Federal Rail Safety Act Section 20109(c)(1) prohibits railroads from "deny[ing], delay[ing] or interfer[ing] with the medical or first aid treatment of an employee who is injured during the course of employment." In the first case to interpret the meaning of (c)(1), OSHA took the position the scope of that prohibition goes beyond initial medical treatment. However, the ALJ’s post-trial decision adopted a narrower scope: "I conclude that Section 20109(c)(1)’s mandate prohibiting railroads from ‘deny[ing], delay[ing] or interfere[ing] with medical or first aid treatment of an employee who is injured during employment’ applies to the temporal period surrounding the injury." Santiago v. Metro North at page 24. It remains to be seen if this narrower scope will prevail on appeal to the ARB or in the federal courts.
However, it is clear the scope of Section 20109(c)(2) is not so limited. Section (c)(2) mandates that railroads "may not discipline, or threaten discipline to, an employee . . . for following the orders or treatment plan of a treating physician." Thus (c)(2) explicitly prohibits railroads from disciplining an employee during the entire period of time the employee is following the orders or treatment plan of a treating doctor. And the absence in (c)(2) of any phrase qualifying that the employee must have been "injured during the course of employment" means that railroads are prohibited from disciplining any employee for following the orders or treatment plan of a treating doctor. This means a railroad cannot use absences from work ordered by a treating doctor as a basis for attendance discipline. And it means an employee cannot be disciplined for insubordination when he follows his doctor’s order not to travel and thus refuses to travel to a railroad medical department appointment.