January 17, 2017

Navigating the Regulatory Environment for Doctors Part 3 – OSHA

In our previous posts in this series, we looked at the discipline process as well as regulations surrounding the handling and prescribing of medication.  This post will focus on the workplace safety regulations applicable to doctors’ offices at both the state and federal level.

The Occupational Safety and Health Administration (OSHA) is a federal agency set up to establish and enforce workplace regulations to assure safe and healthful working conditions.  OSHA regulations cover almost all private sector employers either directly through federal OSHA regulations or through an OSHA state-approved plan.  Arizona operates its own federally-approved state plan, which adopts the federal regulations and enforces them through the Arizona Division of Occupational Safety and Health (ADOSH).

Application to Dental Offices

OSHA and ASDOH have established rules directly applicable to dental offices, a complete copy of which can be found here.  The Offices of Dentists Industry Group notes the top eight most frequently-cited OSHA standards for dental offices:


Representatives of ADOSH have the right to inspect your workplace for violations of OSHA standards at any reasonable time pursuant to A.R.S. § 23-408.  You will not be given notice of the inspection prior to the inspector walking through the door of your practice – in fact, it is a criminal violation to give an employer advance notice of an inspection.  You are permitted to have a representative of your business accompany the inspector during the inspection, but there is no right to delay or postpone the inspection.

If the inspector issues a citation for violation of an OSHA standard, he is required to notify you of the proposed penalty for the violation within a “reasonable time” under A.R.S. § 23-417.  From the date you receive notice of the proposed penalty, you have fifteen working days to notify the director of ADOSH that you intend to contest the citation or proposed penalty.  If you fail to notify the director within fifteen days, a final order will be issued that is not reviewable by any court or agency.  In the process of contesting a citation, proposed penalty, or abatement period, you have the right to request a hearing.


Violations of the OSHA can be substantial.  Under A.R.S. § 23-418, you can be fined up to $7,000.00 for each violation of OSHA regulations, and no less than $5,000.00 per violation for repeated violations.  If you receive notice of a violation and fail to correct it within the allotted time, you may similarly receive a fine of up to $7,000.00 for each day the violation continues beyond the abatement date.

In some cases, violations can lead to criminal charges. For example, it is a Class 2 Misdemeanor to make a false statement, representation, or certification in any record or report required by OSHA regulations.  Furthermore, if a knowing violation of OSHA regulations leads to the death of an employee, you could be charged with a Class 6 Felony.

Hearing Rights and Procedures

You can request a hearing for any assessed OSHA violation.  A request for a hearing must be made in writing, signed, and mailed to the commission, stating that a hearing is desired.  Under A.R.S. § 23-420, the request must include your address and state with particularity the violation, abatement period, or penalty which is being protested.  You are entitled to submit evidence and subpoena documents and witnesses for the purposes of the hearing.  The administrative law judge (ALJ) who presides over your hearing is not bound by formal rules of procedure or legal precedent, and may conduct the hearing in any manner that will achieve “substantial justice.”


If you do not agree with the ruling issued by the ALJ at your hearing, you have the right to appeal the decision to a review board consisting of five members.  Similar to the procedure for a citation, under A.R.S. § 23-423 you have fifteen days from the date the final order from the ALJ is mailed to file a request for review with the commission.  The request must state the grounds for review and whether oral argument is requested.    The board can affirm, reverse, modify, or supplement the decision of the ALJ.  Decisions are made by a majority vote, and they are final unless either party applies to the Arizona Court of Appeals for further review within ten days of service of the final decision.

Running afoul of OSHA regulations can result in serious financial penalties for your dental practice.  We recommend that you regularly perform internal audits of your OSHA compliance to ensure that you are not endangering your employees and that you avoid any citations in the event of an inspection.  If you have any questions, or if you are facing potential sanctions for violating OSHA’s regulations, you should consult an experienced healthcare attorney.