Medical Referral Criteria and Follow-up Flashcards

Under OSHA's Hearing Conservation Amendment (29 CFR 1910.95), which finding most clearly requires referral to a physician or audiologist?

Answer: A confirmed Standard Threshold Shift (STS) of 10 dB average at 2000, 3000, and 4000 Hz

OSHA defines STS as a 10 dB or greater average shift at 2000, 3000, and 4000 Hz, and a confirmed STS triggers the mandatory referral requirement.

Within what timeframe must an employer notify a worker of a confirmed Standard Threshold Shift under OSHA's hearing conservation standard?

Answer: Within 21 calendar days of the determination

OSHA requires workers to be notified of a confirmed STS within 21 calendar days of the determination.

After a worker is found to have a confirmed STS, the employer must take which of the following steps if the worker is not already under physician care for hearing loss?

Answer: Refer the worker to a physician or audiologist at no cost to the worker

OSHA mandates that workers with a confirmed STS who are not under a physician's care be referred to a physician or audiologist at employer expense.

An OHC observes that a worker's audiogram shows an unusual audiometric configuration — a sudden deep notch at 250 Hz only. What is the most appropriate action?

Answer: Refer the worker to a physician or audiologist for further evaluation

Unusual or atypical audiometric configurations that do not fit expected noise-induced patterns require physician or audiologist referral.

Which of the following is a valid reason for an OHC to make an immediate physician referral, independent of audiometric threshold findings?

Answer: Worker presents with visible ear drainage, ear pain, or signs of infection

Physical symptoms such as ear drainage, pain, or signs of infection indicate a medical condition requiring physician evaluation regardless of audiometric results.

What is the OHC's primary responsibility after a worker has been evaluated by a physician following a referral?

Answer: Document the referral outcome and update the worker's audiometric record accordingly

The OHC's role after physician evaluation is to document the referral and findings and maintain accurate audiometric records — not to interpret or dispute medical conclusions.

An employer instructs an OHC not to refer a worker to a physician after an STS is confirmed, fearing it will create an OSHA recordable entry. What should the OHC do?

Answer: Follow OSHA's requirements and make the referral as mandated

OSHA standards require STS follow-up referrals; an OHC must comply with regulatory requirements regardless of employer pressure to avoid recordables.