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.
Extending the Statutes
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.
- Whenever you receive a claim, immediately check state law to
determine whether or not the claim was filed within the statute
- Perform a good investigation in order to determine whether or
not the claimant is competent and whether or not he has been mislead
by the employer in any way.
- Do not attempt to mislead the claimant in an attempt to prevent
- Do not attempt any settlement negotiations until investigation
has determined that the claim is compensable. If settlement negotiations
are begun and the statute of limitations has passed, these negotiations
will be used in an attempt to extend the statute.