A recent decision by the U.S. Department of Labor Administrative Review Board explains that railroads cannot interfere with an employee's injury-related medical treatment at any point during the treatment, not just the period immediately following the injury.
The Federal Rail Safety Act prohibits "delay[ing] or interfer[ing] with the medical or first aid treatment of an employee who is injured during the course of employment." This means your right to prompt medical treatment comes first. The railroad is probably breaking the law if your supervisor tries to make you fill out documents about your injury before you go to the hospital or doctor. In fact, if you ask for treatment the railroad must transport you to where you can get it.
Metro-North electrician Anthony Santiago had a pre-existing back condition that was not symptomatic. It flared up when a chair collapsed under him at work. His treating physicians concluded this injury was work-related. Initially Metro-North agreed. But later Metro-North decided it knew more than the treating physicians and decreed that the work-related component of Santiago's symptoms had "resolved." The treating physicians disagreed and explained why in a letter to Metro-North. Metro-North didn't care and didn't reconsider. This ultimately meant Santiago had to pay more than $16,000 out of his own pocket for an injury-related medical procedure.
Santiago alleged this violated the Rail Safety Act. Claims like these go first to OSHA for investigation. Then they go to a hearing before a Department of Labor administrative law judge. The losing party can then appeal to the Department of Labor's Administrative Review Board.
In Santiago's case the administrative law judge initially agreed with Metro-North that the statute only prohibits interfering with the employee's medical care during the period immediately following the injury. Metro-North had initially conceded Santiago's medical treatment was injury-related. After Santiago had been to several appointments and followed his own doctors' orders, Metro-North declared that Santiago's injury-related symptoms had "resolved," apparently meaning any further ongoing symptoms Santiago suffered could not be related to his on-duty injury. The administrative law judge said this didn't violate the statute because Metro-North didn't interfere with Santiago's medical treatment during the period immediately following his work-related injury.
The Administrative Review Board disagreed and said Metro-North was interpreting the statute too narrowly:
These words plainly convey congressional intent to prevent a railroad carrier or other person from negatively affecting in any manner the medical treatment or first aid treatment for an employee's work injury. Whenever an employee needs medical treatment or attention, the railroad carrier should not step in the way to prevent or delay such treatment. Nothing in the first sentence mandates a time frame, either immediately or long term. Nor is there any temporal limitation on "medical or first aid treatment."
Santiago v. Metro-North.