Labor & Industries (L&I), Washington State

Respirators Chapter 296-842, WAC

Effective Date: 04/01/07

Helpful Tool: Planning for Medical Evaluations

For printing

This information can help you prepare for employee medical evaluations required by Chapter 296-842 WAC, Respirators. This information doesn’t apply to medical evaluation requirements found in other DOSH rules.

Who is allowed to perform medical evaluations?

Only licensed health care professionals (LHCPs) are allowed to perform these evaluations. You may use:

• On-site medical staff
or
• Medical staff from outside services

In Washington state LHCPs include:

• Physicians
• Physician Assistants (PAs)
• Advanced Registered Nurse Practitioners (ARNPs)
• Registered Nurses

What medical questionnaire is required?

Use any of the following:

• The WISHA Medical Evaluation Questionnaire provided in WAC 296-842-22005, of this chapter.
• The OSHA Respirator Medical Evaluation Questionnaire found in Appendix C of 29 Code of Federal Regulations (CFR), Part 1910.134, Respiratory Protection.
• Questionnaires developed by other parties, such as online services, if these questionnaires include the same questions found in Parts 1-3 of the WISHA Medical Evaluation Questionnaire found in WAC 296-842-22005.

- A LHCP may add questions or change the order of required questions.

- In some cases, questions added by the LHCP before administering the questionnaire can minimize the need for LHCP follow-up.

Is there an alternative to using a questionnaire for employee evaluations?

Yes. You can choose to have medical examinations conducted instead of using the questionnaire, as long as you make sure the examination obtains the same information as found in the questionnaire.

Why is confidentiality important?

Aside from legal considerations, confidentiality encourages employees to provide complete and correct health information for the LHCP’s evaluation. This helps make sure reliable medical evaluations are provided.

How do I maintain confidentiality during questionnaire administration?

Here are some strategies to consider when planning for evaluations:

• Make arrangements to have a LHCP administer the questionnaire at the workplace.
• Allow the employee to self-administer the questionnaire and mail it, postage paid, to the LHCP.

- Since employees may have questions about medical issues, arrange for an LHCP to be available by telephone or e-mail during the time the questionnaire is being administered.

• If you decide to have an individual administer the questionnaire who isn’t a LHCP:

- Instruct the individual not to look at the employee’s questionnaire at any time

- Provide pre-addressed, stamped envelopes for completed questionnaires. Instruct employees to place their completed questionnaires in the envelope, seal it, and mail or forward it to the LHCP.

- Instruct employees to place their completed questionnaires in the envelope, seal it, and mail or forward it to the LHCP

• Have the employee use an online questionnaire service that meets the requirements in WAC 296-842-14005, Provide Medical Evaluations.

What if my employee can’t read the questionnaire?

Find out if language translation services are needed, or if employees need help with reading.

• If language translation services are needed you can use:

- An interpreter. It’s not necessary to provide a professional interpreter. Interpreters can be an individual trusted by the employee such as a co-worker, friend, family member, or the LHCP.

- The Spanish-language version of the questionnaire is found in WAC 296-842-22005 click here

- If reading assistance is needed, make arrangements ahead of time to use an individual trusted by the employee such as a co-worker, friend, family member, or the LHCP, to assist them while filling out the questionnaire.

• While making these arrangements remember to address any possible confidentiality issues that could arise.