New Cases

Determining Whether a Case Is New
For TOSHA recordkeeping purposes, the city must evaluate an injury or illness for recordability only if it is work-related, a new case, and meets one or more of the general or specific recording criteria. The city must enter a recordable case on the OSHA/TOSHA 300 Log and complete the applicable incident report within seven calendar days after receiving information that a recordable injury or illness occurred.

An injury or illness is a new case if either of the following applies:

• The employee has not previously experienced a recorded injury or illness of the same type affecting the same part of the body; or
• The employee previously experienced a recorded injury or illness of the same type affecting the same part of the body, but had completely recovered—all signs and symptoms had resolved—and a new workplace event or exposure caused the condition, or its signs or symptoms, to reappear.

A “new case” does not have to be a condition the employee has never experienced before. It can include a new work-related condition, a significant work-related aggravation of a pre-existing condition, or a previously recorded condition that completely resolved and later recurs because of a new workplace event or exposure. Each new case must be evaluated for work-relatedness and then for the applicable recordkeeping criteria.

Continuing Cases and Log Updates
If an employee has not completely recovered from a previously recorded work-related injury or illness, a later flare-up, continuation, or worsening of the condition is generally a continuation of the original case—not a new case. The city should not create a second log entry simply because the condition persists or worsens.

However, the city must update the original OSHA/TOSHA 300 Log entry when the outcome or classification changes. For example, if an employee’s previously recorded back injury was initially recorded as a case involving medical treatment only, but the employee later requires restricted work or days away from work, the city must update the original entry to reflect the more serious outcome and track the applicable number of restricted-work or days-away days.

Similarly, if an injury was initially work-related but did not meet the recording criteria, later developments may make the condition recordable. For example, if an employee sustains a work-related ankle sprain but initially receives only first aid and no work restrictions, the case may not initially be recordable. If the condition does not resolve and a later medical evaluation results in medical treatment beyond first aid, restricted work, days away from work, or another recording criterion, the city must then record the case.

Chronic Occupational Illnesses
A previously recorded chronic work-related illness is generally recorded only once when its signs or symptoms recur or continue without a new workplace exposure. This rule recognizes that certain occupational illnesses can progress, recur, or alternate between remission and active symptoms even after occupational exposure has ended.

Examples may include chronic occupational illnesses such as silicosis, asbestosis, occupational cancers, tuberculosis disease, advanced byssinosis, and similar conditions that may continue or progress without further workplace exposure. The city should not create a new record solely because symptoms recur or the disease progresses in the absence of a new work-related event or exposure.

If, however, a new workplace event or exposure causes the recurrence of symptoms of a previously recorded chronic work-related illness, the city must treat the recurrence as a new case and evaluate it under the normal work-relatedness and recordability rules.

Practical Example
An employee records a work-related back injury after receiving medical treatment. The injury has not fully resolved, and several weeks later the employee’s symptoms worsen and result in restricted work. This is ordinarily a continuation of the original case, so the city updates the existing log entry rather than recording a new case.

By contrast, if the employee fully recovered, all symptoms had disappeared, and months later a new lifting incident at work caused back-pain symptoms to return, the city must evaluate the new incident as a new case.