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e-CFR=20 Data is current as of June 8, 2012


Title 29:=20 Labor

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PART 1913=97RULES OF AGENCY PRACTICE AND PROCEDURE CONCERNING = OSHA=20 ACCESS TO EMPLOYEE MEDICAL RECORDS
Section Contents
=A7 1913.10 &nbs= p; Rules=20 of agency practice and procedure concerning OSHA access to = employee=20 medical records.

Authority:   Sec. 8, = Occupational Safety=20 and Health Act of 1970 (29 U.S.C. 657); Sec. e, Privacy Act (5 = U.S.C.=20 552a(e); 5 U.S.C. 301); Secretary of Labor's Order No. 8=9676 (41 = FR 25059),=20 or 5=962002 (67 FR 65008) as applicable.

=A7 1913.10   Rules of agency practice and = procedure=20 concerning OSHA access to employee medical records.
=20 top

(a) General policy. OSHA access to employee medical = records will=20 in certain circumstances be important to the agency's performance = of its=20 statutory functions. Medical records, however, contain personal = details=20 concerning the lives of employees. Due to the substantial personal = privacy=20 interests involved, OSHA authority to gain access to personally=20 identifiable employee medical information will be exercised only = after the=20 agency has made a careful determination of its need for this = information,=20 and only with appropriate safeguards to protect individual = privacy. Once=20 this information is obtained, OSHA examination and use of it will = be=20 limited to only that information needed to accomplish the purpose = for=20 access. Personally identifiable employee medical information will = be=20 retained by OSHA only for so long as needed to accomplish the = purpose for=20 access, will be kept secure while being used, and will not be = disclosed to=20 other agencies or members of the public except in narrowly defined = circumstances. This section establishes procedures to implement = these=20 policies.

(b) Scope and application. (1) Except as provided in = paragraphs=20 (b) (3) through (6) below, this section applies to all requests by = OSHA=20 personnel to obtain access to records in order to examine or copy=20 personally identifiable employee medical information, whether or = not=20 pursuant to the access provisions of 29 CFR 1910.1020(e).

(2) For the purposes of this section, =93personally = identifiable employee=20 medical information=94 means employee medical information = accompanied by=20 either direct identifiers (name, address, social security number, = payroll=20 number, etc.) or by information which could reasonably be used in = the=20 particular circumstances indirectly to identify specific employees = (e.g.,=20 exact age, height, weight, race, sex, date of initial employment, = job=20 title, etc.).

(3) This section does not apply to OSHA access to, or the use = of,=20 aggregate employee medical information or medical records on = individual=20 employees which is not in a personally identifiable form. This = section=20 does not apply to records required by 29 CFR part 1904, to death=20 certificates, or to employee exposure records, including = biological=20 monitoring records treated by 29 CFR 1910.1020(c)(5) or by = specific=20 occupational safety and health standards as exposure records.

(4) This section does not apply where OSHA compliance personnel = conduct=20 an examination of employee medical records solely to verify = employer=20 compliance with the medical surveillance recordkeeping = requirements of an=20 occupational safety and health standard, or with 29 CFR 1910.1020. = An=20 examination of this nature shall be conducted on-site and, if = requested,=20 shall be conducted under the observation of the recordholder. The = OSHA=20 compliance personnel shall not record and take off-site any = information=20 from medical records other than documentation of the fact of = compliance or=20 non-compliance.

(5) This section does not apply to agency access to, or the use = of,=20 personally identifiable employee medical information obtained in = the=20 course of litigation.

(6) This section does not apply where a written directive by = the=20 Assistant Secretary authorizes appropriately qualified personnel = to=20 conduct limited reviews of specific medical information mandated = by an=20 occupational safety and health standard, or of specific biological = monitoring test results.

