The regulations require employers to record all fatalities, injuries and illnesses that are work-related (29 C.F.R. § 1904.5) or that are new cases (29 C.F.R. § 1904.4) resulting in:

• Death (29 C.F.R. § 1904.7(b)(2));
• Days away from work (29 C.F.R. §1904.7(b)(3));
• Restricted work or transfer to another job (29 C.F.R. § 1904.7(b)(4));
• Medical treatment beyond first aid (29 C.F.R. § 1904.7(b)(5));
• Loss of consciousness (29 C.F.R. § 1904.7(b)(6));
• Needle stick injuries (29 C.F.R. § 1904.8(a));
• Cuts from sharp objects that are contaminated with another person’s blood or other potentially infectious material (29 C.F.R. § 1904.8(a));
• Medical removal under OSHA standards (29 C.F.R. § 1904.9(a));
• Hearing loss (29 C.F.R. § 1904.10(a));
• Tuberculosis (TB) (29 C.F.R. § 1904.11(a)); or
• A significant injury or illness diagnosed by a physician or other licensed health care professional. 29 C.F.R. § 1904.7(b)(7).

An injury or illness is work-related if an event or exposure in the work environment either caused or contributed to the resulting condition or significantly aggravated a pre-existing injury or illness. 29 C.F.R. § 1904.5(a). The work environment is by OSHA 29 C.F.R. § 1904.5(1)(b)(1) defined as “the establishment and other locations where one or more employees are working or are present as a condition of employment.” The work environment includes not only the physical location, but also the equipment or materials used by the employee during the course of his/her workday.

An injury or illness is considered pre-existing if it resulted solely from a non-work-related event or exposure that occurred outside the work environment (C.F.R. § 1904.5(b)(5)). The act deems a pre-existing injury or illness “significantly aggravated” if the event results in death, loss of consciousness, one or more days away from work, days of restricted work, days of job transfer, or medical treatment. A case is considered “significantly aggravated” when no medical treatment was needed for the injury or illness before the workplace event or exposure or when a change in medical treatment was necessitated by the workplace event or exposure if the condition’s aggravation would likely not have resulted but for the occupational event or exposure. 29 C.F.R. § 1904.5(b)(4).

According to 29 C.F.R. § 1904.5(b)(2) employers do not have to record injuries or illnesses under the following conditions:

• At the time of the injury or illness, the employee was present in the work environment as a member of the general public.
• The injury or illness involves signs or symptoms that surface at work, but result solely from a non-work-related event or exposure that occurs outside the work environment.
• The injury or illness results solely from voluntary participation in a wellness program or in a medical, fitness, or recreational activity such as blood donation, physical examination, flu shot, exercise class, racquetball, or baseball.
• The injury or illness is solely the result of an employee eating, drinking, or preparing food or drink for personal consumption (whether bought on your premises or brought in). For example, if the employee is injured by choking on a sandwich while in your establishment, the case would not be considered work-related. However, if an employee was preparing a meal for a business-related meeting and is injured, the case would be considered work-related.
• The injury or illness is solely the result of an employee doing personal tasks (unrelated to employment) at the establishment outside the employee’s assigned working hours.
• The injury or illness is solely the result of personal grooming or self-medication for a non-work-related condition, or is intentionally self-inflicted.
• The injury or illness is caused by a motor vehicle accident and occurs on a company parking lot or company access road while the employee is commuting to or from work.
• The injury is the common cold or flu. Contagious diseases such as tuberculosis, brucellosis, hepatitis A, or plague are considered work-related if the employee is infected at work.
• The illness is a mental illness unless the employee voluntarily provides you with an opinion from a physician or other licensed health care professional with the appropriate training and experience stating that the employee has a mental illness that is work-related.

In situations where you have difficulty determining whether the precipitating event or exposure occurred in the work environment or away from work, 29 C.F.R. § 1904.5(b)(3) provides that employers must evaluate the employee’s work duties and environment to determine whether one or more events or exposures in the work environment either caused or contributed to the resulting condition or significantly aggravated a pre-existing condition.

Another question that often arises is how to handle injuries and illnesses that occur while an employee is traveling. 29 C.F.R. § 1904.5(b)(6) provides that “injuries and illnesses that occur while an employee is traveling are work-related if, at the time of the injury or illness, the employee was engaged in work activities “in the interest of you.” Examples include travel to and from customer contacts; conducting job tasks; and entertaining or being entertained to transact, discuss, or promote business at the direction of you. Injuries and illnesses that occur when the employee is traveling do not have to be recorded if the employee has checked into a hotel or motel for one or more days or has taken a detour for personal reasons.

Injuries or illnesses that occur when the employee is on travel status do not have to be recorded if they meet one of the exceptions listed below. 29 C.F.R. §1904.5)b)(6).

Injuries and illnesses that occur while an employee is working at home will be considered work-related if the injury or illness occurs while the employee is performing work for pay or commission in the home, and the injury or illness is directly related to the performance of the work rather than to the general home environment or setting. If an employee, for example, drops a box of work documents and injures his/her foot, the case is considered work-related. If an employee is injured because he/she trips on the family dog while rushing to answer a work phone call, the case is not considered work-related. If the employee is electrocuted because of faulty home wiring, the injury is not work-related. 29 C.F.R. § 1904.5(b)(7).