One of the worst kept secrets over the past few decades has been how companies and health care providers have joined forces to game the OSHA 300 log to reduce the number of reportable injuries. This created a win-win situation where companies could report lower injury rates and the Department of Labor could take credit for creating safer workplaces. Unfortunately, this increased safety was often a mirage created by the careful managing of physician behavior to skirt OSHA rules.
The OSHA Recordkeeping Handbook (OSHA 3245-01R 2005) states a work-related injury or illness must be recorded if it results in one or more of the following:
- Days away from work
- 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
Let’s look at how gaming the 300 log plays out: Suppose a worker injures his or her back and sees a physician at an occupational medicine clinic. The physician wishes to provide the worker with a prescription for Ibuprofen 600 mg. for pain and inflammation. This would be a common practice in injuries of this sort. Although, in most states, workers’ compensation would cover the cost of the prescription, the prescription would make the injury recordable. The regulations : “Using a non-prescription 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).” An employer focused on managing the 300 log will preferentially use a physician who tells the worker to get ibuprofen over-the-counter and then instructs (but does not document) that the injured worker can take more than it says on the label. The worker must often pay for this medication out-of-pocket but the company can consider the treatment “first aid” and not record the injury.
The point of the OSHA 300 log is to record and track the number of injuries of a certain severity. When the provider behaves differently for companies trying to manage OSHA 300 log that he or she does when treating a similar injury in another setting, the provider “games” the log by helping hide the injury. This is a common practice and the willingness to play this game can impact an occupational medical clinic’s financial success.
OSHA may be wising up. As Secretary of Labor Hilda Solis famously stated in 2009: “Let me be clear: the Department of Labor is back in the enforcement business.”
OSHA seems to be backing up Secretary’s Solis’s statement with action:
- Following a May 2010 inspection, OSHA issued Lowe’s Home Centers Inc. in Rockford Illinois with four willful citations with a proposed penalty of $160,000 for alleged continuous failure to correctly classify injuries or illnesses and not correctly recording the number of days a worker was away from work due to injury or illness in the OSHA 300 log.
- On August 31, 2010, OSHA cited VPP Group LLC in Norwalk, Wisconsin with $369,500 in proposed penalties for 38 alleged serious, willful, and other-than-serious safety and health violations at the company’s meat packing facility in Norwalk, Wisconsin. OSHA Area Director Kim Stille said, “”The company’s disregard for OSHA’s injury and illness recordkeeping requirements could be seen as an attempt to hide poor health and safety practices.”
So OSHA is taking a closer look at 300 logs. It is too early to tell whether they will begin to catch and punish 300 log gaming. But if you are currently playing that game, consider yourself warned.