Active Release Technique

Question: An automotive seat assembler develops tendonitis in his left elbow after refusing to follow the job rotation schedule and working the same job over and over for months. The doctor encourages the employee to follow his daily job rotation, prescribes OTC naproxen, and recommends the employee only work the one-hour workstation once per week to limit exposure. In addition, the doctor also prescribes the onsite nurse to use active release techniques on the employee’s elbow daily for two weeks until the follow-up visit for re-evaluation. Is it recordable?

Answer: NO. While the doctor did recommend the employee only work the workstation once per week, it does not meet the OSHA criteria for restriction of routine work. Also, per the standard interpretation, active release techniques are not considered medical treatment beyond first aid.

1904.7(b)(4)(ii) What is meant by "routine functions"? For recordkeeping purposes, an employee's routine functions are those work activities the employee regularly performs at least once per week.

1904.7(b)(4)(vi) If the injured or ill worker produces fewer goods or services than he or she would have produced prior to the injury or illness but otherwise performs all of the routine functions of his or her work, is the case considered a restricted work case? No, the case is considered restricted work only if the worker does not perform all of the routine functions of his or her job or does not work the full shift that he or she would otherwise have worked.

Letter of Interpretation: In determining whether ART constitutes first aid or a medical treatment under the definitions of the recordkeeping rule, OSHA's Directorate of Evaluation and Analysis, in consultation with the Office of Occupational Medicine, undertook a comprehensive analysis including: 1) evaluation of the literature description of ART; 2) examination of the patent application for ART and the subsequent Certificate of Correction filed at the U.S. Patent Office; 3) review of articles concerning ART in medical journals; 4) review of an insurance provider's classification of the ART procedures you provided to us; and 5) observation of an ART demonstration.

After completing an analysis of the information currently available, OSHA cannot determine that ART generally exceeds what is commonly recognized as massage practices. Based on this determination, OSHA finds that ART is considered first aid for injury and illness recordkeeping purposes. However, please keep in mind that work­ related injuries and illnesses that involve ART are recordable if they also entail the use of medical treatment, a job transfer, restricted work activity, or days away from work. For example, a work-related injury or illness is recordable if prescription medications are administered in response to an injury or illness, in conjunction with the manipulation of the skeleton, it would be recordable.