Upper extremity musculoskeletal disorders were scheduled as occupational disorders in Italy in 2008 (Decree of the Ministry of Labour, 9 April 2008). Compensable disorders now include tendonitis of the supraspinatus, long head of biceps, Duplay’s disease, shoulder bursitis, lateral and medial elbow tendonitis, olecranon’s bursitis, hand-wrist tendonitis, De Quervain syndrome and carpal tunnel syndrome. No guidelines on diagnosis are mandated by the regulation, but the process should rely upon consolidated medical practice. However, the regulation does specify the exposure conditions under which the disease can be considered of occupational origin, albeit in a very broad way, without any detail about how to assess the exposure and how to define a specific level for the exposure to be considered causal. Within the Italian Society of Occupational Medicine (SIML), a framework for assessing the quality of both the diagnostic criteria and the exposure is being developed. This framework will include a set of evidence based, minimum required exposures for considering a disease as likely occupationally induced. The new framework and detailed exposure criteria will be presented.