Reporting heart attacks and in-patient hospitalizations

At some point, your company might send an employee to the hospital due to a serious injury, chemical exposure, or even a heart attack. But do you have to report the incident to OSHA?

First, keep in mind that OSHA defines an in-patient hospitalization as formal admission to the in-patient service for care or treatment. The hospital or clinic determines if the employee was formally admitted. Going to the emergency room for outpatient treatment (like sutures or even setting a broken bone) often doesn’t involve an in-patient hospitalization

Similarly, employers do not need to report an in-patient hospitalization that involves only observation or diagnostic testing such as MRIs, x-rays, or CAT scans. Employers only need to report incidents that involve “care or treatment.”

However, any treatment provided (including first aid) following an in-patient hospitalization obligates the employer to report the event. OSHA posted a frequently asked question clarifying that the reference to “care or treatment” is not limited to “medical treatment beyond first aid.”

Reporting heart attacks

The regulation requires reporting “a work-related fatality or in-patient hospitalization caused by a heart attack.” Depending on the circumstances, OSHA will decide whether to investigate the event.

Now, employers know that heart attacks commonly result from personal medical conditions. The challenge is that employers may not know whether something at work contributed to a heart attack, at least not within OSHA’s required reporting periods (8 hours for a fatality or 24 hours for an in-patient hospitalization).

Some employers focus on the “work-related” provision and, if they feel confident that a heart attack was solely caused by non-work factors, they won’t report a hospitalization. Technically, OSHA does not require reporting non-work-related injuries or illnesses, but OSHA has yet to issue specific guidance on heart attacks.

Various job-related factors might trigger a heart attack, like physical exertion or exposure to electricity. Even if an employer cannot determine the exact trigger, reporting the incident to OSHA should be the best option. OSHA should understand that most heart attacks result from personal medical conditions and the agency won’t necessarily initiate an investigation following the report.

Motor vehicle accidents

Many employees travel and get involved in car accidents or even get struck as a pedestrian. Injuries that occur during travel are work-related if the employee was engaged in work activities in the interest of the employer. Examples include visiting customers, picking up supplies, or traveling between job sites. This raises the question of whether employers must report a hospitalization or death caused by a motor vehicle incident.

The regulation clarifies that employers do not need to report incidents that happened on public streets or highways, or accidents involving public transportation like a train or bus. Any resulting injuries could still be recordable on the 300 Log (they can be work-related), but need not be reported to OSHA.

OSHA does, however, require employers to report fatalities or in-patient hospitalizations that occur in a construction work zone. OSHA does not have authority to investigate motor vehicle accidents on public roads, but does have authority to investigate job sites – and an active construction zone is a job site. A work zone extends from the first warning sign to the “end road work” sign or last traffic control device.