OSHA Recordkeeping: Causes and Consequences of Underreporting Workplace Injuries & Illnesses

OSHA workplace injury and illness reporting season is already upon us, and there’s no better time for employers to take a step back and review their injury and illness recordkeeping practices — not only to make sure you’re in compliance, but to evaluate whether you’re capturing the most accurate possible injury and illness data in order to drive workplace health and safety program improvements.

The Importance of Accurate Recordkeeping & Reporting

You don’t have to be a safety professional to understand why accurate injury and illness data is essential to identifying workplace risks and maintaining effective health and safety programs. Likewise, regulators also rely on injury and illness data as the scientific basis for many of the standards, enforcement policies and compliance resources they develop to help employers protect workers. Considering how fundamental this information is to workplace health and safety, it’s no surprise that injury and illness recordkeeping is one of the most basic obligations employers have under occupational health and safety (OHS) regulations like OSHA’s Recordkeeping Rule, HSE RIDDOR and Canada’s WCB/WSIB reporting requirements.

What is surprising is that after decades of enforcement, (50 years in the case of OSHA) many employers still have difficulty accurately recording and reporting injuries and illnesses. Aside from putting employers at risk for fines and penalties, poor injury and illness recordkeeping creates gaps in our collective understanding of the risks facing workers, and limits the ability of employers and regulators alike to maintain safe and healthy workplaces.

 Diagnosing the Problem

Since the early 2000’s, multiple OHS research studies, including a 2009 U.S. Government Accounting Office (GAO) report, have investigated trends in workplace injury and illness recordkeeping among employers. These studies have identified some troubling levels of both under-recording and underreporting of workplace injuries and illnesses:

  • Under-recording – refers to work-related injuries and illnesses that meet recordable criteria and should have been recorded on the employer's recordkeeping log(s), but were not.
  • Under-reporting - refers to two separate kinds of actions: (1) reporting of inaccurate numbers and severity of workplace injury and illnesses to regulators, and (2) employees that do not report work-related injury or illness to their employer when it is required.

Here are some of the key findings from these studies:

  • Several studies estimate that between 20% to 70% of recordable workplace injuries and illnesses are under-recorded, or not recorded at all.
  • A 2014 study published in the American Journal of Industrial Medicine found that 90% of BLS Survey of Occupational Injury & Illness (SOII) respondents failed to meet one or more reporting requirements, due to either misunderstanding or disregard for OSHA recordkeeping regulations.
  • The American Journal of Industrial Medicine study also showed that 12% of surveyed establishments maintained no OSHA injury and illness records, despite being covered by recordkeeping requirements.
  • A 2018 University of Regina study of workplaces in British Columbia, Canada noted that 40% of eligible injury and illness claims were not reported to the provincial workers’ compensation board (WorksafeBC)
  • A separate 2015 study looked at BC workers’ compensation data and found that between 7% and 24% of work-related fatalities between 1991 and 2009 were not captured by the workers compensation system.

The collective results of these research studies were a major force in prompting OSHA to implement a ) focused on injury and illness recordkeeping compliance. A study in the Journal of Safety Research showed that between 2009 and 2012, OSHA performed 576 NEP inspections of 405 establishments under Federal jurisdiction and 171 establishments under State-plan jurisdiction. Of the 405 establishments inspected by federal OSHA, 66% failed to comply with injury and illness recordkeeping requirements resulting in 809 violations, and over half a million dollars in fines.

Considering this data, we are drawn to a couple glaring conclusions; that poor injury and illness recordkeeping practices are widespread, and that the majority of employers are not in full compliance with applicable recordkeeping regulations.

Causes of Under-Recording & Underreporting

Data obtained through OSHA's 2009-2012 Recordkeeping NEP confirmed many of the conclusions made by other researchers as to the root cause(s) of under-recording and underreporting of occupational injuries and illnesses. They are:

  1. Workplace disciplinary policies and safety incentive programs that contribute to employee fears of reprisal or retaliation when reporting an injury or illness to the employer
  2. Organizational structure, function and policies concerning on-site medical treatment units
  3. Confusion surrounding the criteria for determining whether or not an injury or illness is classified as “recordable” and/or “reportable”

Let’s take a closer look at each of these factors to further understand their effects on injury and illness data, and uncover ways to improve both recordkeeping compliance and workplace EHS culture.

Disciplinary Policies & Safety Incentive Programs

All too often, employers blame unsafe behaviors as the cause of workplace injuries or illnesses. It’s easy to jump to the conclusion that the employee must have done something in an unsafe manner, and it was the employee’s fault that the incident occurred. By doing so they are effectively placing sole responsibility for safety on employees and absolving themselves of any accountability. With this attitude, it isn’t a stretch to then believe that disciplining or even removing those employees who they believe are unsafe will eliminate the risk.

