An injured employee is given a rigid boot as a precautionary measure by the physician. Did that just make this injury an OSHA Recordable?
Scenario: You are the safety manager for a manufacturing company. An employee was carrying some material to her workstation when she stepped awkwardly and felt a snap and then pain in her foot and ankle. Your employee reported the event to her supervisor who followed company protocol and took the employee to the local hospital emergency room to be checked out. An initial x-ray and diagnosis was conducted showing no evidence of a fracture, joint dislocation, and or ankle instability. However, the radiologist recommended a second x-ray be taken seven days later to conclusively rule out a fracture. As a precautionary measure, the occupational physician recommended that a rigid boot be worn by the employee until the second x-ray was taken. The second x-ray conclusively determined there was no fracture and the rigid boot was immediately removed and not worn again. The employee did not experience any broken bones and was not prescribed any medication or given any work restrictions. You decided the employee did not experience an OSHA recordable injury because the rigid boot was purely precautionary. Therefore, you did not log the injury on the OSHA 300 log.
Question: Was your decision to not log this injury a correct decision? Does the use of the rigid boot as a precautionary measure after the first x-ray, and before the second x-ray, constitute medical treatment?
Answer: Section 1904.7(a) of OSHA’s recordkeeping regulation requires employers to record work-related injuries and illnesses that result in medical treatment beyond first aid. Section 1904.7(b)(5)(ii)(F) states the use of any non-rigid means of support, such as elastic bandages, wraps, non-rigid back belts, etc., is considered first aid for OSHA recordkeeping purposes. Section 1904.7(b)(5)(ii)(F) further states that orthopedic devices with rigid stays or other systems designed to immobilize parts of the body are considered medical treatment for recordkeeping purposes.
In this scenario, the employee sustained a work-related injury (sprained ankle) while working in the work environment. In response to the sprain, a licensed health care professional directed the employee to wear a rigid boot. For purposes of OSHA recordkeeping, the rigid boot is an orthopedic device used to immobilize the ankle, and therefore constitutes medical treatment beyond first aid. According to OSHA, the fact that the rigid boot may also have been used as a preventive, precautionary, or prophylactic measure (as in this case) is not relevant to the determination that the device was used to treat the employee’s injury. Similarly, the subsequent x-ray showing no fracture does not alter the fact that medical treatment beyond first aid had already been provided.
For further details, please check this letter of interpretation from OSHA.
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