The extent of occupational illness and injury is much greater than government statistics indicate. Some researchers suspect that the number of injuries is twice as great as reported, and the number of illnesses may exceed the number reported by a factor of five. No one really knows. It's time that we learned the full extent and nature of occupational illness and injury in the U.S. workforce. The proper compensation for workers with workplace injuries and the direction of research on occupational disease prevention depend on accurate recordkeeping.

Employers are required by law to record occupational injuries and illnesses. OSHA regulation 29 CFR 1504 clearly states how to do so. Records must be kept in the Daily Injury and Illness Log (OSHA 200 form). An annual summary of that form is to be posted by the employer every February for the entire month. OSHA 200 logs are to be kept for five years.

Under-reporting of illness and injury may occur if employers aren't aware of the proper reporting procedures, if they misdiagnose conditions, if they fail to inform workers' compensation boards and insurance carriers when an illness/injury has occurred, if they make clerical errors in tabulating records, if they deliberately falsify records, etc.

Failure to comply with the recordkeeping regulations can bring stiff fines -- up to $10,000 for a willful violation. What's more, intentional falsification of records is a crime, grounds for a jail term. It's one of only three provisions of the Occupational Safety and Health Act (the OSH Act) that carries a criminal penalty.

Illnesses

OSHA requires employers to record any work-related illness that is "diagnosed or recognized." A diagnosis is performed by a physician, registered nurse or someone with training and experience to make a diagnosis. OSHA requires employers to record "recognized" (not diagnosed) illnesses because "employers, employees and others may be able to detect some illnesses such as skin diseases or disorders without the benefit of specialized medical training." Recordable illnesses include:

-- skin diseases
-- lung diseases and other respiratory conditions
-- poisoning
-- disorders due to physical agents (such as heat or noise)
-- disorders associated with repeated trauma (such as carpal tunnel syndrome and tendinitis)

These cases do not require any lost time or medical treatment to be reported, only to be diagnosed or recognized.

Injuries

An injury which involves any of the following is must be recorded:

-- medical treatment (other than first aid)
-- loss of consciousness
-- restriction of work motion
-- transfer to another job
-- termination of employment

The distinction between an illness and an injury is not always obvious, but it is important, because all illnesses must be recorded, but some injuries do not need to be recorded. According to OSHA, whether a case is "an injury or an illness is determined by the nature of the original event or exposure which caused the case, not by the resulting condition." Injuries are caused by "instantaneous events." A condition that is caused by anything other than an instantaneous event must be recorded as an illness. "For example, a loss of hearing resulting from an explosion (an instantaneous event) is classified as an injury; the same condition resulting for exposure to industrial noise over a long period of time" must be classified as an illness, which means that it must be recorded even if it does not meet any of the criteria for a recordable injury.

Deaths

Any death of an employee or former employee that occurs as a result of an injury or illness that is recordable must also be recorded. If an employee has a recordable injury or illness and then is terminated or retires, and then dies as a result of the recordable injury or illness, the death must also be recorded.

What's Not Recordable?

An injury that requires only first aid, that is, a minor injury that is resolved with one-time treatment (with followup for observation only, not additional treatment). A minor injury may be treated by a doctor or a nurse, but any injury that must be treated by a doctor or nurse or any injury that requires followup medical treatment is not minor, and must be recorded.

How to Analyze Injury And Illness Records

Local unions can analyze the OSHA 200 records to see if they are accurate and to pinpoint patterns of disease and injury in the workplace. Here's how:

1) Obtain a copy of "A Brief Guide to Recordkeeping Requirements for Occupational Injuries and Illnesses" (U.S. Bureau of Labor Statistics, June, 1986) and "What Every Employer Needs to Know About OSHA Recordkeeping" (OSHA, Report 412-3, l978) from your local OSHA office. These booklets contain detailed instructions to employers on how to properly report occupational illnesses and injuries.

2) Ask your employer in writing for the OSHA 200 daily log, NOT JUST THE SUMMARY, for the past five years. The right to review and copy these records is provided by the OSHA standard, 29 CFR 1904.7 (b) (1): "The log and summary of all recordable occupational injuries and illnesses (OSHA 200) provided for in 29 CFR 1904.2 shall, upon request, be made available by the employer to any employee, former employee, and to their representatives for examination and copying in a reasonable manner and at reasonable times. The employee, former employee, and their representatives shall have access to the log for any establishment in which the employee is or has been employed."

3) Consult people knowledgeable about workers' compensation or insurance problems of the membership, since they know names of individual members who have filed claims which may not be recorded. The failure to list any cases known to the union is a tip-off that something is wrong.

4) Find out what current criteria the employer uses to record occupational illness and injury. This will also provide clues about how the employer interprets the OSHA guidelines when filling out the OSHA 200 log.

For further analysis of the health status of the membership:

5) Obtain copies of employee exposure and medical records, under OSHA standard 29 CFR 1910.20. Employers must provide this information to union representatives, free of charge, within 15 working days. This includes:

-- industrial hygiene reports
-- biological monitoring
-- medical histories and questionnaires*
-- results of medical examinations & lab tests*
-- medical opinions, diagnoses, & recommendations*
-- worker medical complaints*

* Requires prior written consent from affected employee(s). The standard itself contains a sample consent letter.

How to Insure More Accuracy in Recordkeeping

As a result of the discovery of widespread recordkeeping violations by major U.S. employers, OSHA has recognized certain procedures as a model for reporting injuries and illnesses. These procedures were developed by Chrysler Corporation in response to the record fines levied against them. Whether your employer adopts these guidelines or uses some other set of procedures, the union must actively police them to insure accurate and complete reporting. The Chrysler procedures are reprinted below:

1. Each patient visiting the plant medical facility to report injuries or signs or symptoms of illnesses will be asked whether their medical condition is caused or aggravated by work. Responses will be recorded. Where the patient states that an injury or illness is work related, and that case otherwise meets the criteria for recording, that case will be entered on the log pending final determination of causality.

2. Injuries and illnesses for which workers' compensation claims are filed will be entered on the Daily Injury and Illness Log pending final determination. A list of claims paid voluntarily or by decisions will be maintained. This list will be available for examination and copying by the union.

3. Sickness and accident claims for which occupational causation is claimed and which come to the attention of plant medical or safety departments will be investigated for occupational causation. Those instances which meet the recording criteria specified in the BLS guidelines will be entered on the injury and illness log.

4. Instances where employees are granted medical restrictions or job transfers as a result of injuries or illnesses claimed to be of occupational origin will be entered on the log pending final determination.

A list of such restrictions and transfers will be maintained. This list will be available to the union.

5. Where a case is removed from the log as a result of investigation, the reasons will be documented and the record of the investigation maintained. In general, investigations of illnesses will require on-site participation of medical personnel. The record of these investigations will be available to the union.

6. All personnel responsible for investigation of injury and illness reports and the maintenance of injury and illness records will be instructed in the Bureau of Labor Statistics Guidelines. Special attention should be paid to diagnosis and recording criteria for repeated trauma disorders, strains and sprains, back injuries, and Sentinel Health Events defined in the Bureau of Labor Statistics Guidelines.