Stanford, Arthur (dec.), Applicant v. HOUSING AUTHORITY OF THE CITY OF LOS ANGELES, permissibly self-insured, administered by SEDGWICK CMS, Defendants

WORKERS’ COMPENSATION APPEALS BOARD
STATE OF CALIFORNIA
ARTHUR STANFORD (Dec’d), et. al., Applicants
vs.
HOUSING AUTHORITY OF THE CITY OF LOS ANGELES, permissibly self-insured,
administered by SEDGWICK CMS, Defendants
Adjudication Number: ADJ19613976
Los Angeles District Office
OPINION AND ORDER
GRANTING PETITION
FOR RECONSIDERATION
AND DECISION
AFTER RECONSIDERATION
Applicant seeks reconsideration of the “Findings of Fact and Opinion on Decision”
(Findings) issued on August 10, 2025, by the workers’ compensation administrative law judge
(WCJ). The WCJ found, in pertinent part, that applicants’ claim of death benefits was barred by
Labor Code1 section 5406(b) because applicant failed to file a claim for death benefits within one
year from the date of decedent’s death.
Applicant contends that she had a complete lack of knowledge that the death was
industrially related and that defendant did not meet its burden to establish a statute of limitations.
We 	have 	received 	an 	answer 	from 	defendant. 	The 	WCJ 	filed 	a 	Report 	and
Recommendation 	on 	Petition 	for 	Reconsideration 	(Report) 	recommending 	that 	we 	deny
reconsideration.
We have considered the allegations of the Petition for Reconsideration, the Answer, and
the contents of the WCJ’s Report. Based on our review of the record and for the reasons discussed
below, we will grant 	applicant’s petition for reconsideration and as our Decision After
1 All future references are to the Labor Code unless noted.

2
Reconsideration, we will rescind the August 10, 2025 Findings and return this matter to the trial
level for further proceedings.
FACTS
Per the WCJ’s Report:
Retired carpenter ARTHUR STANFORD passed away at home on 01/08/2023.
The death certificate listed cardiopulmonary arrest as the immediate cause of death,
with contributing causes including septic shock, extended spectrum beta-lactamase
bacteremia, spontaneous bacterial peritonitis, decompensated alcoholic cirrhosis,
coagulopathy, intracranial hemorrhage (nontraumatic), and seizures.
The Application for death benefits was filed on 07/29/2024, and the claim was
denied based on the statute of limitations. The matter proceeded to Trial, and both
parties submitted trial briefs.
The undersigned WCJ issued a Findings and Order on 08/29/2025 that the
Petitioner’s claim is barred by the statute of limitations for dependency claims, and
that there is no need 	for development of the record, as the operation of
Labor Code §5406(b) 	alone 	is 	sufficient 	to 	defeat 	the 	claim, 	regardless 	of
knowledge of the date of injury.
Petitioner requests reconsideration, arguing primarily that lack of knowledge of the
industrial nature of the death tolls the statute.
(WCJ’s Report, pp. 1-2.)
In the Report, the WCJ further found that “there is no authority allowing tolling of the
requirement to file within one year of the date of death.” (Id. at p. 4.)
DISCUSSION
I.
Former section 5909 provided that a petition for reconsideration was deemed denied unless
the Appeals Board acted on the petition within 60 days from the date of filing. (§ 5909.) Effective
July 2, 2024, section 5909 was amended to state in relevant part that:
(a) A petition for reconsideration is deemed to have been denied by
the appeals board unless it is acted upon within 60 days from the
date a trial judge transmits a case to the appeals board.
(b) (1) When a trial judge transmits a case to the appeals board, the
trial judge shall provide notice to the parties of the case and the
appeals board.

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(2) For purposes of paragraph (1), service of the accompanying
report, pursuant to subdivision (b) of Section 5900, shall constitute
providing notice.
(§ 5909.)
Under section 5909(a), the Appeals Board must act on a petition for reconsideration within
60 days of transmission of the case to the Appeals Board. Transmission is reflected in Events in
the Electronic Adjudication Management System (EAMS). Specifically, in Case Events, under
Event Description is the phrase “Sent to Recon” and under Additional Information is the phrase
“The case is sent to the Recon board.”
Here, 	according 	to 	Events, 	the 	case 	was 	transmitted 	to 	the 	Appeals 	Board 	on
September 10, 2025, and 60 days from the date of transmission is Sunday, November 9, 2025,
which by operation of law means this decision is due by Monday, November 10, 2025. (Cal. Code
Regs., tit. 8, § 10600.). This decision is issued by or on November 10, 2025, so that we have timely
acted on the Petition as required by section 5909(a).
Section 5909(b)(1) requires that the parties and the Appeals Board be provided with notice
of transmission of the case. Transmission of the case to the Appeals Board in EAMS provides
notice to the Appeals Board. Thus, the requirement in subdivision (1) ensures that the parties are
notified of the accurate date for the commencement of the 60-day period for the Appeals Board to
act on a petition. Section 5909(b)(2) provides that service of the Report and Recommendation shall
be notice of transmission.
According to the proof of service for the Report and Recommendation by the WCJ, the
Report was served on September 10, 2025, and the case was transmitted to the Appeals Board on
September 10, 2025. Service of the Report and transmission of the case to the Appeals Board
occurred on the same day. Thus, we conclude that the parties were provided with the notice of
transmission required by section 5909(b)(1) because service of the Report in compliance with
section 5909(b)(2) provided them with actual notice as to the commencement of the 60-day period
on September 10, 2025.

