County of Riverside v. Workers' Compensation Appeals Board

Citations: 10 Cal. App. 5th 119; 215 Cal. Rptr. 3d 693; 82 Cal. Comp. Cases 301; 2017 WL 1101663; 2017 Cal. App. LEXIS 269Docket: E065688

Court: California Court of Appeal; March 24, 2017; California; State Appellate Court

Original Court Document: View Document

SummaryOriginalCytator Case TreatmentBackward CitatorAnalysis

EnglishEspañolSimplified EnglishEspañol Fácil

The Court of Appeal of California, Fourth Appellate District, affirmed the Workers’ Compensation Appeals Board (WCAB) decision regarding the County of Riverside's challenge to the timeliness of Peter G. Sylves's claim and the applicability of Labor Code section 5500.5. Sylves, a former deputy sheriff for the County, filed his application for adjudication on July 16, 2014, citing continuous trauma related to various medical conditions, including hypertension and back injury, stemming from his employment with the County and later with the Pauma Police Department.

The WCJ initially determined that while some of Sylves's claims were not compensable, his hypertension and back injury were. The County contended that section 5500.5 limited liability to the Pauma Police Department, arguing that Sylves did not demonstrate labor-disabling conditions during his County employment. Sylves countered that the County did not prove a failure to comply with the applicable limitations period and that section 5500.5 did not limit liability to the Pauma Police Department due to the tribe's federal recognition and the WCAB's lack of jurisdiction over it.

Upon reconsideration, the WCAB found substantial medical evidence supporting Sylves's claims and clarified that the statute of limitations for filing did not commence until a medical professional confirmed the industrial nature of his symptoms in 2013, rendering his 2014 claim timely. Additionally, the WCAB concluded that section 5500.5 serves as a procedural framework for apportioning liability among multiple defendants but does not impose a statute of limitations or restrict liability solely to the Pauma Police Department.

The decision following reconsideration concluded that Sylves, employed as a Deputy Sheriff by the County of Riverside from December 27, 1998, to October 28, 2010, sustained multiple injuries, including hypertension, lower back injuries, left shoulder injuries, knee injuries, GERD, and a sleep disorder, which arose during his employment. The County of Riverside failed to prove its statute of limitations defenses. The review was granted on April 27, 2016, to clarify the application of section 5500.5 of the Labor Code. 

The County argues that the Worker’s Compensation Appeals Board (WCAB) incorrectly found Sylves's application for adjudication timely and wrongly assigned liability to the County despite Sylves's last four years of exposure with a different employer. The petition claims the WCAB’s decision was unsupported by substantial evidence and misapplied the law concerning sections 5500.5, 5412, and 5405 of the Labor Code. 

The response to the petition requests denial due to the lack of attached relevant medical evidence, arguing that the petition does not contest the sufficiency of evidence but instead questions the WCAB’s application of the law regarding timeliness and liability. The court notes that it cannot reweigh evidence but may reject WCAB’s findings if deemed unreasonable. The burden of proof for the timeliness of Sylves’s application lies with the County, which must demonstrate that the application was filed outside the one-year limit from the date of injury, as defined by section 5412 for cumulative injuries. The court found no reason to deem the application untimely.

The petition's nature restricts the inquiry into Sylves's knowledge of industrial causation regarding his orthopedic injuries. The County contends that Sylves should have been aware of this causation prior to his claim, arguing that his prior knowledge should negate the application of presumptions under sections 3212.2 and 3212.5. The County also claims Sylves retired due to knee issues rather than back problems. However, most of the County's assertions lack record citations, which prevents the court from evaluating their validity. The Workers' Compensation Appeals Board (WCAB) is responsible for determining whether Sylves had knowledge of an industrial injury and when that knowledge arose, and appellate courts will not overturn the board's factual findings if supported by substantial evidence. The burden of proof lies with the employer to demonstrate that the employee knew or should have known about the job-relatedness of their condition, which is not satisfied merely by showing the employee had symptoms.

An applicant is not deemed to have knowledge of job-related disabilities without medical advice unless their qualifications and circumstances should have made that relationship apparent. The Labor Code mandates a liberal interpretation to protect injured workers. In this case, the WCAB concluded that Sylves was first informed by doctors about the connection between his medical conditions and his employment within a year before filing for adjudication, with evidence supporting that he did not receive such advice until 2013. This conclusion is upheld by substantial evidence. The County's evidence primarily concerns alleged inconsistencies in Sylves's statements about his work intensity between jobs, questioning his truthfulness regarding when he learned of his conditions' work-related nature. However, the court cannot reassess evidence or selectively disregard facts that contradict the WCAB's findings. Sylves also testified uncertainty regarding his history with Dr. Lal, and the County did not address this testimony.

The County's argument regarding the impact of section 5500.5 on the limitations period for Sylves's claims is addressed. Section 5500.5(a) specifies that liability for occupational disease or cumulative injury claims is restricted to employers who employed the employee during the year preceding the injury or the last date of exposure, whichever is earlier. This section was enacted to codify principles from Colonial Ins. Co. v. Industrial Acc. Com., allowing injured employees to seek awards from successive employers or insurers while permitting those liable to seek apportionment from prior employers or insurers. The limitation in section 5500.5(a) aims to reduce the burden on employees and attorneys in tracing employment history. However, the section does not pertain to the statute of limitations for filing claims, and thus the Workers' Compensation Appeals Board (WCAB) did not err in determining Sylves’s claims were timely. The County's concerns about potential liability for long-past injuries were unfounded, as the WCAB did not violate section 5500.5(a) when imposing liability on the County, even considering that Sylves had worked for the Pauma Police Department for the last four years of his employment. The section is clear that liability is limited to the employers within the specified timeframe related to the injury.

Sylves was employed by the Pauma Police Department from December 28, 2010, to July 4, 2014, without subsequent employment. His claims of occupational disease or cumulative injury arose in 2013 when doctors linked his ailments to his job. While section 5500.5(a) could limit liability to the Pauma Police Department, it does not apply here since that department is not a party in the case and has not been claimed against. Section 5500.5 allows a claimant to pursue action against a limited number of employers while permitting those employers to seek contributions from others. The County cannot reduce Sylves's recovery under this provision, as it contradicts the liberal interpretation of workers’ compensation laws.

Furthermore, under section 5500.5(a), if none of the employers from the last year of employment are insured for workers' compensation, liability falls to the last employer with coverage. The Pauma Police Department, being part of a federally recognized Indian tribe, is not subject to the jurisdiction of the Workers’ Compensation Appeals Board (WCAB), thus lacking insurance coverage. Consequently, the County, which does have workers’ compensation insurance, becomes liable.

Sylves requested a remand to the WCAB to order the County to pay his attorney fees, arguing that the County had no reasonable basis for its petition. While the court disagrees with the County’s arguments, it did not find the petition was without merit, as there are no prior decisions addressing the jurisdictional issues involving federally recognized tribes within the context of section 5500.5(a). The order is affirmed, and the request for attorney fees is denied, with costs awarded to the respondent.