Q&A, Recordkeeping

Q&A: Disputing Injury Claims

Recently, one of our subscribers asked the following question:

If an employee reports an injury several days after it occurred and the result would be a recordable injury, what recourse does the company have to dispute the claim if there were no witnesses?

According to OSHA’s recordkeeping criteria, the employer, not the employee, must decide whether an injury or illness as defined by the OSHA recordkeeping rule has occurred. If you are uncertain, you may refer the employee to a doctor or other licensed health care professional for evaluation, and you may consider the healthcare professional’s opinion to determine whether an injury or illness exists. If the physician or other licensed health care professional diagnoses a significant injury within the meaning of 29 CFR 1904.7(b)(7) and the employer determines that the case is work-related, the case must be recorded.

OSHA requires you to record an employee’s injury that requires medical treatment beyond first aid on the OSHA 301 Injury and Illness Incident Report within 7 calendar days after finding out about the incident that caused the injury. You must also record the injury on the OSHA 300 Log.

From the workers’ compensation side, the injury should be reported to the workers’ compensation carrier as soon as the employer becomes aware of or is told by the employee that he or she was injured at work. The employee will need to complete claim paperwork and provide information to the carrier. The carrier will then investigate the claim and determine whether it is compensable—that is, whether the employee sustained a work-related injury—and will review any treatment plan.