WCPanelIQ
PanelDenied

Hernandez, Andres

ANDRES HERNANDEZ, Applicant vs. PEARCE SERVICES, INC.; SPARTA INSURANCE COMPANY, Adjusted By GALLAGHER BASSETT, Defendants

ADJ number
ADJ9972218
Decision date
May 29, 2025
District office
San Luis Obispo
WCJ
—
Claim administrator
Gallagher Bassett (administering for Sparta Insurance Company)
Commissioners
—

Injury / body parts: left knee

LC §5410LC §4661.5LC §4656LC §5405LC §5407CCR §9812

Summary

Andres Hernandez sustained an industrial left knee injury on December 19, 2013 and received a stipulated Award of 14% PD on May 27, 2015. After undergoing knee surgery in October 2018 and receiving resumed temporary disability benefits, applicant filed a Petition to Reopen for new and further disability on February 19, 2019—more than five years after the date of injury. The WCJ found the petition time-barred under Labor Code section 5410's five-year statute of limitations, and the WCAB affirmed after reconsideration. The Board held that while section 5410 can be tolled by an affirmative misstatement or breach of an express legal obligation, defendant merely paid required benefits and provided required notices, and applicant failed to prove he relied on any tolling statement before the limitations period expired on December 19, 2018.

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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