Employee%20Medical%20and%20Exposure%20Records - PowerPoint PPT Presentation

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Employee%20Medical%20and%20Exposure%20Records

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Understand the process for accessing identifiable medical information ... to withhold trade secret information from employee medical or exposure records. ... – PowerPoint PPT presentation

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Title: Employee%20Medical%20and%20Exposure%20Records


1
Employee Medical and Exposure Records
  • Keeping and providing access to medical and
    exposure records

November, 2010
2
This Module will cover the following
  • The scope and purpose of the rule WAC 296-802
  • The specific retention periods and requirements
    for medical and exposure records, and analysis
  • The process for accessing identifiable medical
    information

3
Rule Scope
  • This rule applies to all employers who make,
    maintain, contract for, or have access to
    employee medical or exposure records, or analysis
    of employee medical or exposure records.

All employee medical and exposure records are
included, whether or not they are required by
specific safety and health rules.
Note exposure records are any records, data or
measurements of employee exposure to chemicals or
physical hazards, or biological monitoring results
4
Rule Purpose
  • The rule fulfills 3 primary purposes
  • To require the retention of medical and exposure
    records related to employees exposure to toxic
    substances or harmful physical agents.
  • To ensure access to records by affected
    employees, designated representatives and DOSH.
  • To ensure employees are informed by their
    employers of their right to access records, how
    records are maintained and the procedures for
    obtaining access.

5
Related Rules
  • The following 3 slides provide information on
    these related rules
  • Trade secrets
  • Chemical hazard communication
  • Material Safety Data Sheets (MSDS)

6
Trade Secrets
  • WAC 296-816, Trade Secrets allows employers to
    withhold trade secret information from employee
    medical or exposure records.
  • Employers may condition access to trade secret
    information upon a written agreement not to
    misuse the information.

7
Chemical Hazard Communication
  • The chemical hazard communication standard
    requires manufacturers and importers to assess
    the hazards of chemicals, label the containers
    with the hazards and provide MSDS
  • Employers must provide employees with information
    on the hazards of chemicals they are exposed to.

8
Material Safety Data Sheets
  • WAC 296-800-180, Material Safety Data Sheets as
    Exposure Records, establishes that MSDS are a
    type of exposure record.
  • MSDS must be retained and made available to
    employees, their representatives and the
    department as exposure records.

9
Other legal obligations
  • The requirements of this rule do not affect any
    other legal obligations the employer has to keep
    employee medical information confidential.
  • In general the employer contracts with a medical
    provider to maintain employee medical records in
    a confidential manner.

10
Medical Records Retention
  • Employee medical records must be retained for
    duration of employment plus 30 years.
  • If a specific rule provides a different
    retention period that retention period must be
    followed, e.g. the lead rule requires that
    medical records be retained for at least forty
    years, or for the duration of employment plus
    twenty years, whichever is longer.

Link to list of specific rule retention
requirements
11
Medical Records (Cont.)
  • Retention Exemption
  • If an employee works less than one year the
    medical record does not need to be retained as
    long as the record is provided to the employee
  • The following records do not need to be kept
  • Health insurance claims maintained separately
    from the medical record
  • Records of first-aid treatment, if made on-site
    by a non-physician and kept separately from the
    medical record

12
Exposure Records Retention
  • Exposure records must be retained for 30 years
    from the date they were created.
  • If a specific rule provides a different retention
    period that retention period must be followed.
  • For example the arsenic rule requires that
    exposure records be retained for at least forty
    years, or for the duration of employment plus
    twenty years, whichever is longer.

Specific employee medical exposure records
requirements
13
Exposure Records (Cont.)
  • All monitoring background data does not need to
    be kept for more than one year as long as a
    summary of the data is kept for 30 years.
  • Individual exposure records concerning the
    identity of a substance need not be kept as long
    as some record of the identity of the substance,
    where and when it was used, is kept for 30 years.

14
Analysis of Records
  • Analysis using medical or exposure records must
    be kept for at least 30 years.
  • Employees must not be identified in any portion
    of released analysis that reports the contents of
    employee medical records, e.g., names, social
    security number, or other identifying information.

15
Informing Employees about Records
  • The following information must be provided upon
    employment and at least annually
  • Where records are located
  • Who is responsible for the records
  • Who to contact for access
  • Their rights to copy records
  • The information must be made accessible, but
    formal training is not necessary

16
Employee Access
  • The requirements of this rule apply to both
    current and former employees.
  • Provide employees, or their representatives,
    access to their records upon request
  • In a reasonable time, place and manner
  • Within 15 working days of the request
  • Provide a copy at no cost. A nominal charge may
    be applied for additional copies.

