Under-recording of workplace injuries and illnesses is bad, and far too common. But at the automaker Tesla, in Fremont, California,  under-recording is more than a paper exercise in deception — at Tesla it means withholding needed medical treatment of injured workers so that their injuries aren’t report on OSHA logs.

We wrote previously about reports that workers are getting hurt at Tesla and that many of those injuries are not being recorded.  Earlier this year, Reveal reporters Will Evans and Alyssa Jeong Perry documented how Tesla put style and speed over safety, undercounted injuries and ignored the concerns of its own safety professionals. CalOSHA has inspected the company a number of times and found recordkeeping violations.  Now Evans shows the many ways that Tesla is keeping injuries off the OSHA logs.

Despite a clear pattern of inaccurate reporting, federal OSHA is unable to cite patterns of under-reporting after Congress repealed OSHA’s “Volks” regulation at the beginning of the Administration. Throughout OSHA’s history, the agency had been able to cite employers who violated OSHA’s requirement to keep accurate records for five years. OSHA had issued a regulation addressing a court ruling against that practice, but Congress used the Congressional Review Act to repeal it. No OSHA can’t cite recordkeeping violations longer than 6 months before a citation is issued, making it impossible to cite patterns of violations like those committed at Tesla.

California has modified these restrictions slightly by allowing the agency to cite employers for recordkeeping violations six months from when Cal/OSHA first learns of the violation, instead of six months from when the violation occurred. But the bill was signed too late for the agency to take action against Tesla.

Background

Under-reporting injuries and illnesses on OSHA logs is nothing new.  Unlike fatality reporting, injury and illness reporting is conducted by employers. The Bureau of Labor Statistics (BLS) estimated in 2016, that nearly 3.7 million workers across all industries, including state and local government, had work-related injuries and illnesses that were reported by employers. But due to documented and widespread underreporting of workplace injuries, experts estimate that the true number is closer to  7.4 million to 11.1 million injuries and illnesses a year — two to three times greater than BLS estimates.  Much of the undercounting is the result of employers discouraging workers from reporting injuries and illnesses, either through direct retaliation or through more subtle means such as incentive programs or retaliatory drug testing.  That’s why OSHA’s “electronic recordkeeping regulation,” issued in 2015, forbids employers from retaliating against workers for reporting injuries and illnesses. The Trump administration recently issued a memo weakening the enforcement of that language.

In order to understand Tesla’s strategy, you need to understand how OSHA defines a “recordable injury.” According to OSHA regulations, work-related injuries must be recorded on OSHA injury logs if they require medical treatment beyond first aid, if they result in days away from work or if the worker is assigned job restrictions due to the injury.  Tesla’s practices were designed to avoid anything that triggers recording, according to former medical personnel who worked at Tesla.

To ensure that fewer injuries would be recorded, Tesla hired Access Omnicare, headed by hand surgeon Dr. Basil Besh, to run its factory health center. Access Omnicare promised Tesla it could help reduce the number of recordable injuries and emergency room visits. Reveal obtained a copy of Access’s proposal which stated that  “Access Omnicare’s model, with more accurate diagnoses, reduces “un-necessary use of Emergency Departments and prevents inadvertent over-reporting of OSHA (Occupational Safety and Health Administration) recordability.”

“Over-reporting?”

How to Under-count at Tesla? Let Me Count the Ways

To under-record, and under-record effectively requires some creativity.

Access Omnicare had a rule that injured employees could not be given work restrictions. According to a former Access physician assistant, Anna Watson.

No matter what type of injuries workers came in with – burns, lacerations, strains and sprains – clinic staff were under instructions to send them back to work full duty, she said. Watson said she even had to send one back to work with what appeared to be a broken ankle.

A medical assistant who formerly worked at the clinic remembered an employee who was sent back to work even though he couldn’t stand on one of his feet. Another employee passed out face down on the assembly line – then went back to work.

“You always put back to full duty, no matter what,” said the medical assistant.