In reality, human error is almost never the root cause for workplace incidents. It’s far more likely that some system-related failure of the employer’s workplace health and safety programs was the underlying cause for an employee performing an unsafe action resulting in injury or illness.

For example, if an employee becomes injured because they performed a job task improperly, you really should question whether you’re making it easy enough to do the job safely, as well as review the effectiveness of your job safety training and employee engagement with your training programs, rather than assume that an employee simply ignored safe work practices.

Taking the view that a workplace incident is solely due to human error or unsafe behavior not only blinds us to the true root causes of risk in the workplace, but it sends a clear and dangerous message to employees: “Get hurt and you will be blamed.” If an employee thinks there will be negative consequences (i.e. disciplinary action) for reporting an injury or illness to an employer, they will be less likely to do so.

For more on Root Cause Analysis, check out our On-Demand Webinar “Root Cause Analysis: Improve Investigation of Incidents, Near Hits and Hazards”

It's not always the fear of disciplinary action that causes under-reporting. Poorly designed safety incentive programs can actually lead to under-recording and under-reporting of injuries and illnesses, and damage your workplace safety culture. I know this sounds strange, but let me explain.

Safety incentive programs ultimately rely on one or more health and safety performance metrics to determine if safety goals and performance targets are met. If a safety incentive program relies on data like numbers of injuries and illnesses, DART rates, days without an incident or other lagging EHS metrics, you’re only measuring negative safety outcomes and are likely to assume that the absence of these negative outcomes indicates a safe workplace. It’s easy to see how basing incentive programs on lagging indicators can cause employees to see a conflict between reporting an incident and receiving their safety incentives. In other words, directly rewarding workers for low injury rates (through safety incentive programs) may dissuade them from reporting injuries to the employer, because they don’t want to ruin things for themselves or their coworkers.

OSHA has long recognized the potential for these types of safety incentive programs to result in under-reporting, and formally addressed the issue with its 2016 Improve Tracking of Workplace Injuries and Illnesses Final rule which states that employers should not design workplace safety incentive programs in a way that could discourage employees from reporting workplace injuries and illnesses.

For more interpretation on OSHA guidance for safety incentive programs, Click Here

On-Site Medical Units

You might think that having an on-site medical treatment facility to immediately handle workplace injuries and illnesses would contribute to more accurate recordkeeping data. The reality is that, whether intentional or not, such on-site facilities often result in injuries and illnesses not being recorded on OSHA recordkeeping forms. But how could that be?

By avoiding higher level medical care through treatment in the on-site medical unit, injury and illness cases are effectively kept off the employer's OSHA recordkeeping logs.

In one case, a worker had initially reported pain, numbness and fatigue in the hands, wrists and arms apparently caused by repetitive strain working on a poultry processing line. The employer maintained an on-site medical unit and the worker was treated with over-the-counter remedies such as ice, muscle gel, Epsom salt soaks and non-steroidal anti-inflammatory medication (NSAIDs). The worker’s condition persisted over a ten-week period, visiting the on-site medical unit a total of 94 times. OSHA later discovered that the worker asked to see a doctor several times, but was not referred to a physician, and continued to be sent back to her regular job. No formal assessment of the work-relatedness of her symptoms was performed, and so her injury was not recorded on the OSHA 300 log.

After symptoms persisted, the worker was eventually referred to a physician who diagnosed her with bilateral carpal tunnel syndrome and placed her on work restrictions, at which point, the injury became recordable.

The lesson we should all remember here is that, because the employer neglected to provide sufficient care in an effort to keep the injury ‘off the books’, a worker’s quality of life and ability to work is forever diminished. Is that really worth keeping your DART rate down?

Safety and health care professionals responsible for developing and staffing employers’ on-site medical units should proceed with a clear understanding of applicable nursing and medical regulations, (as well as injury and illness recordkeeping criteria) and ensure that personnel, policies, and procedures are appropriate to the care being provided. In cases where injury and illness recordkeeping criteria are met and appropriate care is not provided, LHCPs working on-site risk their accreditation and licensure, and employers put themselves at risk for regulatory penalties.

Injury & Illness Recordkeeping Criteria

Workplace health and safety regulations like OSHA’s Recordkeeping Rule set forth specific criteria for determining when, and under what circumstances employers must record a workplace injury or illness. Confusion surrounding these criteria was identified as one of the most common causes of under-recording and underreporting. In fact, the results of OSHA’s NEP on injury and illness recordkeeping compliance showed that almost half (47.14%) of the 809 citations issued under the NEP were for un-recorded and/or under-recorded injury and illness cases.

