which fall under DOT and specific safety positions.
Drug Free Workplace Policy—If your company has a Drug Free Workplace Policy in place and you have signed this disclosure document the company is required to implement the policy and provide education in regards to a drug free workplace. It does not require or permit drug testing, specific to cited government code regarding state contractor’s.
Basically signing an agreement that your company has a zero tolerance workplace policy is just that, however, they are only saying they will provide the necessary education to do so, not drug test unless it is specified and clearly disclosed to you.
Drug addiction and alcoholism are recognized as diseases and therefore in some if not in most instances you may have some protection as having a disability. This does not say that you are a drug addict or an alcoholic. Simply said, there have been many cases where an employee, after testing positive on a post accident drug screen, has claimed to have a problem and sought appropriate treatment. Many employees have been able to retain their jobs for at least the first offense.
- Injuries resulting while using company recreational facilities, like ball diamonds, gyms, etc. are not recordable.
- Injuries on company owned parking lots are not recordable, unless the employee was performing a work related task in the parking lot.
- Treatment of first degree burns.
- Application of bandages during first visit.
- Application of elastic bandages during first visit.
- Removal of foreign bodies in the eye that are removed by irrigation.
- Removal of foreign bodies from a wound that are simple in nature, like using tweezers.
- Negative x-ray results.
- Administration of Tetanus shot, if that is all that is done.
Any person over the age of 2 needs to have the Tuberculosis Blood test done
Anyone over 15 also needs to get tested for Syphilis and Gonorrhea.
Photo ID, Vaccination record (if any)
Yes, if you have the physical completed during Flu season (Sept 1st to March 31st)
If the child is under 14 years of age, a parent or legal guardian may sign on his behalf.