What the panel ordered
Petition for Reconsideration denied; WCJ's decision affirmed that applicant's claim is not barred by the statute of limitations.
Defendant sought reconsideration of the January 11, 2024 Amended Findings, Award & Opinion on Decision (F&A) that found applicant's claim was not barred by the statute of limitations.
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 WCJ found the applicant's first date of knowledge sufficient to establish a date of injury was July 1, 2021, making the claim timely filed on July 7, 2021, within the one-year statute of limitations under section 5405.
From the decision · page 2On January 11, 2024, the WCJ issued the F&A, finding in relevant part that "applicant's cumulative trauma is not barred by the Statute of Limitations." (Finding of Fact No. 5.) The WCJ's Opinion on Decision explains that applicant's first date of knowledge sufficient to establish a date of injury pursuant to section 5412 was July 1, 2021. Accordingly, the Application for Adjudication of Claim filed on July 7, 2021 was timely. (Opinion on Decision, at p. 9.)
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant's credible testimony that she did not have knowledge of the industrial cause of her heart condition until July 2021 after speaking with officers at work.
Favours Applicant prevailed
This established the date of knowledge and date of injury under Labor Code section 5412, making the claim timely filed within one year under section 5405.
From the decision · page 6The first evidence in the record of applicant's knowledge occurs during the week of July 1, 2021, when applicant returned to work after an extended medical absence. Applicant's testimony was that upon her return to work, she was speaking with some of the officers who recommended she file a claim for workers' compensation benefits. (Minutes, at p. 4:2.) The WCJ found applicant's testimony to be fully credible (Opinion on Decision, at p. 8), and we accord to that determination the great weight to which it is entitled. (Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312 [35 Cal.Comp.Cases 500].)
Lack of medical records from applicant's cardiologist to establish knowledge in 2020; only QME reports and deposition were submitted.
Favours Applicant prevailed
Without medical evidence showing knowledge in 2020, the claim could not be barred by the statute of limitations starting then.
From the decision · page 5Here, we are not persuaded that applicant obtained the requisite knowledge of the industrial causation of her disability in May, 2020, sufficient to commence the running of the statute of limitations. While applicant was reportedly advised in 2020 by her cardiologist to avoid stress, the only medical evidence in the record is the QME's reports and deposition, and the records from applicant's cardiologist were not submitted. Thus, the record does not contain sufficient evidence to establish that applicant was informed in 2020 that her work caused her cardiac-related disability, or that applicant was aware she had sustained a cumulative injury. (See County of San Bernardino v. Workers' Comp. Appeals Bd. (Nelson-Watkins) (2018) 83 Cal.Comp.Cases 1282, 1285-1286 [2018 Cal. Wrk. Comp.
What the panel did with the medical opinions
The role the physician served, and the weight the opinion carried. Physicians are named here as the decision names them; we do not score them.
Causation of applicant's dilated cardiomyopathy is complex and complicated; most of the time, the cause is unknown without an endomyocardial biopsy, which was not done in this case.
The QME's opinion on the complexity of causation supported the finding that the applicant should not have known the industrial cause of her condition earlier.
From the decision · page 5However, the record reflects no specialized training in identifying or diagnosing latent cardiac conditions or training or medical experience that would otherwise allow applicant to identify the industrial nature of her condition. Moreover, the QME has opined at length that causation of applicant's dilated cardiomyopathy is "complex and complicated," and that "most of the time, we never know because an endomyocardial biopsy is not taken...and it was not done in this case." (Ex. 3, Report of Alan Ross, M.D., dated January 24, 2022, at pp. 33-34.) Given the
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Labor Code section 5412
Labor Code section 5412 defines the date of injury for cumulative trauma as the date the employee first suffered disability and knew or should have known it was work-related.
Applied to determine the date of injury for cumulative trauma claims.
From the decision · page 3In cases involving an alleged cumulative trauma injury, the date of injury is governed by Labor Code section 5412, which holds:
Labor Code section 5405
Labor Code section 5405 requires proceedings to be commenced within one year of the date of injury or last payment or treatment.
Applied to determine timeliness of claim filing.
What proof carried it
The evidence the panel weighed, by kind.
Applicant's credible testimony that she did not have knowledge of the industrial cause of her heart condition until July 2021 after speaking with officers at work.
From the decision · page 6The first evidence in the record of applicant's knowledge occurs during the week of July 1, 2021, when applicant returned to work after an extended medical absence. Applicant's testimony was that upon her return to work, she was speaking with some of the officers who recommended she file a claim for workers' compensation benefits. (Minutes, at p. 4:2.) The WCJ found applicant's testimony to be fully credible (Opinion on Decision, at p. 8), and we accord to that determination the great weight to which it is entitled. (Garza v. Workmen's Comp. Appeals Bd. (1970) 3 Cal.3d 312 [35 Cal.Comp.Cases 500].)
Lack of medical records from applicant's cardiologist to establish knowledge in 2020; only QME reports and deposition were submitted.
From the decision · page 5Here, we are not persuaded that applicant obtained the requisite knowledge of the industrial causation of her disability in May, 2020, sufficient to commence the running of the statute of limitations. While applicant was reportedly advised in 2020 by her cardiologist to avoid stress, the only medical evidence in the record is the QME's reports and deposition, and the records from applicant's cardiologist were not submitted. Thus, the record does not contain sufficient evidence to establish that applicant was informed in 2020 that her work caused her cardiac-related disability, or that applicant was aware she had sustained a cumulative injury. (See County of San Bernardino v. Workers' Comp. Appeals Bd. (Nelson-Watkins) (2018) 83 Cal.Comp.Cases 1282, 1285-1286 [2018 Cal. Wrk. Comp.
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About this page
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