What the panel ordered
Findings of Fact affirmed except amended to add employment by Department of General Services and defer statute of limitations issue; otherwise affirmed
Petition for Reconsideration granted by Appeals Board after administrative delay; remanded statute of limitations issue to WCJ for further findings
What was disputed, and how it came out
Each issue the panel decided, with the reasoning it gave. An outcome is what this panel did on this record — not a rule, and not a prediction.
The Appeals Board deferred the statute of limitations issue to the WCJ for further factual findings due to lack of evidence on whether benefits were last provided by the employer or through retirement medical insurance.
From the decision · page 7Accordingly, as our Decision After Reconsideration we will amend the January 13, 2021 Findings to add that applicant was employed by DGS on November 3, 2008 (Finding 1) and to defer the issue of the statute of limitations (Finding 2), and otherwise affirm the Findings.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant was employed by Department of General Services on November 3, 2008, when he sustained industrial injury.
Favours Applicant prevailed
Establishes employment relationship relevant to claim and statute of limitations issue.
From the decision · page 8FINDINGS OF FACT 1. Applicant sustained an industrial injury to his neck and claims to have sustained
There is no evidence whether applicant's medical treatment after retirement was provided by employer or through Cal-PERS retirement benefits.
Favours neutral
Lack of evidence on last provision of benefits prevents resolution of statute of limitations issue, requiring remand.
From the decision · page 7Here, and reviewing the parties' pleadings, the parties appear to agree that applicant continued to treat for his injury through private medical insurance, however, the parties appear to dispute the issue of whether applicant's treatment was provided by the employer. According to applicant's Petition, his medical insurance was provided through Cal-PERS disability retirement. According to defendant's Answer, applicant's employer was DGS, and after his retirement from DGS in 2013, his medical treatment was paid by his insurance through Cal-PERS as part of his retirement benefits, and thus, benefits were not provided by applicant's employer. Yet, there is simply no evidence by applicant or by defendant with respect to this legal issue.
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code section 5405
The statute of limitations for filing a claim is the later of one year from the date of injury, one year from the last provision of disability payments, or one year from the last provision of medical benefits.
Applied to determine timeliness of claim filing.
From the decision · page 6II. The statute of limitations is an affirmative defense and defendant, as the party asserting the defense, has the burden of proof. (Lab. Code5, § 5705.) Under section 5405, the limitations period for which a claim must be filed is the later of (a) one year from the date of injury, (b) one year from the last provision of disability payments per Labor Code sections 4650 et. seq., or (c) one year from the last provision of medical benefits. "Limitations provisions in the [workers'] compensation law must be liberally construed in favor of the employee unless otherwise compelled by the language of the statute, and such enactments should not be interpreted in a manner which will result in a loss of compensation." (Blanchard v. Workers' Comp. Appeals Bd. (1975) 53 Cal.App.3d 590, 595, 40 Cal. Comp.
Labor Code section 5705
The party asserting the statute of limitations defense has the burden of proof.
Applied to place burden of proof on defendant for statute of limitations defense.
From the decision · page 6II. The statute of limitations is an affirmative defense and defendant, as the party asserting the defense, has the burden of proof. (Lab. Code5, § 5705.) Under section 5405, the limitations period for which a claim must be filed is the later of (a) one year from the date of injury, (b) one year from the last provision of disability payments per Labor Code sections 4650 et. seq., or (c) one year from the last provision of medical benefits. "Limitations provisions in the [workers'] compensation law must be liberally construed in favor of the employee unless otherwise compelled by the language of the statute, and such enactments should not be interpreted in a manner which will result in a loss of compensation." (Blanchard v. Workers' Comp. Appeals Bd. (1975) 53 Cal.App.3d 590, 595, 40 Cal. Comp.
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About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
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