We know that workplace injuries can contribute to increased insurance premiums. That’s reason enough to establish solid workplace safety programs. But in many cases, injuries can also lead to hefty fines dealt out by OSHA—a million dollars or more in some industries.
Dr. Julie Parsons, Occupational Medicine Medical Director of Advanced Urgent Care & Occupational Medicine, has over 20 years’ experience in workers’ compensation. In her eyes, the workers’ compensation provider has two important jobs:
1. Providing the utmost care to each injured patient
2. Treating injuries such that they are not OSHA recordable, if possible
How can you ensure quality injury care while remaining OSHA-sensitive in treatment? According to Dr. Parsons, workplace injuries can be treated tactfully to avoid unnecessary recordables under OSHA guidelines, while maintaining the highest standard of patient care.
What makes an injury OSHA-recordable?
A recordable injury or illness under OSHA is one that requires medical treatment beyond first aid, as well as one that causes death, days away from work, restricted work, or loss of consciousness. Time spent at the initial doctor visit for observation or diagnostics to determine if an injury or illness is present is not considered medical treatment beyond first aid, but prescription of medication is.
How Dr. Parsons works to avoid OSHA recordables
When a minor injury occurs, another physician might prescribe medications, put the patient on work restrictions, or take them off work altogether. This causes the injury to become recordable, which can be damaging to the employer and harmful to the recovery of the injured employee.
Dr. Parsons believes it’s important to keep the employee working and off unnecessary medications, if possible.
“Studies show that patients have better outcomes and return to normal function more quickly if you keep them working,” Dr. Parsons explained. “One of the worst things you can do is take someone off work.”
She gave the example of a 20-year-old man who visits Advanced Urgent Care & Occupational Medicine after pulling a muscle in his back while at work. Dr. Parsons argues that there’s no reason he couldn’t use ice or heat to ease pain and inflammation, as well as perform stretches to expedite his recovery.
“He could take some over-the-counter pain medicine, and then be re-checked rather quickly,” Dr. Parsons said. “Most of the time, he’s going to be back to almost 100% in a short period of time.”
In cases where employees are a part of a larger workplace team, a provider can also recommend that the injured employee temporarily work in a different, less strenuous position or complete required training—still performing “full duty” work.
It’s helpful for a provider to have a good working relationship with employers. If the provider knows the nature of the jobs, they can comfortably recommend alternative work options for their patient.
“They might not be able to do all the jobs within the team, but they may be able to do one of them. That helps keep it non-recordable,” Parsons said. “We have a strong return-to-work philosophy at Advanced Urgent Care & Occupational Medicine, and a strong communication philosophy with employers and insurers.”
Providers have several OSHA-approved means to treat injuries while remaining non-recordable:
- Using a nonprescription medication at nonprescription strength. (For medications available in both prescription and nonprescription form, a recommendation by a physician or other licensed health care professional to use a nonprescription medication at prescription strength is considered medical treatment for record-keeping purposes.)
- Administering tetanus immunizations. (Other immunizations, such as Hepatitis B vaccine or rabies vaccine, 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, or using butterfly bandages or Steri-Strips™. (Other wound closing devices such as sutures and staples are considered medical treatment.)
- Using hot or cold therapy.
- Using any nonrigid means of support, such as elastic bandages, wraps or nonrigid back belts. (Devices with rigid stays or other systems designed to immobilize parts of the body are considered medical treatment for record-keeping purposes.)
- Using temporary immobilization devices while transporting an accident victim (e.g., splints, slings, neck collars, back boards).
- 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 massages. (Physical therapy or chiropractic treatment is considered medical treatment for record-keeping purposes.)
- Drinking fluids for relief of heat stress.
OSHA sensitivity = attention to detail
Often, providers are not vigilant when it comes to remaining OSHA-sensitive. That can be disastrous for the employers who count on them to keep employees healthy, and to help the company avoid harsh penalties.
Dr. Parsons says that attention to detail is a work comp provider’s most important weapon when treating and evaluating workplace injuries.
“I review every single work comp patient’s chart, whether they’re my patient or not. I have taught the mid-level providers my style of communication, which is totally transparent with the employers and patients. I think we give a lot better care because details are not missed. We are very OSHA-sensitive,” Dr. Parsons said.