WCPanelIQ
PanelQMEMed-legalDenied

Dougherty, James

JAMES DOUGHERTY, Applicant vs. SACRAMENTO COUNTY SHERIFF'S DEPARTMENT, permissibly self-insured, Defendant

ADJ number
ADJ16971609
Decision date
Jun 4, 2023
District office
Sacramento
WCJ
Sarah L. Lopez
Claim administrator
Sacramento County Sheriff's Department (permissibly self-insured)
Commissioners
—

Injury / body parts: right eye, optic nerve, retina

LC §5709LC §5405LC §5406LC §5406.5LC §5406.6LC §5408LC §4850LC §5705LC §5303LC §5303LC §4650LC §5303CCR §10515CCR §10617CCR §10517CCR §9812

Summary

Applicant James Dougherty, a deputy sheriff, sustained an accepted specific injury to his right eye on September 6, 2015 from being punched during an inmate assault. His symptoms recurred years later, and after PQME Dr. Sami opined that his retinal hole and cataract resulted from the 2015 trauma (ruling out a cumulative injury theory), applicant dismissed his July 1, 2021 cumulative trauma claim and proceeded on a December 2, 2022 specific injury claim. Defendant asserted a statute of limitations defense, arguing the application was untimely. The WCJ found defendant failed to prove the defense because applicant was never adequately noticed that his medical treatment benefits could be limited or denied, tolling the statute. The Board denied reconsideration, holding the statute was tolled for lack of proper notice and, alternatively, that the specific injury claim related back to the timely July 1, 2021 application.

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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