On the Fifth Circuit’s Reversal of OSHA’s Mental Illness Recordkeeping Rule
On July 21, 2026, the U.S. Court of Appeals for the Fifth Circuit held in Exxon Mobil Corp. v. OSHRC that Section 8(c)(2) of the Occupational Safety and Health Act does not authorize OSHA to require employers to record work-related mental illnesses and vacated 29 C.F.R. § 1904.5(b)(2)(ix). The court’s reasoning turned on the scope of the word “illnesses” in the statute — a question of congressional authorization, not a finding about whether psychological injury is real or occupationally significant.
That distinction is the one I would ask employers to hold onto. I believe the most consequential risk in the coming weeks is not legal exposure but misinterpretation:
- Recordability Is a Legal Test, Not a Clinical One. A condition’s absence from the OSHA 300 log says nothing about its severity, its work-relatedness, or its cost. The log has never been a complete inventory of occupational health burden, and it is less of one today.
- Duty of Care Is Unchanged. State workers’ compensation systems, disability and accommodation obligations, and an employer’s basic obligation to a worker injured in its service operate independently of Part 1904. Nothing about this decision narrows them.
- Data Visibility Still Matters. Employers who tracked these cases solely because a federal rule required it will now be managing a category of injury they can no longer see. In my experience, loss of visibility precedes loss of control. I would encourage organizations to preserve internal tracking of psychological injury regardless of recordability status.
- Recovery Drivers Are Not Regulatory. The evidence base is consistent that psychosocial factors — fear-avoidance, recovery expectations, perceived support at work — are among the strongest predictors of delayed return to work following any injury, physical or psychological. Those mechanisms are indifferent to what a court has held about recordkeeping authority.
I recognize the reasonable position that a mandate no longer in force should not be voluntarily self-imposed, and employers will make their own judgments about how far to go. My own view is that the organizations that continue to identify and manage psychological injury will carry lower total claim costs and better outcomes than those that treat this decision as permission to stop looking.
Employers should coordinate with counsel before making any change to recordkeeping policy — including on questions this opinion does not resolve, such as the treatment of previously logged entries and whether state-plan jurisdictions impose independent requirements. This statement reflects my clinical perspective and is not legal advice.
Did the court rule that work-related mental illness isn’t real?
No. The decision turned on whether the OSH Act authorizes OSHA to require recording of mental illnesses — a question of congressional authorization, not clinical significance.
Do employers still have to track work-related mental illness?
Not as a federal recordkeeping obligation under Part 1904. Duty-of-care, workers’ compensation, and accommodation obligations are unaffected, and internal tracking remains valuable.
What law did the Fifth Circuit rely on?
Section 8(c)(2) of the Occupational Safety and Health Act, in Exxon Mobil Corp. v. OSHRC.
Scott E. Cherry, DO, MPH, FACOEM
Chief Medical Officer Axiom Medical