Ambulances were highly risky as well, if your goal is to hide serious injuries.  Tesla forbids staff from calling 911 without permission after workers have been injured –even when fingers have been severed or employees have suffered serious injuries. Instead they put them in a Lyft or Uber and send them to a clinic after which they’re put back on the assembly line with no work modifications, even if they can barely walk. One worker’s back was painfully crushed when a hood fell on him. “I couldn’t walk, I couldn’t sit down. I couldn’t even stand up straight,” Stephon Nelson recalled. But Tesla refused to call 911 or send him to the hospital in an ambulance, putting him in an Uber instead.

Why? To save money? More likely because “911 logs become public records. And first responders, unlike drivers for ride-hailing services, are required to report severe work injuries to California’s Division of Occupational Safety and Health, the state’s workplace safety agency.”

Other tactics Tesla used were to claim that some injuries and illnesses were not work-related and refuse treatment to temporary employees:

Watson recalled one worker who had passed out on the job and went to the hospital because of her exposure to fumes in the factory. Even though a work-related loss of consciousness is required to be counted, no such injury was recorded on Tesla’s injury logs.

Temp workers hurt on the production line also were often rebuffed by the clinic, said former clinic employees. At one point, there was a blanket policy to turn away temps, they said.

Tracy Lee developed a repetitive stress injury over the summer when a machine broke and she had to lift car parts by hand, she said. Lee said the health center sent her away without evaluating her because she wasn’t a permanent employee.

By law, Tesla is required to record injuries of temp workers who work under its supervision, no matter where they get treatment. But not all of them were.

Beware the Night

Getting hurt during the day is bad enough. But getting hurt at night is especially dangerous because there are no doctors or nurses on duty.

Two medical assistants who used to work there said they often were left on their own – one on duty at a time – and struggled to tend to all the injured. Both had to do things such as take vital signs, which medical assistants aren’t allowed to do without on-site supervision, according to the Medical Board of California. Reveal granted them anonymity because they fear speaking out will hurt their careers. Dr. Basil Besh said no one works alone. Besh is hand surgeon who owns Access Omnicare which

For a severely injured worker lying on the assembly line, it could take 10 to 15 minutes for a medical assistant to arrive and then contact on-call doctors, a medical assistant said. Getting a code for Tesla’s Lyft account was a drawn-out process that could take hours, she said.

The medical assistants said they were alarmed and uncomfortable with the doctors’ orders to use Lyft because they worried some patients could pass out or need help en route. One worker directed to take a Lyft was light-headed and dizzy. Another had his fingers badly broken, contorted and mangled.

Moving Right Along

And despite promises from Tesla CEO Elon Musk to do better, Tesla has not cleaned up its act, according to Watson:

Many more injured workers never were counted, she said.  Tesla’s official injury logs, provided to Reveal by a former employee, show 48 injuries in August. Watson reviewed the list for the three weeks she was there and estimated that more than twice as many injuries should have been counted if Tesla had provided appropriate care and counted accurately.

And despite the fact that there is evidence that Tesla is violating the law, CalOSHA has not responded to the information Watson supplied to them.

Watson called Cal/OSHA officials to insist they investigate her complaint. She told them that she had detailed knowledge of a system that undercounted injuries by failing to treat injured workers. But Cal/OSHA officials told her that it wasn’t the agency’s responsibility, she said. They suggested contacting another agency, such as the medical board or workers’ compensation regulators.

Watson, meanwhile, has moved on to a new job

She said she just wants someone to make sure that Tesla workers get the care they need. “You go to Tesla and you think it’s going to be this innovative, great, wonderful place to be, like this kind of futuristic company,” she said. “And I guess it’s just kind of disappointing that that’s our future, basically, where the worker still doesn’t matter.”

This blog was originally published at Confined Space on November 6, 2018. Reprinted with permission.

About the Author: Jordan Barab wasDeputy Assistant Secretary of Labor at OSHA from 2009 to 2017, and spent 16 years running the safety and health program at the American Federation of State, County and Municipal Employees (AFSCME).