CAOHC Medical Referral Criteria and Follow-up

Question 1

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

Accepted Answer

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

Answer

A 5 dB shift at any single frequency from baseline

Answer

Any audiogram showing thresholds above 15 dB HL

Answer

A worker complaint of ringing in the ears after a single shift

Question 2

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

Accepted Answer

Within 21 calendar days of the determination

Answer

Within 5 working days of the audiometric test

Answer

Within 30 working days of the end of the testing cycle

Answer

Within 60 calendar days of the annual test

Question 3

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?

Accepted Answer

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

Answer

Immediately reassign the worker to a quieter department

Answer

File an OSHA 300 recordable entry within 24 hours

Answer

Retest the worker every week for 90 days before referral

Question 4

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?

Accepted Answer

Refer the worker to a physician or audiologist for further evaluation

Answer

Document it as normal noise-induced hearing loss pattern

Answer

Retest in a different booth and average the two results

Answer

Apply age correction and retest at the next annual cycle

Question 5

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

Accepted Answer

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

Answer

Worker reports that hearing protection feels uncomfortable

Answer

Worker's thresholds show a minor improvement at 4000 Hz

Answer

Worker has worked in noise-exposed areas for fewer than 6 months

Question 6

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

Accepted Answer

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

Answer

Determine whether the physician's findings are work-related and file accordingly

Answer

Assume responsibility for the medical treatment plan going forward

Answer

Re-administer the audiometric test to verify the physician's conclusions

Question 7

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?

Accepted Answer

Follow OSHA's requirements and make the referral as mandated

Answer

Follow the employer's instructions since liability rests with the employer

Answer

Delay the referral until the worker's next scheduled annual audiogram

Answer

Request written confirmation from the employer before proceeding