(7) Even if not covered by the terms of this section, all = medically=20 related information reported in a personally identifiable form = shall be=20 handled with appropriate discretion and care befitting all = information=20 concerning specific employees. There may, for example, be personal = privacy=20 interests involved which militate against disclosure of this kind = of=20 information to the public ( See, 29 CFR 70.26 and = 70a.3).

(c) Responsible persons =97(1) Assistant Secretary. = The=20 Assistant Secretary of Labor for Occupational Safety and Health = (Assistant=20 Secretary) shall be responsible for the overall administration and = implementation of the procedures contained in this section, = including=20 making final OSHA determinations concerning:

(i) Access to personally identifiable employee medical = information=20 (paragraph (d)), and

(ii) Inter-agency transfer or public disclosure of personally=20 identifiable employee medical information (paragraph (m)).

(2) OSHA Medical Records Officer. The Assistant = Secretary shall=20 designate an OSHA official with experience or training in the = evaluation,=20 use, and privacy protection of medical records to be the OSHA = Medical=20 Records Officer. The OSHA Medical Records Officer shall report = directly to=20 the Assistant Secretary on matters concerning this section and = shall be=20 responsible for:

(i) Making recommendations to the Assistant Secretary as to the = approval or denial of written access orders (paragraph (d)),

(ii) Assuring that written access orders meet the requirements = of=20 paragraphs (d) (2) and (3) of this section,

(iii) Responding to employee, collective bargaining agent, and = employer=20 objections concerning written access orders (paragraph (f)),

(iv) Regulating the use of direct personal identifiers = (paragraph=20 (g)),

(v) Regulating internal agency use and security of personally=20 identifiable employee medical information (paragraphs (h) through=20 (j)),

(vi) Assuring that the results of agency analyses of personally = identifiable medical information are, where appropriate, = communicated to=20 employees (paragraph (k)),

(vii) Preparing an annual report of OSHA's experience under = this=20 section (paragraph (l)), and

(viii) Assuring that advance notice is given of intended = inter-agency=20 transfers or public disclosures (paragraph (m)).

(3) Principal OSHA Investigator. The Principal OSHA = Investigator=20 shall be the OSHA employee in each instance of access to = personally=20 identifiable employee medical information who is made primarily=20 responsible for assuring that the examination and use of this = information=20 is performed in the manner prescribed by a written access order = and the=20 requirements of this section (paragraphs (d) through (m). When = access is=20 pursuant to a written access order, the Principal OSHA = Investigator shall=20 be professionally trained in medicine, public health, or allied = fields=20 (epidemiology, toxicology, industrial hygiene, biostatistics,=20 environmental health, etc.).

(d) Written access orders =97(1) Requirement for = written access=20 order. Except as provided in paragraph (d)(4) below, each = request by=20 an OSHA representative to examine or copy personally identifiable = employee=20 medical information contained in a record held by an employer or = other=20 recordholder shall be made pursuant to a written access order = which has=20 been approved by the Assistant Secretary upon the recommendation = of the=20 OSHA Medical Records Officer. If deemed appropriate, a written = access=20 order may constitute, or be accompanied by, an administrative=20 subpoena.

(2) Approval criteria for written access order. Before = approving=20 a written access order, the Assistant Secretary and the OSHA = Medical=20 Records Officer shall determine that:

(i) The medical information to be examined or copied is = relevant to a=20 statutory purpose and there is a need to gain access to this = personally=20 identifiable information,

(ii) The personally identifiable medical information to be = examined or=20 copied is limited to only that information needed to accomplish = the=20 purpose for access, and

(iii) The personnel authorized to review and analyze the = personally=20 identifiable medical information are limited to those who have a = need for=20 access and have appropriate professional qualifications.

(3) Content of written access order. Each written access = order=20 shall state with reasonable particularity:

(i) The statutory purposes for which access is sought,

(ii) A general description of the kind of employee medical = information=20 that will be examined and why there is a need to examine = personally=20 identifiable information,

(iii) Whether medical information will be examined on-site, and = what=20 type of information will be copied and removed off-site,

(iv) The name, address, and phone number of the Principal OSHA=20 Investigator and the names of any other authorized persons who are = expected to review and analyze the medical information.

