Workers' Compensation Appeals Board of California has the answer
An employee can file a claim alleging a cumulative injury until one year after they knew or should have known that a disability was industrially related, a panel of the Workers' Compensation Appeals Board of California said in a recent case.
The applicant in the case of Simmons vs. Bimbo Bakeries Inc., Ace American Insurance; ESIS worked as a route sales professional from February 2000 to August 2018.
Last April, a workers’ compensation administrative law judge found that the applicant sustained injuries to his lumbar spine, thoracic spine, and right hip arising out of and in the course of employment and that the injuries caused 19% permanent disability.
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The defendant asked for reconsideration. The defendant argued that the judge should have found that the statute of limitations barred the applicant’s claim for a cumulative trauma injury because the applicant had knowledge that an industrial injury caused the disability over one year before he filed his claim.
A panel of the Workers' Compensation Appeals Board of California affirmed the judge’s decision. The defendant failed to show that the applicant had actual knowledge that work caused his back-related disability over one year before he filed the claim and failed to show that the statute of limitations barred the claim.
The defendant argued that the employer had no reason to believe that the applicant might have sustained a work-related injury, while the applicant had actual knowledge that his work duties’ cumulative effect caused a back injury. The defendant claimed that the applicant might naturally have suspected that his back pain was related to the heavy lifting that he did at work.
In response, the panel determined that suspicion of work-relatedness did not amount to knowledge. The panel found that the defendant failed to show that the applicant had special medical training or qualifications or received a claim form outlining his workers’ compensation rights or medical advice that his symptoms were work-related. The applicant was a layperson, the panel noted.
The panel cited the case of City of Fresno v. Workers' Comp. Appeals Bd. (1985), which stated that an employee was not considered to have knowledge that their disability was job-related if they did not receive medical advice to that effect, unless the nature of the disability and the applicant's training, intelligence, and qualifications were such that he should have recognized the relationship between his disability and the known adverse factors involved in his employment.
