Jim Pocius | August 1, 2001
States differ with regard to the amount of time they will allow for a claimant to file a WC claim. James Pocius discusses the variation and provides some cost saving tips for risk management.
It is important to note in all workers compensation cases that there are time limits in which actions must be filed. The legal term for this type of time limit is a statute of limitation.
States differ with regard to the amount of time they will allow for a claimant to file a claim. In California, there is a 1-year statute of limitation provided by the Act. In Florida, a claimant may file a petition within 2 years "after the date on which the employee knew or should have known that the injury or death arose out of work performed in the course and scope of employment."
In Texas, an employee "shall file with the commission a claim for compensation for an injury not later then 1 year after the date on which the injury occurred or, if the injury is an occupational disease, the employee knew or should have known that the disease was related to employment."
In Pennsylvania, "All claims for compensation shall be forever barred, unless, within 3 years after the injury, the parties have agreed that compensation is payable or, one of the parties has filed a petition for benefits."
These statutes of limitation are absolute and the issue of whether a claim is time barred can be raised at any time during the litigation proceedings. In legal terms, this means that a statue of limitations is not an affirmative defense and can be raised for the first time on appeal in many jurisdictions. However, as with most legislation, these limits are sometimes difficult to determine.
In many jurisdictions, the workers compensation commissions or courts have found various ways to extend these statutes of limitation. For instance, some jurisdictions have held that it was the date of disability—not the date of trauma—that governs the commencement of the statute of limitations. Zimmerman v W.C.A.B. (Pa Cmwlth 1991).
Most Acts also require that the statutes of limitation section be liberally construed in favor of the claimant. Cook v Industrial Commission (126 Ill December 1984).
This strict time limit can also be extended by the claimant's lack of knowledge with regard to the medical condition and its connection to work. For instance, the statute in Florida indicates that the statute of limitation begins to run 2 years after the date on which the employee "knew or should have known that the injury or death arose out of work performed." Pennsylvania has also adopted, through court cases, this type of interpretation.
The biggest erosion with regard to a strict enforcement of the statute of limitations has occurred based on the behavior of the employer. Most states allow that a statue can be extended if the employer's actions intentionally or unintentionally deceive the claimant or lull the claimant into a false sense of security. Kocis v W.C.A.B. (Pa Cmwlth 1999).
It is very difficult to determine what type of behavior by the employer will extend the statute. Most cases are decided on the fact of the individual case. For example, payment of wages in lieu of compensation where no services were performed did extend the statue. Miller v Springfield Township (Pa Super 1964). An out of state payment of workers compensation benefits for the same injury also extended the statute. Martin v W.C.A.B. (Pa Cmwlth 1990).
Similarly, a court can decide that the employer did not mislead the claimant, and then the statute will not be extended. An employer's failure to advise the claimant of the statute of limitations for filing workers compensation benefits did not, in and of itself, prevent the employer from asserting the statute. Tegeler v Industrial Commission, 220 Lenoy Dec. 114 (1996). Statements made by a representative of the employer to the widow of the employee that she had no claims for future benefits also did not extend the statute. Beaudette v Illinois Industrial Commission (1st Dist 1999).
In California, a denial of a low back claim by indicating a colon problem was not work related, did not extend the statute of limitations even thought the claimant later filed an application for benefits based on a problem with his coccyx. The court determined that the letter notifying the claimant that his colon problem was denied did not in anyway mislead the claimant regarding his ability to file a claim. Laam v W.C.A.B. (1978).
In summary, employers' must be very careful to avoid misleading the claimant in order to prevent that claimant from filing a workers compensation claim. If the employer intentionally or unintentionally deceives the claimant or lulls the claimant into a false sense of security, the statute will be extended.
A final consideration regarding statutes of limitation is several states have provided that people who are mentally incompetent or who are minors are not bound by the statute of limitations. For these special categories of employees, the period usually does not begin to run until there is a guardian or a representative appointed to protect the interests of this category of workers.
While it appears that statues of limitation are bright line rules that would preclude the filing of workers compensation claims after a certain amount of time has expired, these rules have been eroded somewhat by the courts. A statue of limitations can be extended by a claimant's lack of knowledge or by the fact that an employer has mislead the claimant in some way. A statute of limitations can also be extended by the incompetency of the claimant.
Below are some risk management tips for employers to follow after receiving a workers compensation claim. These recommendations can save both time and money. By following these tips, employers can continue to use the statue of limitations to dismiss untimely workers compensation claims.
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