When are Musculoskeletal Treatments Recordable Under OSHA? - American Society of Employers - Anthony Kaylin

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When are Musculoskeletal Treatments Recordable Under OSHA?

On May 2, 2024, OSHA provided guidance on whether musculoskeletal injuries are recordable under three treatment scenarios: first aid, Active Release Technique [“ART”] (massage that targets soft tissues), and exercises and stretching.

For something to be recordable, OSHA states that the general applicability is:

“Under section 1904.7, a work-related injury or illness meets the general recording criteria if it results in any of the following: death, days away from work, restricted work or transfer to another job, medical treatment beyond first aid, or loss of consciousness. In addition, a case that involves a significant injury or illness diagnosed by a physician or other licensed health care professional meets the general recording criteria even if it does not result in death, days away from work, restricted work or job transfer, medical treatment beyond first aid, or loss of consciousness.”

The memo states that for any musculoskeletal issues, one should review whether the above applies first.  If not, the memo describes when first aid, Active Release Technique (ART), and exercises and stretching would be recordable.
With respect to first aid, OSHA reminded employers that the definition of “first aid” set forth in 29 CFR 1904.7(b)(5)(ii) is a comprehensive list of first aid treatments. Specifically, the memo points out:

First aid is defined in 29 CFR 1904.7(b)(5)(ii) as:

  • Using a nonprescription medication at nonprescription strength (for medications available in both prescription and non-prescription form, a recommendation by a physician or other licensed health care professional to use a non-prescription medication at prescription strength is considered medical treatment for recordkeeping 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, 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 non-rigid means of support, such as elastic bandages, wraps, non-rigid back belts, etc. (devices with rigid stays or other systems designed to immobilize parts of the body are considered medical treatment for recordkeeping purposes).
  • 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 massages (physical therapy or chiropractic treatment are considered medical treatment for recordkeeping purposes).
  • Drinking fluids for relief of heat stress.

First aid by a medical provider does not on its own make the treatment recordable.   Therefore, if treatment was made that was not included on the list, that would be considered medical treatment beyond first aid, and generally meets recording criteria.  Further, first aid could become reportable if done improperly.  Therefore, HR should have designated workers appropriately trained in first aid techniques.

For example, if treatment is the use of aspirin or the like, generally the treatment is not recordable.    However, OSHA states in the memo that if the application of first aid to a work-related musculoskeletal injury or illness keeps the employee from performing one or more routine functions of the job, or from working the full workday the employee would otherwise have been scheduled to work, then the employee's work has been restricted and the case is recordable.

With respect to Active Release Technique (ART), in 2006, OSHA concluded that ART is "massage" for purposes of OSHA recordkeeping. Since massage therapy is included on the list of first aid treatments in section 1904.7(b)(5)(ii), if the only treatment an injured worker receives is ART, the employer is not required to record the injury regardless of who is applying the treatment.

On the other hand, the use of exercise or stretching is not part of first aid.  Such therapeutic exercise is considered medical treatment when it is designed and administered to treat a particular work-related injury or illness as part of a treatment plan and ends once the objectives of the treatment have been met.  As such, OSHA considers it recordable, even if not conducted at the workplace.

Last, if an employee has an injury or illness that is not work-related, it is not recordable.  Only a work-related injury or illness is recordable. 

 

Source:  Enforcement Guidance Under OSHA's Recordkeeping Regulation When First Aid, Active Release Techniques (ART), and Exercise/Stretching  5/2/2024, Cozen O'Connor 6/12/24

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