What the panel treated as outcome-determinative, and which side it favoured.
Applicant was unaware of the continuous trauma claim until consulting legal counsel on April 1, 2014.
Favours Applicant prevailed
This established the date of injury for the continuous trauma claim under Labor Code Section 5412, affecting liability and statute of limitations.
From the decision · page 5It was at that point that State Compensation Insurance Company
then denied treatment.
It was this denial that caused the Applicant to seek legal counsel. At that time, legal counsel
explained to the Applicant that he had a potential continuous trauma injury. Applicant's attorney then
filed a new Application on Applicant's behalf. Additional carriers through the period of employment
were then joined.
Applicant testified unrebutted that he did not know what a CT claim was until that point. He
was found to be credible by the WCJ. Petitioner goes to great length to claim that Applicant had
some type of constructive knowledge earlier, but this argument is without merit or justification. The
Applicant was ignorant of the law. He was clearly detrimentally relying on State Compensation
Insurance Fund providing him with medical treatment.
No medical records or advice indicated the applicant knew about the continuous trauma injury before April 1, 2014.
Favours Applicant prevailed
Supports the finding that the applicant did not have knowledge of the injury before consulting counsel, critical for date of injury determination.
From the decision · page 10The real issue was when did the Applicant attain the requisite knowledge that he had sustain a
cumulative trauma work related injury? The employee is not charged with knowledge just because he
or she had some symptoms. Medical opinion expressed to an employee that his or her disability was
caused by employment is sufficient for the purposes of Labor Code Section 5412. However, an
applicant is generally not deemed to understand, or have knowledge of a CT injury, unless so advised
by a physician. City of Fresno v. WCAB (Johnson)(1985), 50 CCC 53. There are no medical records
evidencing that this advice was given to the Applicant by any doctor or that he knew what a CT injury
was in this case other than when he first consulted with his attorney on April 1, 2014.
Medical opinions found the right knee, right hip, neck, and lumbar injuries were not compensable consequences of the specific left knee injury.
Favours Defendant prevailed
This limited compensability for the specific injury claim, affecting the outcome on compensable consequences.
From the decision · page 9Based upon applicant's credible testimony and the medical reports of Dr. Michael Kimball,
M.D., Dr. Peter Hanson, M.D. and Dr. John Lane, M.D., various dates, it is found that applicant
sustained injury to his left knee arising out of and occurring in the course of employment on July 15,
2004. He did not sustain compensable consequence injuries to his right knee, right hip, lumbar or
neck from this injury.
There was only one continuous trauma period covering the injuries to left knee, right knee, right hip, neck, and back.
Favours Applicant prevailed
This supported the finding of one CT period and affected liability and compensability determinations.
From the decision · page 9Based upon applicant's credible testimony and the medical reports of Dr. Michael Kimball, M.D.,
Dr. Peter Hanson, M.D. and Dr. John Lane, M.D., various dates, it is found that applicant sustained
injury to his left knee, right knee, right hip, neck and back arising out of and occurring in the course
of employment during the period 2003 to and including January 20, 2017. The date of injury
pursuant to Labor Code Section 5412 is discussed below.
THERE IS ONLY ONE CONTINUOUS TRAUMA PERIOD
Applicant's petition to rescind election against Zurich American Insurance Company was granted due to mistake about Zurich's coverage.
Favours Applicant prevailed
This affected the parties liable for the continuous trauma claim and clarified election status.
From the decision · page 11Based upon the foregoing, it found that there is good cause shown to allow the Applicant to
withdraw his election. As such, there is no election against Zurich American Insurance Company by
the Applicant.
APPLICANT'S CLAIM IS NOT BARRED BY THE STATUTUE OF LIMITATIONS