WCPanelIQ
PanelGranted

Washington, Derrick

DERRICK WASHINGTON, Applicant vs. NATIONAL GYPSUM; XL SPECIALTY INS. CO., adjusted by SEDGWICK CLAIMS MANAGEMENT SERVICES, Defendants

ADJ number
ADJ17195883
Decision date
Dec 1, 2024
District office
Oakland
WCJ
—
Claim administrator
Sedgwick Claims Management Services (adjusting for XL Specialty Ins. Co.)
Commissioners
KATHERINE A. ZALEWSKI, CHAIR, CRAIG SNELLINGS, COMMISSIONER, JOSEPH V. CAPURRO, COMMISSIONER
LC §5405LC §5909LC §5900LC §5400LC §5401LC §5402LC §5313LC §5903LC §5952LC §5701LC §5906CCR §10600

Summary

Applicant Derrick Washington sought reconsideration of a WCJ's F&O finding his claim barred by the one-year statute of limitations under Labor Code section 5405(a), where the claimed injury was May 4, 2021 and the application was filed January 18, 2023. The WCJ had ruled that the statute was only tolled until June 9, 2021 because defendant allegedly mailed applicant a DWC-1 claim form on June 4, 2021 to a valid address, invoking the mailbox presumption of receipt. The Appeals Board found the WCJ's determination unsupported by substantial evidence because the relied-upon exhibit (Exh. H) contained no DWC-1 claim form, only partial instructions, had no proof of service, and defendant's witness could not authenticate it. The Board also noted new evidence that mail to applicant's address of record was being returned undelivered. The Board granted reconsideration, rescinded the F&O, and returned the matter to the trial level for further proceedings, including potential development of the record on whether the injury required only first aid.

Issues

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Holding

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Analysis

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Applicant takeaway

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Defense takeaway

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Provider takeaway

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