(v) The name, address, and phone number of the OSHA Medical = Records=20 Officer, and

(vi) The anticipated period of time during which OSHA expects = to retain=20 the employee medical information in a personally identifiable = form.

(4) Special situations. Written access orders need not = be=20 obtained to examine or copy personally identifiable employee = medical=20 information under the following circumstances:

(i) Specific written consent. If the specific written = consent of=20 an employee is obtained pursuant to 29 CFR 1910.1020(e)(2)(ii), = and the=20 agency or an agency employee is listed on the authorization as the = designated representative to receive the medical information, then = a=20 written access order need not be obtained. Whenever personally=20 identifiable employee medical information is obtained through = specific=20 written consent and taken off-site, a Principal OSHA Investigator = shall be=20 promptly named to assure protection of the information, and the = OSHA=20 Medical Records Officer shall be notified of this person's = identity. The=20 personally identifiable medical information obtained shall = thereafter be=20 subject to the use and security requirements of paragraphs (h) = through (m)=20 of this section.

(ii) Physician consultations. A written access order = need not be=20 obtained where an OSHA staff or contract physician consults with = an=20 employer's physician concerning an occupational safety or health = issue. In=20 a situation of this nature, the OSHA physician may conduct on-site = evaluation of employee medical records in consultation with the = employer's=20 physician, and may make necessary personal notes of his or her = findings.=20 No employee medical records, however, shall be taken off-site in = the=20 absence of a written access order or the specific written consent = of an=20 employee, and no notes of personally identifiable employee medical = information made by the OSHA physician shall leave his or her = control=20 without the permission of the OSHA Medical Records Officer.

(e) Presentation of written access order and notice to = employees.=20 (1) The Principal OSHA Investigator, or someone under his or = her=20 supervision, shall present at least two (2) copies each of the = written=20 access order and an accompanying cover letter to the employer = prior to=20 examining or obtaining medical information subject to a written = access=20 order. At least one copy of the written access order shall not = identify=20 specific employees by direct personal identifier. The accompanying = cover=20 letter shall summarize the requirements of this section and = indicate that=20 questions or objections concerning the written access order may be = directed to the Principal OSHA Investigator or to the OSHA Medical = Records=20 Officer.

(2) The Principal OSHA Investigator shall promptly present a = copy of=20 the written access order (which does not identify specific = employees by=20 direct personal identifier) and its accompanying cover letter to = each=20 collective bargaining agent representing employees whose medical = records=20 are subject to the written access order.

(3) The Principal OSHA Investigator shall indicate that the = employer=20 must promptly post a copy of the written access order which does = not=20 identify specific employees by direct personal identifier, as well = as post=20 its accompanying cover letter ( See, 29 CFR=20 1910.1020(e)(3)(ii)).

(4) The Principal OSHA Investigator shall discuss with any = collective=20 bargaining agent and with the employer the appropriateness of = individual=20 notice to employees affected by the written access order. Where it = is=20 agreed that individual notice is appropriate, the Principal OSHA=20 Investigator shall promptly provide to the employer an adequate = number of=20 copies of the written access order (which does not identify = specific=20 employees by direct personal identifier) and its accompanying = cover letter=20 to enable the employer either to individually notify each employee = or to=20 place a copy in each employee's medical file.

(f) Objections concerning a written access order. All = employee,=20 collective bargaining agent, and employer written objections = concerning=20 access to records pursuant to a written access order shall be = transmitted=20 to the OSHA Medical Records Officer. Unless the agency decides = otherwise,=20 access to the records shall proceed without delay notwithstanding = the=20 lodging of an objection. The OSHA Medical Records Officer shall = respond in=20 writing to each employee's and collective bargaining agent's = written=20 objection to OSHA access. Where appropriate, the OSHA Medical = Records=20 Officer may revoke a written access order and direct that any = medical=20 information obtained by it be returned to the original = recordholder or=20 destroyed. The Principal OSHA Investigator shall assure that such=20 instructions by the OSHA Medical Records Officer are promptly=20 implemented.

