An employee medical record is a record concerning an employee’s health status that is made or maintained by a physician, nurse, or other health care personnel or technician, as defined in 29 CFR 1910.1020(c)(6). The term comes from the US federal OSHA standard on access to employee exposure and medical records. That standard applies to general industry, maritime and construction employers that make, maintain, contract for or have access to such records for employees exposed to toxic substances or harmful physical agents (§1910.1020(b)(1)).
What the definition includes and excludes
The standard lists what an employee medical record includes (§1910.1020(c)(6)(i)):
- Medical and employment questionnaires or histories, including job description and occupational exposures
- Results of medical exams (pre-employment, pre-assignment, periodic or episodic) and laboratory tests, including X-rays taken to set a baseline or detect occupational illness, and biological monitoring not defined as an employee exposure record
- Medical opinions, diagnoses, progress notes and recommendations
- First aid records
- Descriptions of treatments and prescriptions
- Employee medical complaints
It also lists what falls outside the definition (§1910.1020(c)(6)(ii)):
- Physical specimens, such as blood or urine samples, routinely discarded as part of normal medical practice
- Health insurance claim records, if kept separately from the employer’s medical program and not accessible to the employer by name or other direct personal identifier
- Records created solely to prepare for litigation and privileged from discovery
- Records of voluntary employee assistance programs (alcohol, drug abuse or personal counseling), if kept separately from the employer’s medical program
Why the definition matters for employers
Whatever meets the definition carries the standard’s duties:
- Retention. Each employee medical record must be kept for at least the duration of employment plus 30 years, unless a specific OSHA standard sets a different period (§1910.1020(d)(1)(i)).
- Access. Access means the right to examine and copy (§1910.1020(c)(1)). Each employee has access to the medical records of which they are the subject, with a narrow exception for some terminal illness or psychiatric information (§1910.1020(e)(2)(ii)(A) and (D)). A designated representative needs the employee’s specific written consent (§1910.1020(e)(2)(ii)(B)).
- OSHA. Employers must give OSHA representatives prompt access on request (§1910.1020(e)(3)(i)).
- Format. Any form works as long as the information is preserved and retrievable, except that chest X-ray films must be kept in their original state (§1910.1020(d)(2)).
The exceptions to retention, the 15-working-day access rule and the consent safeguards are covered in our post on OSHA employee medical records.
Medical records and personnel files
The exclusions for insurance claims and assistance programs apply only when those records are kept separately from the employer’s medical program, so where a record is filed affects how it is treated. Keeping the medical file apart from the HR file in practice is covered in employee health records vs personnel files. Note that the OSHA 300 Log of injuries and illnesses follows its own, shorter retention rule.
MyC keeps one record per worker, with surveillance by exposure group, fitness-to-work and decades of history, in its occupational health EHR.
Related terms
- Employee exposure record: Employee exposure record, under OSHA 29 CFR 1910.1020, means workplace or biological monitoring, safety data sheets or chemical inventories on toxic exposures.
- OSHA 300 Log: The OSHA 300 Log is the form on which US employers covered by 29 CFR Part 1904 record each work-related injury and illness that meets OSHA's recording criteria.
- Medical surveillance: Medical surveillance is the program of medical exams and tests that specific OSHA standards require employers to offer workers exposed to certain hazards.
- Fitness-to-work: Fitness-to-work is an assessment of whether a worker's health lets them do a specific job safely, without danger to their own health or that of others.