# The Court That Put the Mind Outside the Workplace Auremont Vale 2026-07-22T17:48:43+00:00 [Canonical article](https://auremontvale.com/journal/the-court-that-put-the-mind-outside-the-workplace/) A refinery technician entered a burning unit twice, and four clinicians later diagnosed him with work-related PTSD. The Fifth Circuit held that OSHA could not require Exxon to record the condition because Congress’s reference to workplace “illnesses” covered only physical illness. ## The Case at a Glance **Case**: Exxon Mobil Corp. v. Occupational Safety and Health Review Commission **Court**: Fifth Circuit · July 21, 2026 **Question**: May OSHA require employers to record work-related mental illness under 29 U.S.C. § 657(c)(2)? **Result**: Mental-illness recordkeeping rule vacated; the $691 citation set aside. A ruptured pipe fed an eight-hour fire at Exxon’s Baytown refinery. Flames rose roughly 150 feet above the hydro-desulfurization unit, workers were injured, and the damage took five months to repair. Employee 2, a process technician who knew the unit’s maze of pipes and valves, entered the burning unit with firefighters even though he was not assigned to the refinery’s emergency-response team. They dressed him in protective gear and followed him inside so he could help shut off the fuel feeding the blaze. After he emerged, someone discovered that at least one bypass remained open, so Employee 2 put the protective gear back on and entered the unit a second time. After the fire, Employee 2 developed symptoms that four health professionals diagnosed as post-traumatic stress disorder caused by the explosion. His primary-care physician prescribed medication. After Exxon rejected the opinions of his first three providers as insufficiently specialized, Employee 2 found a psychologist through Exxon’s own employee-assistance program. Exxon acknowledged that she met OSHA’s qualification requirements. She diagnosed work-related PTSD and recommended that he remain away from work for another six months. On July 21, 2026, the United States Court of Appeals for the Fifth Circuit decided whether the federal workplace-safety system could officially record Employee 2’s condition. The court held that the Occupational Safety and Health Act’s command to maintain records of work-related “illnesses” reaches physical illnesses only. It vacated OSHA’s mental-illness recordkeeping rule and erased the citation against Exxon. The dispute turned on whether Congress’s command to record work-related “illnesses” included mental illness. Congress used the word “illnesses.” The Fifth Circuit held that, in context, the term covered only physical illnesses. The case did not determine whether Employee 2 was entitled to medical care, disability leave or workers’ compensation. It concerned whether a qualifying work-related mental illness had to appear on the OSHA forms that record what a workplace has done to the people inside it. OSHA logs form part of the data system that directs occupational safety. Employers use those records to identify recurring hazards and evaluate their safety programs. Inspectors use them to decide where to look and what dangers require attention. OSHA uses them to target interventions. The Bureau of Labor Statistics uses them to construct the national picture of workplace injury and disease—the picture from which lawmakers, regulators, employers and researchers decide what must be prevented next. Removing mental illness from that system leaves the clinical diagnosis intact while erasing it from the employer’s safety record. The harm can remain in the worker’s medical file while disappearing from the inspector’s field of vision and the nation’s statistics. Section 657(c)(2) does not contain the words “mental illness.” Its severity language speaks of first aid, medical treatment, loss of consciousness, restriction of work or motion, and transfer to another job. Nearby provisions discuss toxic materials and harmful “physical agents.” Congress’s reference to “psychological factors” appears in a declaration of purpose concerning research, not in the subsection that directly imposes employer recordkeeping duties. And after *Loper Bright*, a court may not defer to OSHA simply because the agency’s interpretation is reasonable or longstanding. Judges must exercise independent judgment and identify the best reading of the statute. A statute may be enacted against a world of well-known physical dangers without being confined to those dangers. Congress often legislates in general categories precisely because it cannot list every factual application the future will present. Congress chose the ordinary category “illnesses.” Its 1970 meaning supplies the boundary, including whether illnesses of the mind fell within it. The opinion did not identify any statutory phrase or dictionary definition that expressly excluded mental illness. It inferred the limitation from surrounding provisions that discuss physical hazards and from examples of recordable conditions that often involve bodily injury. Section 657(c)(2) directs the Secretary to require accurate records of work-related “deaths, injuries and illnesses.” It does not say bodily illnesses, physiological illnesses or illnesses caused by physical agents. Indeed, in the very next paragraph Congress expressly used the adjective “physical,” directing employers to maintain records of exposure to harmful “physical agents.” Congress knew how to draw a physical boundary. It drew one where it wanted one. The court’s interpretation carries “physical” backward from subsection (c)(3), inserts it before “illnesses” in subsection (c)(2), and thereby adds a limit the text does not contain. Congress placed “psychological factors” in its declaration of purpose rather than the employer-recordkeeping subsection. The phrase supplies statutory context: psychological harm belongs within the Act’s statutory scheme even though the declaration of purpose does not itself impose employer duties. Congress declared that occupational safety and health would be advanced through research “including the psychological factors involved.” 