(g) Removal of direct personal identifiers. Whenever = employee=20 medical information obtained pursuant to a written access order is = taken=20 off-site with direct personal identifiers included, the Principal = OSHA=20 Investigator shall, unless otherwise authorized by the OSHA = Medical=20 Records Officer, promptly separate all direct personal identifiers = from=20 the medical information, and code the medical information and the = list of=20 direct identifiers with a unique identifying number for each = employee. The=20 medical information with its numerical code shall thereafter be = used and=20 kept secured as though still in a directly identifiable form. The=20 Principal OSHA Investigator shall also hand deliver or mail the = list of=20 direct personal identifiers with their corresponding numerical = codes to=20 the OSHA Medical Records Officer. The OSHA Medical Records Officer = shall=20 thereafter limit the use and distribution of the list of coded = identifiers=20 to those with a need to know its contents.

(h) Internal agency use of personally identifiable employee = medical=20 information. (1) The Principal OSHA Investigator shall in each = instance of access be primarily responsible for assuring that = personally=20 identifiable employee medical information is used and kept secured = in=20 accordance with this section.

(2) The Principal OSHA Investigator, the OSHA Medical Records = Officer,=20 the Assistant Secretary, and any other authorized person listed on = a=20 written access order may permit the examination or use of = personally=20 identifiable employee medical information by agency employees and=20 contractors who have a need for access, and appropriate = qualifications for=20 the purpose for which they are using the information. No OSHA = employee or=20 contractor is authorized to examine or otherwise use personally=20 identifiable employee medical information unless so permitted.

(3) Where a need exists, access to personally identifiable = employee=20 medical information may be provided to attorneys in the Office of = the=20 Solicitor of Labor, and to agency contractors who are physicians = or who=20 have contractually agreed to abide by the requirements of this = section and=20 implementing agency directives and instructions.

(4) OSHA employees and contractors are only authorized to use=20 personally identifiable employee medical information for the = purposes for=20 which it was obtained, unless the specific written consent of an = employee=20 is obtained as to a secondary purpose, or the procedures of = paragraphs (d)=20 through (g) of this section are repeated with respect to the = secondary=20 purpose.

(5) Whenever practicable, the examination of personally = identifiable=20 employee medical information shall be performed on-site with a = minimum of=20 medical information taken off-site in a personally identifiable = form.

(i) Security procedures. (1) Agency files containing = personally=20 identifiable employee medical information shall be segregated from = other=20 agency files. When not in active use, files containing this = information=20 shall be kept secured in a locked cabinet or vault.

(2) The OSHA Medical Records Officer and the Principal OSHA=20 Investigator shall each maintain a log of uses and transfers of = personally=20 identifiable employee medical information and lists of coded = direct=20 personal identifiers, except as to necessary uses by staff under = their=20 direct personal supervision.

(3) The photocopying or other duplication of personally = identifiable=20 employee medical information shall be kept to the minimum = necessary to=20 accomplish the purposes for which the information was = obtained.

(4) The protective measures established by this section apply = to all=20 worksheets, duplicate copies, or other agency documents containing = personally identifiable employee medical information.

(5) Intra-agency transfers of personally identifiable employee = medical=20 information shall be by hand delivery, United States mail, or = equally=20 protective means. Inter-office mailing channels shall not be = used.

(j) Retention and destruction of records. (1) Consistent = with=20 OSHA records disposition programs, personally identifiable = employee=20 medical information and lists of coded direct personal identifiers = shall=20 be destroyed or returned to the original recordholder when no = longer=20 needed for the purposes for which they were obtained.

