ADJ18188574 · January 14, 2025

The WCAB found that the statute of limitations issue required further development of the record, including medical legal evaluation to determine the date of injury and knowledge of disability, and that the prior WCJ decision barring the claim was premature without such findings.

From the decision · page 5Accordingly, we grant reconsideration and return this matter to the trial level for further proceedings consistent with this opinion.

Applicant filed claim on 8/1/2020 but canceled it shortly after and was advised of one-year statute of limitations from date of injury or last treatment.

Favours neutral

This established the timeline for the statute of limitations issue and the need to clarify the date of injury and knowledge of disability.

From the decision · page 2Applicant filed a claim form dated 8/1/2020 which was received by the employer on 8/13/2020 and by SCIF on 8/14/2020 as noted on the date stamp on the DWC-1 claim form (Defense Exhibit A, DWC-1 form dated 8/1/2020). On 8/18/2020, Applicant requested by email to "cancel" her claim because she was pursuing EDD benefits instead which had been her doctor's suggestion (See Defense Exhibit D, E-mail from Applicant dated 8/18/2020). On 8/20/2020 Defendant denied Applicant's injury claim and, in the denial letter to Applicant, advised that because she chose to cancel her claim, defendant was unable to investigate to determine compensability. Defendant also provided notice that Applicant had one year from the date of injury or date of last furnishing of indemnity or medical treatment to commence proceedings before the WCAB by filing an Application for Adjudication of Claim or her rights to benefits maybe lost (See Joint Exhibit 1, SCIF denial letter claim notice of date of injury 7/6/2020, dated 8/20/2020).

Applicant amended date of injury to cumulative trauma period 7/6/2020 to 11/16/2020 and alleged psychiatric injury from work.

Favours Applicant prevailed

This amendment required further development to determine the correct date of injury and knowledge under Labor Code 5412.

From the decision · page 2On 6/13/2024, Applicant amended the date of injury to reflect cumulative trauma during the period 7/6/2020-11/16/2020.

No medical records or findings on compensable disability or knowledge of industrial causation; only allegations of psychiatric injury causation by work.

Favours Applicant prevailed

Lack of medical evidence and findings on laches defense meant the statute of limitations issue was not properly resolved and required further proceedings.

Labor Code 5405, 5412

Statute of limitations under Labor Code 5405 and cumulative trauma injury date under Labor Code 5412.

The Board applied these statutes to determine the applicable statute of limitations period and the date of injury for cumulative trauma injuries.

From the decision · page 4Applicant amended her Application for Adjudication to reflect a cumulative trauma injury from July 6, 2020 to November 16, 2020. Section 5412 defines the date of injury for cumulative injuries as "the date upon which the employee first suffered disability therefrom and either knew, or in the exercise of reasonable diligence should have known, that such disability was caused by his present or prior employment." (§ 5412.) The "date of injury" under section 5412 is a statutory construct for purposes of the statute of limitations and the post-termination defense. Section 5412 requires a twofold analysis: (1) the existence of disability, and (2) knowledge that such disability was industrial.

No medical records indicating compensable disability or knowledge of industrial causation; only allegations of psychiatric injury causation by work; no findings on laches affirmative defense.