17
Employee Access (Cont.)
  • A physician representing the employer may
    restrict access to health information regarding a
    terminal illness or psychiatric condition if the
    physician believes this information could harm
    the employee.
  • The physician may recommend that this
    information only be released to a designated
    employee representative.

18
Employee Access (Cont.)
  • A healthcare professional maintaining employee
    medical records may delete the identity of a
  • Family member
  • Personal friend or fellow employee who has
    provided confidential information concerning the
    employees health status.

19
Employee Access (Cont.)
  • Provide requested exposure records for an
    employee's current or transfer work assignment.
  • In the absence of records specific to the
    employee, exposure records of other employees
    with the same job duties or related working
    conditions may be provided.

20
Written Authorization for Access
  • Provide designated representatives access to
    employee medical records when the employee
    provides specific written authorization.
  • If the authorization does not contain an
    expiration dates it expires in 90 days.
  • An employee may revoke the authorization at any
    time.

Sample authorization letter to release medical
information
21
DOSH Access Orders
  • DOSH may issue an access order when it is
    necessary to obtain identifiable employee medical
    information.
  • The rule specifies the contents of an access
    order. WAC 296-802-500

An access order is not needed - For records
that do not contain personal identification
information - To verify compliance with medical
surveillance requirements of another rule - To
access records, such as medical opinions or
biological monitoring results, when required by
another rule
22
Record Transfer and Disposal
  • When an employer goes out of business
  • All records are transferred to the new employer
  • If no other employer continues the business,
    current and former employees may access the
    records, and the employer must notify DOSH of
    intent to dispose or transfer records to DOSH
    when required under rule

23
Questions Answers
  • Q. Is post vaccination hepatitis B antibody
    testing considered an exposure or a medical
    record?
  • Medical record because it measures a
    physiological change.

Q. Would the inclusion of a job title in an
analysis that includes employee medical
information be a breach of confidentiality? A. It
could if there were a limited number of these
positions and the title could easily be used to
identify an employee or imply identification.
24
Q A
  • Q. May the employer keep an employees tuberculin
    skin test record in the personnel file?
  • A. No, the skin test result is confidential
    medical information. The employer or employers
    representatives would not have access to this
    record with specific written authorization.

Q. Does posting the OSHA 300A form constitute a
breach of confidentiality? A. No, as it does not
contain personally identifiable medical
information. There are few conditions that must
be posted as privacy cases and identifiers
removed, e.g., tuberculosis and HIV infection
25
Q A
  • Q. What would be some reasons for DOSH to issue
    an Access Order?
  • - To document employer knowledge, or
  • - To document poor management of employees with
    evidence of adverse health effects, or
  • - To verify compliance during follow-up
    inspections

Q. May an employee request exposure records of
similarly situated employees? A. Yes, in the
absence of personally relevant records the
employee may request records of other employees
who may have experienced similar exposures.
26
Q A
  • Q. Must employers maintain records of treatment
    of minor wounds as medical records?
  • A. No, generally cleaning, flushing, or soaking
    wounds, and the application of wound coverings is
    considered first-aid.

Q. Must the employer maintain exposure records
including the identity of a hazardous
chemical? A. No, the identity may be retained
either as part of the exposure record or as a
separate record. Documentation of where and when
the substance was used must be included.
27
Q A
  • Q. Must employers retain medical records of short
    term employees (employed for less than a year)?
  • A. No, not as long as they provide the records to
    the employee upon termination.

Q. Must employers provide employees or their
representatives with the exposure records of all
employees with similar exposures. A. Not
routinely, the rule only allows access to records
of similarly exposed employees when employee
personal records are inadequate.
28
Q A
  • Q. Does the employer have any protection against
    the unnecessary disclosure of trade secrets?
  • A. Yes, the Trade Secret rule, chapter 296-816
    WAC provides these protections.

Q. Are unions considered employee
representatives? A. Yes, but only in regards to
access to exposure records. In order to access
exposure information unions must state which
records they want disclosed and the specific
occupational health need.
29
Other Questions?
Please contact
  • Pam Edwards
  • DOSH Technical Services
  • 360-902-6457
  • edwp235_at_lni.wa.gov
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