What the panel ordered
The WCAB granted defendant's petition for reconsideration, rescinded the WCJ's Findings and Award, and returned the matter to the trial level for further proceedings consistent with the opinion.
Defendant petitioned for reconsideration of the Arbitrator's Findings and Award issued on February 5, 2026. The WCAB granted the petition, rescinded the Findings and Award, and returned the matter to the WCJ for further proceedings.
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 WCAB found that the applicant had three distinct COVID-19 infections and that they could not be merged into one cumulative injury. The AME's determination regarding the third infection was not substantial medical evidence. The case was returned for further medical reporting to determine the number and nature of injuries and apportionment.
From the decision · page 10Applicant's first case of COVID was in February 2020 and thus pre-dates the COVID presumptions. Sections 3212.87 and 3212.88 were repealed effective January 1, 2024, thus dates of injury in December 2020 and November 2022 fall squarely within these sections. Section 3212.87(b)(1), which covers peace officers such as applicant, requires that "The employee has tested positive for COVID-19 within 14 days after a day that the employee performed labor or services at the employee's place of employment at the employer's direction." If the injured worker meets the criteria set forth in the section, section 3212.87(b)(2) states that "The date of injury shall be the last date the employee performed labor or services at the employee's place of employment at the employer's direction prior to the positive test." Here, the AME was not provided a positive test result for the December 2020 case of COVID-19, so he did not perform his analysis of industrial causation under the rubric of section 3212.87. It is unclear why he did not apply the criteria of section 3212.87 to his review of applicant's November 2022 case.
The WCAB found that the burden of proof for the statute of limitations rests with the defendant, and there was insufficient evidence to determine when the statute began to run. The applicant's knowledge of industrial causation was not established until the AME evaluation in 2024.
From the decision · page 6Notwithstanding the definition of "date of injury" contained in sections 3212.86, 3212.87, or 3212.88, COVID-19 is generally considered a specific injury. Defendant contends that applicant's claim is barred by the one year statute of limitations to apply for workers' compensation benefits pursuant to section 5405. With respect to whether applicant's claims are barred by the statute of limitations, the three points designated in section 5405 as the start of the one year statute of limitations period are: date of injury; the last payment of disability indemnity; and the last date on which medical treatment benefits were furnished.
The facts that decided it
What the panel treated as outcome-determinative, and which side it favoured.
Applicant had three distinct COVID-19 infections in February 2020, December 2020, and November 2022.
Favours Defendant prevailed
The WCAB found that these infections could not be merged into one cumulative injury, requiring separate determinations and further medical reporting.
From the decision · page 10Applicant's first case of COVID was in February 2020 and thus pre-dates the COVID presumptions. Sections 3212.87 and 3212.88 were repealed effective January 1, 2024, thus dates of injury in December 2020 and November 2022 fall squarely within these sections. Section 3212.87(b)(1), which covers peace officers such as applicant, requires that "The employee has tested positive for COVID-19 within 14 days after a day that the employee performed labor or services at the employee's place of employment at the employer's direction." If the injured worker meets the criteria set forth in the section, section 3212.87(b)(2) states that "The date of injury shall be the last date the employee performed labor or services at the employee's place of employment at the employer's direction prior to the positive test." Here, the AME was not provided a positive test result for the December 2020 case of COVID-19, so he did not perform his analysis of industrial causation under the rubric of section 3212.87. It is unclear why he did not apply the criteria of section 3212.87 to his review of applicant's November 2022 case.
The AME's determination that the November 2022 COVID-19 infection was not industrial due to exposure to applicant's wife was not substantial medical evidence.
Favours Defendant prevailed
This undermined the prior finding of industrial causation for the third infection, leading to remand for further evaluation.
From the decision · page 12positive for COVID-19 two days earlier is not substantial medical evidence. The latency period and presentation of symptoms differs person-to-person. If it is determined that applicant has any permanent disability as a result of the third infection, the AME should re-evaluate the issue of industrial causation.
The burden of proof for the statute of limitations rests with the defendant, and there was insufficient evidence to determine when the statute began to run.
Favours Defendant prevailed
The WCAB found that applicant's knowledge of industrial causation was not established until the AME evaluation in 2024, so the statute of limitations defense failed.
From the decision · page 6Notwithstanding the definition of "date of injury" contained in sections 3212.86, 3212.87, or 3212.88, COVID-19 is generally considered a specific injury. Defendant contends that applicant's claim is barred by the one year statute of limitations to apply for workers' compensation benefits pursuant to section 5405. With respect to whether applicant's claims are barred by the statute of limitations, the three points designated in section 5405 as the start of the one year statute of limitations period are: date of injury; the last payment of disability indemnity; and the last date on which medical treatment benefits were furnished.
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.
Applicant developed three distinct COVID-19 infections with varying severity and symptoms. The AME did not apply COVID presumption criteria to the December 2020 and November 2022 infections due to lack of positive test results and other reasons. The AME's determination that the November 2022 infection was not industrial due to exposure to his wife was not substantial medical evidence.
From the decision · page 3On September 30, 2024, applicant was evaluated by internal medicine Agreed Medical Evaluator (AME) Jeffrey A. Hirsch, M.D., who issued an AME report on October 29, 2024, and a supplemental AME report on March 19, 2025. (Collectively Ex. 1.)
The rules the panel named
Authorities as the decision cited them, with how this panel applied each one.
Lab. Code, §§ 3208.2, 5303
The anti-merger provisions in sections 3208.2 and 5303 require separate determination of facts and law for each injury and prohibit merging injuries.
The WCAB applied these provisions to find that the three COVID-19 infections could not be merged into one cumulative injury.
From the decision · page 11Section 3208.2 provides: When disability, need for medical treatment, or death results from the combined effects of two or more injuries, either specific, cumulative, or both, all questions of fact and law shall be separately determined with respect to each such injury, including, but not limited to, the apportionment between such injuries of liability for disability benefits, the cost of medical treatment, and any death benefit.
The one-year statute of limitations to apply for workers' compensation benefits starts from the date of injury, last payment of disability indemnity, or last date medical treatment was furnished, with tolling provisions for claim filing.
The WCAB found the burden of proof for the statute of limitations rests with the defendant and that the applicant's knowledge of industrial causation was not established until the AME evaluation in 2024.
From the decision · page 6Notwithstanding the definition of "date of injury" contained in sections 3212.86, 3212.87, or 3212.88, COVID-19 is generally considered a specific injury. Defendant contends that applicant's claim is barred by the one year statute of limitations to apply for workers' compensation benefits pursuant to section 5405. With respect to whether applicant's claims are barred by the statute of limitations, the three points designated in section 5405 as the start of the one year statute of limitations period are: date of injury; the last payment of disability indemnity; and the last date on which medical treatment benefits were furnished.
What proof carried it
The evidence the panel weighed, by kind.
Applicant's testimony and medical reports showing three distinct COVID-19 infections with temporary disability and return to work after each.
From the decision · page 10Turning to the issue of whether applicant's COVID-19 infections can be merged into one cumulative injury, they cannot. While there may be overlapping symptoms, there were three
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About this page
- A published decision of the California Workers' Compensation Appeals Board, taken apart by what it turned on. The Board publishes the decision itself; this page adds the extraction and quotes the passage behind every claim.
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