Page 58 - Occupational Health & Safety, April 2017

HEALTH CARE
When an Employee Says No
Proper documentation is needed to protect your organization from liability when an employee refuses emergency medical care during work related and non-work related illness and injury. BY JIM DZIENDZIEL
Or...
You are a supervisor at a small injection molding plant. Emily, your third shift press operator, began complaining of chest pains and trouble breathing shortly after returning from lunch. Your operation does not have a Plant Medical Department, and you check on Emily to see whether she is all right. Al- though she is pale and sweaty, Emily insists that she is okay, and even after vomiting twice in your presence, she refuses to allow you to call 911 and insists on driv- ing herself home. Emily was later found deceased in her car in the employee parking lot and now, a year later, her family wants to bring suit against you and her employer. Your employer never had a policy cov- ering this type of event and there are no records to prove that you were not negligent in not calling 911.
Recordkeeping Requirements
Every employer regardless of size must have a policy and procedure in place to cover the eventuality when an employee will refuse emergency medical care for an occupational or non-occupational illness or injury. Today’s litigious society has created a false sense of worker entitlement for damages when an employee makes a rash judgment that results in a permanent loss of lifestyle or function. Statutes of limitations can vary from state to state, and often an employer may not receive news of a lawsuit until many months to many years after the event, when records have been lost, destroyed, or never kept at all. The employer may even be liable for workers’ compensation disability benefits and OSHA recordkeeping violations long af- ter the employee terminated employment from the organization. Section 381 of the Michigan Workers Compensation Act (WCA), for example, requires a worker to notify his employer of an injury within 90 days after the injury or within 90 days after the worker knew or should have known of the injury. The em- ployer usually is not free from responsibility because the WCA allows the worker up to two years after the injury to make a claim for compensation benefits (Michigan, 2000).
OSHA has often proposed to add additional lan- guage to the existing employee and illness record- keeping rule (29 CFR 1904) that all covered employ- ers must accurately record all employee injuries and illnesses for up to five years after an incident. OSHA further states that employers who discover previ- ously unknown employee injuries or illness within five years of any incident would be required to revise their OSHA records to include this information or face possible OSHA enforcement for recordkeeping violations (OSHA, 2015). OSHA also holds employ- ers responsible for recording occupational illnesses
52 Occupational Health & Safety | APRIL 2017
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You are a supervisor at a large assembly plant. Paul, your afternoon maintenance techni- cian, smashes his right index finger between a part and an impact wrench and suffers a bloody wound to the fingertip. Paul reports to the Plant Medical Department and asks for a Band-Aid. The occupational health nurse quickly assesses the bleeding open wound and summons the plant phy- sician, who advises Paul that he needs to be sent to the hospital emergency room for more advanced treatment and possible x-rays and sutures. Paul states that he doesn’t want to go to the emergency room and leaves Medical. Three months later, Paul notifies your company that he has to have a distal fingertip ampu- tation and is suing your company and the Medical Department staff because his finger tip developed an infection that was not treated properly.
A review by your organization’s legal department found little or no documentation of Paul’s injury and, worse yet; there was no documentation of Paul’s refus- al of medical care against medical advice! Now OSHA wants to get into the act because your plant didn’t re- cord the case within seven days of the injury.
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