Recent Noteworthy Panel Decisions (NPDs) involving the determination of an applicant’s official date of injury and the statute of limitations as well as who is liable for the applicant’s injury. As demonstrated below, the defendant’s liability is a “legal” issue, not a “medical” one.
In California, two types of industrial injuries are recognized by the Labor Code: specific injury and cumulative trauma (CT) injury. Under Labor Code § 3208.1, a specific injury occurs as the result of one incident, while a CT injury occurs as “repetitive mentally or physically traumatic activities extending over a period of time.” Though there is little dispute over date of injury for a specific injury, the date of injury for a CT injury is often questionable. Labor Code § 5412 determines the date of a CT injury as “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.” In short, the date of injury under § Labor Code 5412 is when the employee both suffers disability and knows that his/her work caused the disability. This date triggers the applicant’s statute of limitations.
Labor Code § 5500.5 deals with carrier liability and determines the CT date of injury as either (whichever was first) the date determined by Labor Code § 5412 OR the applicant’s “last injurious exposure.” Therefore, an injured worker’s single CT claim may very well have two different dates of injury, given the “inextricably intertwined” language of Labor Code §§ 3208.1, 5412 and 5500.5.
The NPD of Pfundstein v. Hendrickson Trucking illustrates this disparity. Michael Pfundstein was diagnosed with Carpal Tunnel Syndrome (CTS) in 2007, four months after he began working with Hendrickson Trucking. On his own, Michael received treatment, and went back to work without filing a workers’ compensation claim. Later, on October 3, 2013, he filed a claim (and an Application for Adjudication on October 4) when a QME, Dr. Weinmann, advised he mention his returning CTS symptoms to a workers’ compensation attorney. Based on Labor Code § 5412, for statute purposes, Michael’s date of injury would have been October 3, 2013, the date he both suffered disability and knew that his/her work caused the disability. For carrier liability purposes, it was determined that Michael’s date of injury was 8/8/2008, the date of “last injurious exposure.” The WCAB upheld this, and Henderson Trucking was deemed legally liable for Michael’s workers’ compensation benefits.
An injury is usually considered a medical issue. However, the NPD of Webb v. The Vintage Club took into consideration all of the above to decide whether the determination of injury dates for carrier liability purposes is medical or legal. Applicant Stefanie Webb was diagnosed with CTS in 2005, but did not file a claim because she did not know the disability was a result of her work at The Vintage Club. In 2009, she pushed down on a stapler at work and experienced another CTS-related injury, which she reported. Her physician told her that her CTS was work-related, and Stefanie underwent surgery to treat her CTS. The 2009 date triggered the statute of limitations, and a judge determined that even though Stephanie was first injured in 2005, her injurious exposure continued until April of 2009 and, therefore, The Vintage Club’s insurance carrier in 2009 (rather than its 2005 carrier) bore the brunt of the liability. The majority of WCAB commissioners affirmed. Determining the date of injury is a legal determination, not a medical one.
All of the above reinforces the importance of correct identification of the date of injury for Statute of Limitation defenses and carrier liability purposes.