Is This Recordable?

Some of this confusion arises from the multiple exceptions for what types of injuries and illnesses must be recorded. For example, when an injury only requires simple first-aid, does not require formal medical treatment and does not result in any days away restricted or transferred (DART), such an injury would not qualify as a “recordable” injury and would not need to be documented in the employer’s OSHA injury and illness recordkeeping logs.

Similarly, another area where under-recording can easily occur is in cases of work-related musculoskeletal disorders (MSDs) and other repetitive stress injuries (RSIs). In such cases, initial symptoms often go overlooked, are under-recorded, or are simply not reported by workers until symptoms become unbearable. Remember the case of the poultry plant worker and the on-site medical unit?

Adding to this confusion is the fact that in many cases, injuries and illnesses are incorrectly categorized as less severe than they actually are. For example, a recorded injury that does not list the number of days away restricted or transferred (DART), or lists fewer days than actually occurred, is a common example of under-recording. Sometimes this happens because employers don’t realize they need to count all calendar days starting the day after the incident occurs (with the option to cap at 180), and don’t count restricted days or days away that fell on scheduled PTO or holidays. This is a common mistake that tends to make the reported numbers of these days lower than they actually are.

What About Temporary Workers?

Yet another aspect of recordkeeping that creates confusion for employers involves documenting temporary worker injuries and illnesses. The American Journal of Industrial Medicine study found that employers widely misunderstood temporary and host employer obligations for recording injuries among temporary workers. Of 53 establishments surveyed that reported using temporary workers, only 36% stated that injuries among temporary workers would be included on the establishment’s OSHA 300 log as required by the recordkeeping regulations when temporary workers work under the direct supervision of the host employer.

A common point of confusion was that the host employer incorrectly equated responsibility for recording injuries and illnesses among temporary workers with liability for filing workers’ compensation claims, a responsibility of the temporary employer. One thing to keep in mind is that in the U.S., OSHA recordkeeping is distinct and separate from workers’ compensation recording criteria. The two should never be used interchangeably.

To eliminate under-recording and underreporting of workplace injuries and illnesses, employers and employees alike need to have a solid understanding of applicable injury and illness recordkeeping criteria, and how to properly complete OSHA injury and illness recordkeeping forms. For a complete overview of OSHA injury and illness recordkeeping criteria, watch our On-Demand Webinar “OSHA's Recordkeeping Standard: Your Guide to Compliance”

VelocityEHS Can Help!

Employers should regularly and critically evaluate their injury and illness recordkeeping systems, policies and training to ensure they’re doing everything possible to accurately capture workplace injury and illness data. Luckily, VelocityEHS can help employers eliminate many of the recordkeeping mistakes that are the source of under-recording and underreporting.

Eliminate barriers to injury and illness reporting

The VelocityEHS Incident Management solution offers a centralized, highly flexible injury and illness reporting software platform right out-of-the-box. In addition to comprehensive incident reporting, investigation, root cause analysis and action item management features, workers can record and report injuries and illnesses right from their mobile device! Built-in data validation features guide users through the reporting process to make sure all required information is documented accurately and completely, every time.

Simplify Training 

Everyone in the workplace plays a role in preventing injuries and illnesses, so it makes sense that all workers should have a clear understanding of applicable recordkeeping requirements (i.e. what injuries need to be recorded/reported and when), as well as the systems and policies in place for recording and reporting them.

VelocityEHS On-Demand Training gives you an all-in-one system for managing workplace training across your entire organization. In addition to unlimited access to our extensive library of on-demand training courses covering a wide range of workplace EHS topics, VelocityEHS gives you a flexible and intuitive Learning Management System (LMS) that makes it easy to manage workplace training and reach workers across your entire organization through a single, cloud-based system.

Streamline Injury & Illness Reporting

To help reduce under-reporting and improve the quality of occupational injury and illness data, OSHA’s 2016 Improve Tracking of Workplace Injuries and Illnesses Final rule (a.k.a. the “Electronic Reporting Rule) also requires many U.S. employers to submit their injury and illness recordkeeping data to OSHA via its online Injury Tracking Application.

If you’ve got electronic reporting requirements, VelocityEHS can help you make compliance fast and simple. Our Incident Management solution not only centralizes injury and illness recordkeeping across your entire enterprise, but also gives you the ability to automatically generate and export fully-formatted 300A injury and illness summary data in a standard .CSV file format for direct electronic submission to OSHA’s Injury Tracking Application (ITA).

To see for yourself how VelocityEHS can help your business improve injury and illness recordkeeping, Request a Demo today or give us a call at 1.866.919.7922.