1904 Subpart C
An injury or illness is a new case when the employee has not previously experienced a recorded injury or illness of the same type affecting the same body part, or when the employee had fully recovered from a prior recorded injury of the same type and a workplace event or exposure caused the signs or symptoms to reappear. See 1904.6(a) and its subparts 1904.6(a)(1) and 1904.6(a)(2).
No — if the employee did not previously have a recorded injury or illness of the same type affecting the same body part, you must consider the current injury or illness to be a new case. The rule refers specifically to a previously recorded case, so a prior unrecorded condition does not negate the requirement to treat the current incident as a new case. See 1904.6(a)(1).
Yes — if the employee had fully recovered (all signs and symptoms disappeared) from the prior recorded injury and a workplace event or exposure caused the signs or symptoms to reappear, you must treat that recurrence as a new case. See 1904.6(a)(2).
No — for chronic occupational illnesses where signs or symptoms may recur or continue without a new workplace exposure, the case should generally be recorded only once rather than every time symptoms reoccur. Examples include occupational cancer, asbestosis, byssinosis and silicosis. See 1904.6(b)(1). You may also consider industry guidance such as OSHA's silica initiative when evaluating long-term chronic cases in high‑exposure industries (see OSHA's silica memorandum for industry context) (https://www.osha.gov/laws-regs/standardinterpretations/2023-09-22).
Yes — when an episode or recurrence of signs or symptoms (for example, an episode of occupational asthma) is caused by an event or exposure in the workplace, that episode must be treated as a new case. See 1904.6(b)(2).
Yes — you are not required to seek an HCP's advice, but if you do, you must follow the HCP's recommendation about whether the case is new or a recurrence. If you receive recommendations from multiple HCPs, you must choose which recommendation is most authoritative (best documented, best reasoned, or most authoritative) and record the case accordingly. See 1904.6(b)(3).
You must evaluate the recommendations and select the one that is most authoritative based on which is best documented, best reasoned, or otherwise most authoritative, and then record the case according to that selected recommendation. See 1904.6(b)(3).
No — if the employee did not recover completely (some signs or symptoms remained), a later flare-up is not considered a new case under the new-case rule; the case is a continuation rather than a new case. The regulation requires complete recovery (all signs and symptoms disappeared) before a later workplace-caused recurrence can be treated as a new case. See 1904.6(a)(2).
No — the determination of whether an injury or illness is a "new case" is separate from whether it meets the recording criteria such as medical treatment beyond first aid. You first decide if the incident is a new case under 1904.6 and then determine recordability under 1904.7 and related guidance. For musculoskeletal injuries, OSHA's enforcement guidance explains how first aid, Active Release Techniques, and exercises relate to recordability (see OSHA's musculoskeletal injuries memorandum).
Yes — if an event or exposure in the workplace caused the signs or symptoms to reappear after a complete recovery, that recurrence must be treated as a new case. The regulation requires that the workplace event or exposure caused the reappearance of symptoms for a later occurrence to be a new case. See 1904.6(a)(2).
Yes — the regulation looks to whether the employee previously experienced a recorded injury or illness of the same type affecting the same part of the body; it does not limit that prior record to the current employer. If there is a prior recorded case of the same type and body part, the later incident is not automatically a new case unless the employee had fully recovered and the signs or symptoms reappeared due to a workplace exposure. See 1904.6(a)(1) and 1904.6(a)(2).
No — for chronic occupational illnesses whose signs or symptoms may recur or continue without a new workplace exposure, you generally record the condition only once rather than each time it worsens. Examples given include occupational cancer, asbestosis, byssinosis and silicosis. See 1904.6(b)(1).
Yes — if you sought and received a recommendation from a physician or other licensed health care professional about whether the case is a new case or a recurrence, you must follow that professional's recommendation. If you receive multiple recommendations, choose the most authoritative one and record accordingly. See 1904.6(b)(3).
Treat each episode caused by an event or exposure in the workplace as a new case. OSHA explicitly states that when signs or symptoms recur as a result of a workplace event or exposure (for example, episodes of occupational asthma), each episode must be treated as a new case. See 1904.6(b)(2).
You should use objective medical evidence when available and may rely on the opinion of a physician or other licensed health care professional if you seek one; if you do, you must follow that professional's recommendation about whether the case is new or a recurrence. If multiple HCP opinions exist, select the most authoritative based on documentation and reasoning. See 1904.6(a)(2) and 1904.6(b)(3).
No — for a recurrence to be a new case under 1904.6(a)(2), the reappearance of signs or symptoms must be caused by an event or exposure in the workplace; if the triggering exposure occurred outside the workplace, it would not qualify as a new work-related case under that provision.
The treatment type affects recordability under the general recording criteria but not the separate new-case determination. You must still decide whether the musculoskeletal condition is a new case under 1904.6. OSHA's enforcement guidance explains that musculoskeletal injuries treated only with first aid, Active Release Techniques (ART), or exercise/stretching may not be recordable unless they meet another recording criterion (e.g., restricted work), so treat new-case and recordability questions as separate analyses. See 1904.6 and OSHA's musculoskeletal injuries memorandum.
Document the facts that support your determination: prior recorded cases (dates and records), medical evidence of complete recovery or continued symptoms, any workplace event/exposure that caused reappearance, and any HCP recommendations relied upon (including if you received multiple opinions and why you selected the most authoritative). Follow HCP recommendations if you obtained them. See 1904.6(b)(3) and the general new-case rules in 1904.6.