OSHA 300: New case or continuation of a previous injury?

Suppose an employee had a recordable work-related injury two years ago, with days away after surgery. This month, the employee needs another surgery that will also require days away. Is this a new case or a continuation of the two-year-old injury?

In other words, should the employer create a new entry on the current year’s 300 Log, or update the entry on the 300 Log from two years ago? Note that employers must update 300 Log entries throughout the five-year retention period.

Recovery is key

If the employee had recovered completely from the original injury (all signs and symptoms disappeared) and some event or exposure at work caused a new injury to the same body part, then the employer would create an entry on the current year’s 300 Log for the new case. In fact, even if the employee had mostly recovered, but an event at work significantly aggravated the older injury, the employer would have to create a new entry.

However, if the employee had not recovered completely and another surgery is now necessary to address the original condition, the employer can update the 300 Log entry from two years ago with the additional days away.

The regulations define a “new case” at 1904.6(a), which explains that “recovered completely” means “all signs and symptoms had disappeared” from the previous injury. Determining if the employee “recovered completely” can be challenging. Employees may have discomfort or limitations for years, then require surgery if the condition just isn’t healing.

Conversely, if the employee had any ongoing symptoms, and the employer cannot identify a workplace event that aggravated original condition, the current need for surgery should not be a “new” case. The employer would update the two-year-old 300 Log entry with the additional day counts.

Contributing factors

When evaluating possible aggravation of a pre-existing condition, OSHA warns that a workplace event or exposure does not have to be a significant factor, but merely a discernible factor. A Letter of Interpretation dated December 21, 2005, addressed an employee with carpal tunnel syndrome whose symptoms recurred several years later. Here’s what happened.

After initial treatment of cortisone injections, the employee showed “overall improvement” but did not completely heal. Several years later, after moving to a new position within the company, the employee had a recurrence of carpal tunnel and needed additional cortisone injections. Was this a new case?

The doctor did not believe the new job significantly contributed to the recurrence. However, OSHA said an aggravation could create a new case if the job duties had any contribution, even if the work exposure was not a significant contributor.

Since OSHA could not make a determination, the employer had to evaluate the job duties and ask the employee about ongoing symptoms to determine if this was a new case (a work-related aggravation of a pre-existing condition). Even if the employee had not recovered completely, a significant aggravation from job duties (one that required a change in treatment) would create a new case.

Conversely, if job duties made no contribution at all, and if the employee had ongoing issues (had not recovered completely), then the employer could update the original 300 Log entry from two years previously.