ADJ1058134 — California WCAB decision

ADJ1058134 · September 4, 2025

The WCAB granted the Petition for Reconsideration, rescinded the June 10, 2025 Findings and Order, substituted a new Finding of Fact that defendant failed to meet its burden of proving the statute of limitations, and returned the matter to the trial level for further proceedings.

Issues decided

Medical opinions weighed

Authorities named

District office

Los Angeles

What the panel ordered

Applicant sought reconsideration of the WCJ's Findings and Order issued on June 10, 2025, which found the claim barred by the statute of limitations. The WCJ filed a Report and Recommendation on Petition for Reconsideration. The WCAB granted reconsideration, rescinded the June 10, 2025 F&O, and returned the matter to the trial level for further proceedings.

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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.

Other disputed issueDeferredbilateral shoulders · bilateral knees · internal · psyche · bilateral upper extremities · back

The issue of industrial injury was raised but not decided by the WCJ and is deferred for trial level determination.

From the decision · page 9Applicant raises another issue in the petition for reconsideration, which is that applicant sustained industrial injury. While the issue of injury was raised at trial, it was not decided by the WCJ, and thus it is not ripe for adjudication at this time. We will return that issue to the trial level for the WCJ to determine in the first instance.

The facts that decided it

What the panel treated as outcome-determinative, and which side it favoured.

Defendant failed to provide statutory notice of benefits to applicant.

Favours Applicant prevailed

Without notice, the statute of limitations defense cannot be established.

From the decision · page 9We are bound to follow the holdings of the Supreme Court, and the holding of Reynolds precludes application of the statute of limitations in cases where the employer has not provided statutory notice. There is no dispute in this case that the employer did not provide statutory notices of applicant's right to file a claim. Thus, per the Labor Code it was incumbent upon the claims administrator to provide statutory notices. Here, there is not any evidence at all establishing when a notice of benefits issued. Accordingly, defendant has not met its burden of proof as to the running of the statute of limitations.

Employer did not provide statutory notice of applicant's right to file a claim.

Favours Applicant prevailed

This triggered the claims administrator's duty to provide notice, which was not shown to have occurred.

From the decision · page 9We are bound to follow the holdings of the Supreme Court, and the holding of Reynolds precludes application of the statute of limitations in cases where the employer has not provided statutory notice. There is no dispute in this case that the employer did not provide statutory notices of applicant's right to file a claim. Thus, per the Labor Code it was incumbent upon the claims administrator to provide statutory notices. Here, there is not any evidence at all establishing when a notice of benefits issued. Accordingly, defendant has not met its burden of proof as to the running of the statute of limitations.

Date of injury pursuant to Labor Code section 5412 was not found by the WCJ.

Favours neutral

Without a date of injury, the running of the statute of limitations cannot be properly determined.

From the decision · page 81) The date of injury pursuant to section 5412. 2) The date that applicant was provided a notice of benefits. 3) The date upon which the application for adjudication was filed. Here, the date of injury pursuant to section 5412 was never found. This is a common error made on all sides of statute of limitations disputes. In order to determine when a statute of limitations runs, the date of injury must first be decided. Here the WCJ made no findings of fact as to the date of injury. Another common error is to mistake the date of injury under section 5412 as synonymous with the dates of liability under section 5500.5. Sometimes these dates will coincide. Oftentimes, these dates are disparate. The parties and the WCJ must be cognizant that a date of injury under section 5412 must be found in order to determine whether the statute of

The rules the panel named

Authorities as the decision cited them, with how this panel applied each one.

Labor Code section 5705

The statute of limitations is an affirmative defense and the defendant has the burden of proof.

Applied to determine burden of proof 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. (§ 5705.) The limitations period for which a claim must be filed is the later of (1) one year from the date of injury, (2) one year from the last provision of disability payments per sections 4650 et seq., or (3) one year from the last provision of medical benefits. (Ibid.) "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.Cases 784] (internal citations omitted).) Establishing a date of injury is imperative to establishing the running of the statute of limitations.

Labor Code section 5412

Date of injury for cumulative injury claims is the date the employee first suffered disability and knew or should have known it was caused by employment.

Applied to establish date of injury for statute of limitations calculation.

From the decision · page 6Date of injury for cumulative injury claims is established under section 5412, which states: "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." (§ 5412.) As used in section 5412, "disability" means either compensable temporary disability or permanent disability. (Chavira v. Workers' Comp. Appeals Bd.

Labor Code section 138.4

Claims administrator must provide notice of benefits if employer fails to do so, estopping the administrator from asserting statute of limitations defense until notice is given.

Applied to require claims administrator to notify applicant, preventing statute of limitations defense without notice.

From the decision · page 8Furthermore, it is also well established that where an employer is insured for workers' compensation liability, the insurer stands in the shoes of the employer. (§ 3755.) The Labor Code expressly requires that a claims administrator give notice when the employer fails to do so:

Reynolds v. Workmen's Comp. Appeals Bd. (1974) 12 Cal.3d 726

Employer's failure to provide statutory notice precludes raising statute of limitations defense.

Applied to bar statute of limitations defense where employer failed to notify employee of claim rights.

From the decision · page 1Applicant contends, in pertinent part, that the WCJ misapplied the burden of proof as the statute of limitations is defendant's burden and that the statute of limitations was tolled in this case pursuant to the holding in Reynolds because defendant failed to adequately notify applicant of his right to file a workers' compensation claim. (Reynolds v. Workmen's Comp. Appeals Bd. (1974) 12 Cal.3d 726 [39 Cal.Comp.Cases 768].)

ADJ1058134 · September 4, 2025

What the panel ordered

What was disputed, and how it came out

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The facts that decided it

What the panel did with the medical opinions

The rules the panel named

What proof carried it

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