1926.1101(m)(4): Physician's Written Opinion for Asbestos
Employers must get a written opinion from the examining physician with exam results, any conditions that raise risk from asbestos, recommended limits on work or respirator use, and statements that the worker was told the results and about the added lung cancer risk from smoking and asbestos. The physician must not reveal unrelated findings to the employer, and the worker gets a copy within 30 days.
Key takeaways
- 1926.1101(m)(4) is part of OSHA's construction standards (29 CFR Part 1926, Subpart Z).
- OSHA cited it 42 times in the last 3 years, in 42 inspections, with $670 in current penalties.
- Most citations: MI (42).
- Related part: 1926.1101(m) Medical surveillance— (130 citations).
- Free 5-minute toolbox talk for your crew below.
In this article
What this rule covers
29 CFR 1926.1101(m)(4) ("Physician's written opinion") is one requirement inside 1926.1101 Asbestos, an OSHA construction standard (Part 1926, Subpart Z). It includes 7 sub-paragraphs. The official text below is copied word for word from the Electronic Code of Federal Regulations (eCFR). The numbers, injury cases and training on this page show how OSHA enforces it on real job sites.
Official text
(4) Physician's written opinion. 42 citations
(i) The employer shall obtain a written opinion from the examining physician. This written opinion shall contain the results of the medical examination and shall include: Open (m)(4)(i) 42 citations
(A) The physician's opinion as to whether the employee has any detected medical conditions that would place the employee at an increased risk of material health impairment from exposure to asbestos;
(B) Any recommended limitations on the employee or on the use of personal protective equipment such as respirators; and
(C) A statement that the employee has been informed by the physician of the results of the medical examination and of any medical conditions that may result from asbestos exposure.
(D) A statement that the employee has been informed by the physician of the increased risk of lung cancer attributable to the combined effect of smoking and asbestos exposure.
(ii) The employer shall instruct the physician not to reveal in the written opinion given to the employer specific findings or diagnoses unrelated to occupational exposure to asbestos.
(iii) The employer shall provide a copy of the physician's written opinion to the affected employee within 30 days from its receipt.
Source: eCFR, text current as of 2026-10-15. Read all of 1926.1101.
Where and how often it was cited
| Year | Citations |
|---|---|
| 2024 | 18 |
| 2025 | 16 |
| 2026 | 8 |
Top states: MI (42)
Largest penalties
| Employer | Location | Penalty for this rule |
|---|---|---|
| ATLAS SERVICE GROUP, LLC | BURTON, MI | $250 |
| MID-MICHIGAN MANAGEMENT, L.L.C. | OKEMOS, MI | $120 |
| ATLAS SERVICE GROUP, LLC | BERKLEY, MI | $100 |
| BOLLE CONTRACTING, LLC | FLINT, MI | $100 |
| ACE EXCAVATING & GRAVEL INC. | KALAMAZOO, MI | $100 |
Free toolbox talk
A 5-minute crew talk on 1926.1101(m)(4), plus alerts when this rule changes. Free.
OSHA interpretation letters
- Employee's rights upon termination to access to physician's written opinion and respirator fit test results. (2005-10-20)
- Asbestos standard: Written opinion from the examining physician. (1998-05-05)
Related parts of this rule
- 1926.1101(m) Medical surveillance— 130 citations
- 1926.1101(m)(2) Medical examinations and consultations 70 citations
- 1926.1101(m)(4)(i) 42 citations
- 1926.1101(m)(2)(ii) Content 42 citations
- 1926.1101(m)(2)(i) Frequency 28 citations
- 1926.1101(m)(1) General 18 citations
- 1926.1101(m)(1)(i) Employees covered 18 citations
- 1926.1101(m)(1)(i)(B) 12 citations
- 1926.1101(m)(2)(ii)(C) 8 citations
Get your crew competent
Trainers on Black Belt Safety: Marc Harvey, Dana Reyes
Trainers and suppliers: feature your business on this rule for $25/month.
Frequently asked questions
What must the physician's written opinion include?
Exam results, whether the employee has conditions increasing risk from asbestos, recommended limitations, and statements that the employee was informed of results and of the combined smoking and asbestos lung cancer risk.
Will my employer learn unrelated diagnoses?
No. The employer must instruct the physician not to reveal findings or diagnoses unrelated to asbestos exposure.
When do I get a copy?
Within 30 days from the employer's receipt of the opinion.
About this page
Sources
- 29 CFR 1926.1101 (eCFR), text current as of 2026-10-15
- U.S. Department of Labor enforcement data: OSHA inspections, citations and accident records, copied nightly; data as of 2026-10-19
3-year window. Federal OSHA only; state-plan rules are not counted. Plain-language text is a summary, not legal advice; the official text controls. Black Belt Safety is not part of OSHA or the Department of Labor.