(2) Personally identifiable employee medical information which = is=20 currently not being used actively but may be needed for future use = shall=20 be transferred to the OSHA Medical Records Officer. The OSHA = Medical=20 Records Officer shall conduct an annual review of all = centrally-held=20 information to determine which information is no longer needed for = the=20 purposes for which it was obtained.

(k) Results of an agency analysis using personally = identifiable=20 employee medical information. The OSHA Medical Records Officer = shall,=20 as appropriate, assure that the results of an agency analysis = using=20 personally identifiable employee medical information are = communicated to=20 the employees whose personal medical information was used as a = part of the=20 analysis.

(l) Annual report. The OSHA Medical Records Officer = shall on an=20 annual basis review OSHA's experience under this section during = the=20 previous year, and prepare a report to the Assistant Secretary = which shall=20 be made available to the public. This report shall discuss:

(1) The number of written access orders approved and a summary = of the=20 purposes for access,

(2) The nature and disposition of employee, collective = bargaining=20 agent, and employer written objections concerning OSHA access to=20 personally identifiable employee medical information, and

(3) The nature and disposition of requests for inter-agency = transfer or=20 public disclosure of personally identifiable employee medical=20 information.

(m) Inter-agency transfer and public disclosure. (1) = Personally=20 identifiable employee medical information shall not be transferred = to=20 another agency or office outside of OSHA (other than to the Office = of the=20 Solicitor of Labor) or disclosed to the public (other than to the = affected=20 employee or the original recordholder) except when required by law = or when=20 approved by the Assistant Secretary.

(2) Except as provided in paragraph (m)(3) of this section, the = Assistant Secretary shall not approve a request for an = inter-agency=20 transfer of personally identifiable employee medical information, = which=20 has not been consented to by the affected employees, unless the = request is=20 by a public health agency which:

(i) Needs the requested information in a personally = identifiable form=20 for a substantial public health purpose,

(ii) Will not use the requested information to make individual=20 determinations concerning affected employees which could be to = their=20 detriment,

(iii) Has regulations or established written procedures = providing=20 protection for personally identifiable medical information = substantially=20 equivalent to that of this section, and

(iv) Satisfies an exemption to the Privacy Act to the extent = that the=20 Privacy Act applies to the requested information ( See, 5 = U.S.C.=20 552a(b); 29 CFR 70a.3).

(3) Upon the approval of the Assistant Secretary, personally=20 identifiable employee medical information may be transferred = to:

(i) The National Institute for Occupational Safety and Health = (NIOSH)=20 and

(ii) The Department of Justice when necessary with respect to a = specific action under the Occupational Safety and Health Act.

(4) The Assistant Secretary shall not approve a request for = public=20 disclosure of employee medical information containing direct = personal=20 identifiers unless there are compelling circumstances affecting = the health=20 or safety of an individual.

(5) The Assistant Secretary shall not approve a request for = public=20 disclosure of employee medical information which contains = information=20 which could reasonably be used indirectly to identify specific = employees=20 when the disclosure would constitute a clearly unwarranted = invasion of=20 personal privacy ( See, 5 U.S.C. 552(b)(6); 29 CFR = 70.26).

(6) Except as to inter-agency transfers to NIOSH or the = Department of=20 Justice, the OSHA Medical Records Officer shall assure that = advance notice=20 is provided to any collective bargaining agent representing = affected=20 employees and to the employer on each occasion that OSHA intends = to either=20 transfer personally identifiable employee medical information to = another=20 agency or disclose it to a member of the public other than to an = affected=20 employee. When feasible, the OSHA Medical Records Officer shall = take=20 reasonable steps to assure that advance notice is provided to = affected=20 employees when the employee medical information to be transferred = or=20 disclosed contains direct personal identifiers.

[45 FR 35294, May 23, 1980; 45 FR 54334, Aug. 15, 1980, as = amended at=20 71 FR 16674, Apr. 3, 2006]

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