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II.
Decisions 	of 	the 	Appeals 	Board 	“must 	be 	based 	on 	admitted 	evidence 	in 	the
record.” (Hamilton v. Lockheed Corporation (Hamilton) (2001) 66 Cal.Comp.Cases 473, 476
(Appeals Board en banc).) Furthermore, decisions of the Appeals Board must be supported by
substantial evidence. (Lab. Code, §§ 5903, 5952(d); Lamb v. Workmen’s Comp. Appeals Bd.
(1974) 11 Cal.3d 274 [39 Cal.Comp.Cases 310]; Garza v. Workmen’s Comp. Appeals Bd. (1970)
3 Cal.3d 312 [35 Cal.Comp.Cases 500]; LeVesque v. Workmen’s Comp. Appeals Bd. (1970)
1 Cal.3d 627 [35 Cal.Comp.Cases 16].) 	An adequate and complete record is necessary to
understand the basis for the WCJ’s decision. (Lab. Code, § 5313; see also Cal. Code Regs., tit. 8,
§ 10761.)
The running of the statute of limitations is an affirmative defense, and therefore, the burden
of proof as to whether an application is barred by the statute of limitations rests with defendant.
(§§ 5409, 5705; see City of Fresno v. Workers’ Comp. Appeals Bd. (“Johnson”) (1985) 163
Cal.App.3d 467, 471 [50 Cal.Comp.Cases 53].) The applicable statute of limitations in death cases
is section 5406, which states:
(a) Except as provided in Section 5406.5, 5406.6, or 5406.7, the period within
which may be commenced proceedings for the collection of the benefits provided
by Article 4 (commencing with Section 4700) of Chapter 2 of Part 2 is one year
from:
(1) The date of death if death occurs within one year from date of injury.
(2) The date of last furnishing of any benefits under [*3] 	Chapter 2
(commencing with Section 4550) of Part 2, if death occurs more than one
year from the date of injury.
(3) The date of death, if death occurs more than one year after the date of
injury and compensation benefits have been furnished.
(b) Proceedings shall not be commenced more than one year after the date of death,
nor more than 240 weeks from the date of injury.
(§ 5406.)

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“Limitations provisions in the [workers’] compensation law must be liberally construed in
favor of the employee unless otherwise compelled by the language of the statute, and such
enactments should not be interpreted in a manner which will result in a loss of compensation.”
(Blanchard v. Workers’ Comp. Appeals Bd. (1975) 53 Cal.App.3d 590, 595, 40 Cal. Comp. Cases
784, 787 (internal citations omitted).)
It is well settled that where the employer has a statutory or regulatory duty to provide notice
to the injured worker of a right and fails to do so, the employer is estopped from raising the statute
of limitations as a bar to the claim. (Reynolds v. Workmen’s Comp. Appeals Bd., (1974) 12 Cal.3d
726.)
Administrative Director Rule 9812 requires the employer to send notices to dependents in
death cases. 	(Cal. Code Regs., tit. 8., § 9812(f) [“[T]he claims administrator shall advise the
dependent(s) of the status of any benefits to which they may be entitled or which they have
claimed as a result of the employee's death.”].)
Section 5406(b) states that no death claim shall be commenced more than 240 weeks from
the “date of injury.” (§ 5406(b).) “For purposes of death benefit claims, the date of injury may
depend on the claimant’s knowledge of the industrial nature of the injury causing death.” (Massey
v. Workers’ Comp. Appeals Bd. (1993) 5 Cal.4th 674, 678, fn. 1 [58 Cal.Comp.Cases 367],
emphasis in the original, citing Berkebile v. Workers’ Comp. Appeals Bd. (1983) 144 Cal.App.3d
940 [48 Cal.Comp.Cases 438].) The Second District Court of Appeal held in Berkebile that:
In 	that 	the 	applicant’s 	right 	to 	workers’ 	compensation 	death 	benefits 	are
independent and severable from the decedent’s inter vivos rights, a determination
as to the decedent’s knowledge of the industrial origin of his disability is not
dispositive of the statute of limitations issue. The date of the applicant’s
knowledge of the industrial nature of the decedent’s condition is the pertinent
‘date of injury’ for purposes of the death claim.”
(Berkebile, supra, 144 Cal.App.3d at 945, emphasis added.)
The underlying injury claimed in this matter appears to be a cumulative injury. Date of
injury for cumulative injury claims is ordinarily established under section 5412, which states: “The
date of injury in cases of occupational diseases or cumulative injuries is that date upon which the
employee first suffered disability therefrom and either knew, or in the exercise of reasonable
diligence should have known, that such disability was caused by his present or prior employment.”
(§ 5412.)

