The diagnosis identifying a mental injury may also appear to be an additional diagnosis of a physical injury that is consolidating. These mental RRAs may be caused by either an organic injury or an injury that is itself mental. In this context, there is no need to specify that the initial event must have been recognized by the CSST as constituting an employment injury.

Case law generally gives the notions of recurrence, relapse or aggravation the meaning of a progressive re-emergence, re-appearance or outbreak of an injury or its symptoms. It should be noted that case law, in general, attaches little importance to the precise distinction between these three notions.

In this type of claim, the CSST's role is to determine whether or not there is a link between the initial injury and RRA, that is, whether this mental injury is a consequence of the industrial accident experienced by the employee. In the event that RRA is accepted or rejected, according to case law, the courts do not appear to take into consideration only the time period that has elapsed since the initial injury. They must consider a set of factors, as for example the seriousness of the initial injury, the existence of long-term after-effects, the medical follow up since the consolidation of the injury, the existence of a personal condition, and so on. In this context, case law has accepted RRAs that had developed many years after the occurrence of the initial injury.