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Thread: Statute of Limitations for WC Claim California

  1. #1
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    Default Statute of Limitations for WC Claim California

    Is there a statute of limitations for an employee to file a WC Claim in the State of Califonia? If so, could you give me a link to it?

    I have a situation where an employee who left the company filed a WC claim 20 months after doing so. She left because of other medical problems, has been in constant touch with company employees (including myself and the CEO) and never notified anyone that she had an injury during the employment.

  2. #2
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    I don't know the answer but this link might provide some resources:

    http://www.dir.ca.gov/DWC/faqs.html

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    Already been there and it does not help. Thanks anyway.

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    I thought I saw a phone number for questions that the link did not answer....

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    When CAIW gets here, he'll know.
    I don't respond to Private Messages unless the moderator specifically refers you to me for that purpose. Thank you.

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    There is a one year SOL for filing a claim for WC benefits.
    That one year begins from the date there is reasonable knowledge of the injury/illness.
    5405. The period within which proceedings may be commenced for the
    collection of the benefits provided by Article 2 (commencing with
    Section 4600) or Article 3 (commencing with Section 4650), or both,
    of Chapter 2 of Part 2 is one year from any of the following:
    (a) The date of injury.
    (b) The expiration of any period covered by payment under Article
    3 (commencing with Section 4650) of Chapter 2 of Part 2.
    (c) The last date on which any benefits provided for in Article 2
    (commencing with Section 4600) of Chapter 2 of Part 2 were furnished.
    The confusing part would be the requirement to file a DWC-1/First Report of Injury with the employer within 30 days of that knowledge.
    5400. Except as provided by sections 5402 and 5403, no claim to
    recover compensation under this division shall be maintained unless
    within thirty days after the occurrence of the injury which is
    claimed to have caused the disability or death, there is served upon
    the employer notice in writing, signed by the person injured or
    someone in his behalf, or in case of the death of the person injured,
    by a dependent or someone in the dependent's behalf.
    Even if the actual form is not filed with the ER/IC timely, the fact there is knowledge by the ER through any source is generally sufficient to constitute a valid claim, and permits the ER/IC to investigate the claim.
    5402. (a) Knowledge of an injury, obtained from any source, on the
    part of an employer, his or her managing agent, superintendent,
    foreman, or other person in authority, or knowledge of the assertion
    of a claim of injury sufficient to afford opportunity to the employer
    to make an investigation into the facts, is equivalent to service
    under Section 5400.
    For CT/Cumulative Trauma injury/illness....
    5412. The date of injury in cases of occupational diseases or
    cumulative injuries is that 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.
    The above labor codes are here http://www.leginfo.ca.gov/cgi-bin/wa...ction=retrieve

    For a psych/stress claim to be valid, the EE/employee, must have worked for this ER a minimum of 6 months prior to filing the claim.
    3208.3 (d) Notwithstanding any other provision of this division, no
    compensation shall be paid pursuant to this division for a
    psychiatric injury related to a claim against an employer unless the
    employee has been employed by that employer for at least six months.
    The six months of employment need not be continuous.
    If this is a claim for compensation due to a psych/stress injury/illness, there are mandates under the labor code specific to this issue...
    (e) Where the claim for compensation is filed after notice of
    termination of employment or layoff, including voluntary layoff, and
    the claim is for an injury occurring prior to the time of notice of
    termination or layoff, no compensation shall be paid unless the
    employee demonstrates by a preponderance of the evidence that actual
    events of employment were predominant as to all causes combined of
    the psychiatric injury and one or more of the following conditions
    exist:
    (1) Sudden and extraordinary events of employment were the cause
    of the injury.
    (2) The employer has notice of the psychiatric injury under
    Chapter 2 (commencing with Section 5400) prior to the notice of
    termination or layoff.
    (3) The employee's medical records existing prior to notice of
    termination or layoff contain evidence of treatment of the
    psychiatric injury.
    (4) Upon a finding of sexual or racial harassment by any trier of
    fact, whether contractual, administrative, regulatory, or judicial.
    (5) Evidence that the date of injury, as specified in Section 5411
    or 5412, is subsequent to the date of the notice of termination or
    layoff, but prior to the effective date of the termination or layoff.
    There are also some SOL mandates here http://www.leginfo.ca.gov/cgi-bin/wa...ction=retrieve.

    As you can see, some of the SOL's are dependent upon the injury/illness benefits are being claimed for.

    The phone 1-800-736-7401 -- cbg may be referring to is to an Information and Assistance officer at the WCAB.
    FAQ's for employER's is here http://www.dir.ca.gov/dwc/employer.htm

    IMO... file this claim with your carrier. If you are self insured, hand it off to your TPA/Third Party Adm, or if you are the go to person, it would be important to deny the claim timely, or it could be presumed accepted after 90 days.
    IF you are covered under a policy issued by a IC, or SCIF, you should not make the determination on your own, but file the claim with your carrier.

  7. #7
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    To all of you and CAIW especially. Thank you.

  8. #8
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    Quote Originally Posted by aswas71788 View Post
    To all of you and CAIW especially. Thank you.
    Told ya.
    I don't respond to Private Messages unless the moderator specifically refers you to me for that purpose. Thank you.

  9. #9
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    You're welcome...aswas71788
    and, thanX Patty.
    Guess I was feeling "oaty" there...

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