Ask the expert: Needlestick referral and employee insurance

By: January 18th, 2011 Email This Post Print This Post

Q: In the event of a needlestick, can our practice send an employee to his or her personal doctor and pay the co-pay or any other fees or do we have to send them to a doctor that the office has contacted with?

A: Always stay away from taking care of occupational bloodborne pathogen exposure expenses through an employee’s insurance. Services required by the Bloodborne Pathogens standard must be at no cost to the employee and OSHA does not consider an employee’s medical insurance to be at no cost. For a related interpretation, see Ask the expert: Vaccinations and out-of-pocket expenses.

As to referring your employee for postexposure management, OSHA requires that “the employer provide post-exposure evaluation and follow-up to employees for bloodborne pathogens, such as hepatitis C (HCV), as recommended by the CDC. The current CDC recommendations for HBV, HIV and HCV are found in the Updated U.S. Public Health Service Guidelines for the Management of Occupational Exposures to HBV, HCV, and HIV and Recommendations for Postexposure Prophylaxis in Vol 50, No. RR-11, published in the June 29, 2001 MMWR (Attached as Appendix E),” according to Enforcement Procedures for the Occupational Exposure to Bloodborne Pathogens.

That is why it is best to contract with a facility that has expertise in occupational bloodborne pathogens exposures.

Could you ensure that by referring an employer to his/her personal physician that treatment will be given in accordance with USPHS recommendations? Too much uncertainty there, in my opinion.

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By Tracy Stieglitz on February 1st, 2011 at 5:10 pm

If an employee has a new positive PPD and needs a chest x-ray to rule out TB does the employer have to pay for the x-ray or can the employee’s insurance?” Thank you

By Tracy Stieglitz on February 1st, 2011 at 5:13 pm

If an employee has a new positive PPD and need a chest x-ray to rule out TB does the employer have pay or can the employee’s insurance? Thank you

By David LaHoda on February 1st, 2011 at 5:21 pm

Who paid for the PPD…probably the employer…so why ask the worker to pay for the chest x-ray?

TB PPD testing is not necessarily required by OSHA—it is more of a state public health department and infection control matter—nevertheless, if you are doing PPDs for OSHA compliance, the testing would have to be at-no-cost to the employee. And using the worker’s insurance is not considered at-no-cost to the employee, as OSHA sees it.


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