Charlotte Observer

By Ames Alexander and and Kerry Hall Singe

Many doctors face pressure to conceal workplace injuries – even if it means providing inadequate medical treatment, according to a new study by Congress’ watchdog agency.

The report by the U.S. Government Accountability Office – spurred by the Observer’s stories on hidden injuries in the poultry industry – concludes that the government hasn’t done enough to ensure the accuracy of workplace injury numbers.

And that has allowed workplace hazards to persist, several lawmakers said following the report’s release Monday.

“The widespread underreporting so clearly documented in this report is undermining the health and safety of American workers,” said Sen. Tom Harkin, D- Iowa, chairman of the Senate Health, Education, Labor and Pensions Committee. “If we don’t know the full extent of the workplace hazards workers face, we cannot fully address these risks.”

In a survey of 504 occupational health practitioners – including company doctors and nurses – the GAO found:

More than a third said they were pressured to provide insufficient treatment to workers so that job-related injuries did not show up on company injury logs.

More than half said they experienced pressure from company officials to downplay injuries or illnesses.

More than two-thirds said they knew of employees who feared disciplinary action if they reported injuries.

Compounding that fear: Many companies require workers to undergo drug testing after they are hurt on the job.

The GAO pointed to another factor that discourages reporting: company programs that reward employees if their plants go long periods without recordable injuries.

Companies are required to record all workplace injuries that result in time off work or medical attention beyond first aid. It’s an honor system, and the injury logs are used by regulators and others to gauge plant safety. Low injury rates allow companies to avoid scrutiny from safety regulators and may help them win contracts and reduce workers’ compensation costs.

Workplace injury and illness rates – a key factor in determining whether regulators inspect a company – have declined nationally in recent years. But some experts suspect that’s partly because employers aren’t reporting all on-the-job injuries.

At a conference in New York City last year, occupational doctors spoke about how their employers had encouraged them to treat some injuries in a way that would not make them recordable. A cut, for instance, must be recorded if the worker gets stitches – but not if the doctor simply covers it with a bandage.

“One practitioner said that an injured worker’s manager took the worker to multiple providers until the manager found one who would certify that treatment of the injury required only first aid, which is not a recordable injury,” the GAO report stated.

OSHA is supposed to conduct audits to ensure that companies accurately report injuries. But the GAO found that the agency doesn’t routinely interview workers when it tries to verify injury reports, so it may miss chances to document underreporting. The watchdog agency recommended that inspectors be required to interview workers during records audits.

Some workplace safety inspectors also told the GAO that they rarely learn about injuries from workers. That’s because their audits are typically conducted about two years after injuries occur – and by that time, many injured workers are no longer employed at the worksite. The GAO urged the government to reduce the time between workplace injuries and audits.

Federal OSHA, which oversees safety in about half the states, said it would implement all the GAO’s recommendations. It’s unclear whether the remaining states, including the Carolinas, will adopt them as well.

“Many of the problems identified in the report are quite alarming, and OSHA will be taking strong enforcement action where we find underreporting,” U.S. Labor Secretary Hilda Solis said.

Last month, federal OSHA said it would launch a national program aimed at catching companies that hide workplace injuries.

Tom O’Connor, executive director of the National Council for Occupational Safety and Health, a group that advocates for worker safety, called the findings “dramatic,” adding: “If healthcare professionals are being asked to not record injuries properly, then we have a pretty broken system.”

The report shows that it’s not “just a few bad actors” concealing on-the-job injuries, he said, and that underreporting is “just worse than a lot of people thought.”