29 U.S.C. § 651(b)(5). In the same declaration, it called for reporting procedures that would “accurately describe the nature” of the nation’s occupational-safety problem. Research identifies hazards; records show their incidence; statistics reveal their scale; standards and interventions respond to what the evidence discloses. Congress designed those functions to inform one another. 29 U.S.C. § 673 commands the Secretary to maintain an effective program for collecting and analyzing occupational-safety statistics. Those statistics “shall include all disabling, serious, or significant injuries and illnesses.” The statute then says that employer reports for this program are to be based on the records maintained under § 657(c)—the very records at issue in the case. Employee 2’s PTSD was diagnosed repeatedly, treated with prescription medication and serious enough that a qualified psychologist recommended another six months away from the refinery. Yet the court’s interpretation means that such a condition cannot enter the statistical program Congress commanded to encompass “all disabling, serious, or significant” illnesses, because the disabling condition was psychiatric rather than physical. Section 673 therefore bears directly on the question before the court. Congress ordered statistics covering all serious illnesses and tied those statistics to the employer records maintained under § 657(c). The opinion also relied on severity criteria such as “restriction of work or motion” and “loss of consciousness,” reasoning that those examples point toward physical harm. OSHA distinguishes days away from work from restricted or light-duty work. Congress separately named **medical treatment**, and Employee 2’s physician prescribed medication for his PTSD. Under OSHA’s rules, issuing a prescription constitutes medical treatment. Even without the regulatory definition, medication prescribed by a physician is medical treatment in the ordinary sense of those words. The Fifth Circuit’s analysis gave less weight to the criterion that matched Employee 2’s case: medical treatment through prescription medication. That selective reading infects the opinion’s reliance on *noscitur a sociis*, the canon counseling that a word may be understood through the company it keeps. Because “illnesses” appears beside “deaths” and “injuries,” the panel reasons that illnesses should be understood as another category of physical harm. The three nouns share occupational causation: they are the deaths, injuries, and illnesses produced by work. A canon can refine a word’s meaning. It cannot collapse one noun into another. If “injuries” already supplied the category and forced “illnesses” to carry essentially the same physical meaning, Congress’s decision to use both becomes difficult to explain. The more natural understanding is additive: Congress grouped distinct forms of workplace harm because it intended to capture all of them. Nor does the carveout for “minor injuries” establish that every illness must be physical. At most, the wording creates an awkward question about why Congress referred expressly to minor injuries without repeating minor illnesses. Legislative awkwardness is common. It does not authorize a court to narrow the separate noun “illnesses” by half. A provision discussing bandages and first aid tells us that small cuts need not enter the federal recordkeeping system. It does not tell us that severe PTSD is not an illness. The dictionary discussion did not identify a definition that limited illness to the body. The court surveys definitions from around 1970 describing illness as disease, sickness, ailment, malady or a disorder of health. None of those definitions says “physical only.” None says that a disorder ceases to be an illness when it affects the mind. Nevertheless, because the definitions do not expressly mention nonphysical conditions, the court treats their silence as evidence of exclusion. The phrase “disorder of health” states a category broad enough to include mental illness. Exhaustive enumeration of every covered condition was unnecessary. Employee 2 had been diagnosed with a disorder of health by four professionals. He had been prescribed medication. A psychologist had concluded that returning to the refinery was medically inadvisable for six more months. The dictionaries did not exclude his condition, but the court’s interpretation did. One contemporaneous dictionary, *Webster’s Third*, removed any possible ambiguity by defining illness as an unhealthy condition of “body or mind.” The panel did not rebut that particular definition with contrary evidence about usage. Instead, it invoked Justice Antonin Scalia’s generalized criticism that *Webster’s Third* was sometimes too permissive in recording disputed meanings. The panel also notes that one dictionary contained a separate entry for “mental illness” cross-referencing “insanity.” A separate entry does not resolve whether mental illness falls within the broader category of illness. The entry nevertheless shows that “mental illness” was established language when Congress enacted the statute. Whatever the period’s crude or incomplete psychiatric taxonomy, the concept was established before OSHA’s later rulemaking. Creating a separate entry for heart disease says nothing about whether the heart belongs to the body; the