• Part 1904 offers guidance on what is considered a recordable new case of injury or illness.

An injury or illness is considered a new case if:

• The employee has not previously experienced a recorded injury or illness of the same type that affects the same part of the body, or
• The employee has previously experienced a recorded injury or illness of the same type that affected the same part of the body but has recovered completely (all signs and symptoms have disappeared) from the previous injury or illness and an event or exposure in the work environment caused the signs or symptoms to reappear.

For occupational illnesses, where the signs or symptoms may recur or continue in the absence of an exposure in the workplace, the case must only be recorded once. Examples may include occupational cancer, asbestosis, byssinosis and silicosis.

However, when an injury or illness results from an event or exposure in the workplace, such as occupational asthma or contact dermatitis, employers must treat each incident as a new case. Often, but not always, individuals with these conditions are symptom-free if exposure does not occur.

Finally, a letter of interpretation dated March 17, 2021, addressed how to record the significant aggravation of a non-occupational pre-existing condition (such as asthma that requires using a rescue inhaler). The letter stated that “the significant aggravation of a non-work-related pre-existing condition only needs to be recorded once on the OSHA 300 log. Once a significant aggravation of a pre-existing condition has been recorded, subsequent exposures and medical treatment do not need to be recorded, unless a change in medical treatment is necessitated to treat a work-related exposure.”

How does an employer to determine whether an employee has "recovered completely" from a previous injury or illness?

An employee has "recovered completely" from a previous injury or illness when he or she is fully healed or cured. Employers must use their best judgment based on factors such as the passage of time since the symptoms last occurred and the physical appearance of the affected part of the body. If the signs and symptoms disappear for a day only to reappear the following day, that is strong evidence the injury has not properly healed. The employer may, but is not required to, consult a physician or other licensed health care provider (PLHCP). If the employer does consult a PLHCP to determine whether an employee has recovered completely, it must follow the PLHCP's recommendation. If the employer receives recommendations from two or more PLHCPs, the employer may decide which recommendation is the most authoritative and record the case based on that recommendation.

If employers seek advice from a physician on whether a case is a new case, do they have to use that recommendation?

Employers are not required to seek the advice of a physician or other licensed healthcare professional. However, if an employer does seek such advice, they must follow the physician’s or other licensed healthcare professional’s recommendation about whether the case is a new case or a recurrence. If the employer receives recommendations from two or more physicians or other licensed healthcare professionals, they must make a decision as to which recommendation is the most authoritative (best documented, best reasoned, or most authoritative), and record the case based upon that recommendation.

Does the employer have to record a work-related incident if an employee experiences minor musculoskeletal discomfort, the health care professional determines that the employee is fully able to perform all routine job functions, but the employer assigns a work restriction to the injured employee?

A case would not be recordable if 1) the employee experiences minor musculoskeletal discomfort, and 2) a health care professional determines that the employee is fully able to perform all routine job functions, and 3) the employer assigns a work restriction to that employee for the purpose of preventing a more serious condition from developing. However, the case may become recordable under the other general recording criteria, such as medical treatment beyond first aid.

For example, suppose an employee reports back pain, visits a medical professional, and is returned to work without restrictions but is asked to attend a follow-up appointment in a week. In this circumstance, the employer may impose restrictions without creating a restricted work recordable case, with the intent of preventing the condition from worsening before the next appointment.