California Insurance Guarantee Ass'n v. Workers' Compensation Appeals Board

INTRODUCTION

We granted the petition of the California Insurance Guarantee Association (CIGA) for a writ of review, filed after the Workers’ Compensation Appeals Board (WCAB or Board) denied CIGA’s petition for reconsideration of an award of benefits to injured worker David Carls. 1 CIGA contends the Board erred in rejecting its statute of limitations defense. 2 CIGA admits that the statutory period was tolled by the employer’s failure to advise Carls of his rights under the workers’ compensation law; however, it contends that Carls had actual knowledge of his rights more than one year before Carls filed a claim for benefits, causing the statutory period to run. CIGA also challenges the Board’s finding that CIGA was estopped to assert the statute of limitations due to its delay in determining that the 1997 injury was a covered claim. Because CIGA has failed to show that it carried its burden to prove *857 actual knowledge sufficient to end the tolling of the statute of limitations, we reject its first contention. We also reject CIGA’s substantial evidence challenge to the estoppel finding. We conclude that on the record presented, the Board did not err in rejecting…

Concurring and Dissenting. — The majority opinion affirms the order of the Workers’ Compensation Appeals Board (Appeals Board) rejecting the statute of limitations defense raised by petitioner California Insurance Guarantee Association (CIGA). It does so on two grounds. The first is that the failure of the employer to furnish the employee (applicant) with the statutory notice of his right to proceed under the workers’ compensation law tolled running of the one-year period within which a claim must be filed. (See Lab. Code, §§ 5401, subd. (a), 5405, subd. (a); all further statutory citations are to this code.) The second is that CIGA’s conduct in failing to acknowledge coverage for the accident at issue estops it from asserting the limitations defense. Based on the record before us (and, more particularly the absence of a further record on the issue), I agree that we must uphold the ruling of the Appeals Board on estoppel. But I cannot accept the conclusion of my colleagues that the limitations period continued to be tolled once applicant’s attorney took action on his behalf before the Appeals Board hearing officer with respect to the claim at issue.

*867 The basic facts are amply…

We granted the petition of the California Insurance Guarantee Association (CIGA) for a writ of review, filed after the Workers' Compensation Appeals Board (WCAB or Board) denied CIGA's petition for reconsideration of an award of benefits to injured worker David Carls. [1] CIGA contends the Board erred in rejecting its statute of limitations defense. [2] CIGA admits that the statutory period was tolled by the employer's failure to advise Carls of his rights under the workers' compensation law; however, it contends that Carls had actual knowledge of his rights more than one year before Carls filed a claim for benefits, causing the statutory period to run. CIGA also challenges the Board's finding that CIGA was estopped to assert the statute of limitations due to its delay in determining that the 1997 injury was a covered claim. Because CIGA has failed to show that it carried its burden to prove actual knowledge sufficient to end the tolling of the statute of limitations, we reject its first contention. We also reject CIGA's substantial evidence challenge to the estoppel finding. We conclude that on the record presented, the Board did not err in rejecting CIGA's statute…