same logic applies to mental illness and health. OSHA’s regulation already treated mental illness more cautiously than other workplace injuries and illnesses. It placed mental illness among the exceptions to OSHA’s usual presumption of work-relatedness. Unless the employee voluntarily supplied an opinion from a qualified physician or licensed professional connecting the illness to work, the employer did not have to treat it as work-related at all. The employer had no obligation to search for undisclosed mental-health conditions. It could obtain another professional opinion. The illness still had to satisfy OSHA’s general severity criteria. And if it was recorded, the employee received special privacy protections. Together, these safeguards formed the compromise OSHA adopted after extensive rulemaking. Employers had raised legitimate concerns about privacy, diagnostic uncertainty and contested causation. OSHA responded by making mental illness harder to classify as work-related than ordinary injuries. The agency explained that it had recorded occupational mental illnesses since the Act’s inception, but it nevertheless imposed voluntary disclosure, professional verification, a second-opinion mechanism and special confidentiality protections. OSHA also concluded that abandoning those records would deprive employers, employees and safety professionals of useful information while distorting statistics maintained over many years. 66 Fed. Reg. 5916, 5952–53 (Jan. 19, 2001). Employee 2’s experience reveals how formidable that brake already was. He sought help through Exxon’s programs. Two licensed clinical social workers and his physician diagnosed PTSD, but Exxon concluded that none possessed the specialized qualifications required by the rule. He then found Dr. Chelsea McCann through Exxon’s own EAP portal. She conducted a battery of assessments. Exxon conceded that she was qualified. Even then, the company exercised its right to seek another opinion and relied on a provider who reviewed Employee 2’s records without examining him in person. Whatever one thinks of the ultimate disagreement among the clinicians, that history bears no resemblance to an agency casually expanding its dominion over the American mind. It shows a worker attempting to pass through a regulatory gate designed to protect both employers and employee privacy. The Fifth Circuit treated the rule as an expansion of OSHA’s authority rather than as a set of limits on when employers had to record mental illness. It is true that regulatory modesty cannot create statutory authority where none exists. A narrow rule may still be unauthorized. But OSHA did not locate its underlying authority in the exception. It located that authority in Congress’s command to record work-related “illnesses.” The exception limited when one subset of those illnesses would be treated as work-related. By describing § 1904.5(b)(2)(ix) as though it created the entire category of mental illness from nothing, the court confused the safeguard with the power it constrained. The panel vacated the regulation itself. The special protection requiring voluntary disclosure and qualified professional verification disappeared along with the recording obligation. *Loper Bright* requires independent judgment, not inverse deference. Courts are not supposed to favor an agency because the statute is ambiguous; neither are they supposed to favor the narrowest possible reading because the defendant is an agency. The judicial task remains interpretation: reading the enacted words in their full statutory setting and choosing the best meaning. Here, the court relied on dictionaries that did not exclude mental illness, a neighboring-words canon that did not resolve the question, selected severity criteria, and a reading that gave little effect to § 673’s command to collect statistics on all serious illnesses. Congress did not have to write “including PTSD, depression, anxiety disorders and every other presently or subsequently recognized psychiatric diagnosis.” Legislatures enact categories. Agencies apply them to cases. Courts police the boundaries. But a boundary must come from the law, not from a judge’s intuition that a workplace injury becomes less occupational when it cannot be sutured, splinted or seen on a scan. The body-mind boundary erected by the Fifth Circuit appears nowhere in Congress’s work. Congress spoke of “illnesses.” It expressly placed psychological factors inside the field of occupational health. It demanded reporting procedures that accurately describe the problem. It ordered statistics encompassing “all” serious or disabling illnesses and connected those statistics to the employer records maintained under § 657(c). The Fifth Circuit’s reading adds a physical-only limit that Congress did not place before the word “illnesses.” Employee 2 entered the burning refinery twice because he knew which valves were feeding the fire. OSHA records serve a different function: they tell employers, inspectors, researchers, and regulators what kinds of harm a workplace is producing. The Fifth Circuit’s ruling excludes work-related mental illness from that federal reporting system, even when the condition requires treatment and keeps an employee away from work. Employee 2’s PTSD remains in his medical records, his prescription history, and the recommendation that he stay away from the refinery. Under the court’s interpretation, it does not appear on Exxon’s federal workplace-injury log. Four professionals diagnosed an illness caused by the refinery fire. Congress required employers to record work-related illnesses, but the Fifth Circuit held that this one fell outside the statute because it was psychiatric rather than physical.