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As used in section 5412, “disability” means either compensable temporary disability or
permanent disability. (Chavira v. Workers’ Comp. Appeals Bd. (1991) 235 Cal.App.3d 463 [56
Cal.Comp.Cases 631]; State Comp. Ins. Fund v. Workers’ Comp. Appeals Bd. (Rodarte) (2004)
119 Cal.App.4th 998 [69 Cal.Comp.Cases 579].) Medical treatment alone is not “disability” for
purposes of determining the date of a cumulative injury pursuant to section 5412, but it may be
evidence of compensable permanent disability. (Rodarte, supra, 119 Cal. App. 4th at p. 1005.)
Likewise, modified work is not a sufficient basis for finding compensable temporary disability,
but it may be indicative of a compensable permanent disability, especially if the worker is
permanently precluded from returning to their usual and customary job duties. (Id.)
The existence of disability is a medical question beyond the bounds of ordinary knowledge,
and, as such, will typically require medical evidence. (City & County of San Francisco v. Industrial
Acc. Com. (Murdock) (1953) 117 Cal.App.2d 455 [18 Cal.Comp.Cases 103]; Bstandig v. Workers’
Comp. Appeals Bd. (1977) 68 Cal. App. 3d 988 [42 Cal.Comp.Cases 114].) Knowledge requires
more than an uninformed belief. Because the existence of disability typically requires medical
evidence, an “applicant will not be charged with knowledge that his disability is job related without
medical advice to that effect unless the nature of the disability are such that applicant should have
recognized the relationship between the known adverse factors involved in his employment and
his disability.” (City of Fresno v. Workers’ Comp. Appeals Bd. (Johnson) (1985) 163 Cal.App.3d
467, 473 [50 Cal.Comp.Cases 53].)
The dates of injurious exposure under section 5500.5 and the date of injury under section
5412 are separate analyses. While the two dates may coincide, they are not synonymous.
It appears that defendant may be conflating these two dates interchangeably.
It is incumbent upon defendant to produce evidence related to the date that applicant knew,
or in the exercise of reasonable diligence should have known that the cause of decedent’s death
was industrially related. It is not enough for defendant to show that applicant knew of decedent’s
symptoms. (Johnson, supra, 163 Cal.App.3d at 471.)
[T]he rule that an applicant will not be charged with knowledge that his disability
is job related without medical advice to that effect unless the nature of the disability
and applicant’s training, intelligence and qualifications are such that applicant
should have recognized the relationship between the known adverse factors
involved in his employment and his disability.
(Johnson, supra, 163 Cal.App.3d at 473 (emphasis added).)

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Turning to the merits of the case, the WCJ focused the decision upon the fact that applicant
did not file the application within one year from the date of death. While section 5406(b) states
that “[p]roceedings shall not be commenced more than one year after the date of death”, the
running of such time period is tolled until defendant provides applicant with the notice required.
No such notice is in evidence. Upon return, and if defendant wishes to proceed upon this argument,
defendant should produce the notice provided to applicant of her right to file for death benefits.
Next, and to the extent that defendant argues the claim may be untimely based upon the
date of injury, no such date has been established in the record. There is simply no medical evidence
upon which a determination of section 5412 date of injury can be made. Even defendant’s own
denial letter stated: “there is no substantial medical, factual or legal evidence to support that the
cause of death of Arthur Stanford was due to his work related injury.” (Defendant’s Exhibit A.)
We defer any determination as to the date of injury to the trial level so that a record may be created
and a date of injury established.
Accordingly, we grant applicant’s petition for reconsideration and as our Decision After
Reconsideration, we rescind the August 10, 2025 Findings and return this matter to the trial level
for further proceedings.
For the foregoing reasons,
IT IS ORDERED that applicant’s Petition for Reconsideration of the Findings of Fact and
Opinion on Decision issued on August 10, 2025, by the WCJ is GRANTED.

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IT IS FURTHER ORDERED as the Decision After Reconsideration of the Workers’
Compensation Appeals Board that the Findings of Fact and Opinion on Decision issued on
August 10, 2025, by the WCJ is RESCINDED and this matter is RETURNED to the trial level
for further proceedings.
WORKERS’ COMPENSATION APPEALS BOARD
/s/ KATHERINE WILLIAMS DODD, COMMISSIONER
I CONCUR,
/s/ JOSÉ H. RAZO, COMMISSIONER
/s/ JOSEPH V. CAPURRO, COMMISSIONER
DATED AND FILED AT SAN FRANCISCO, CALIFORNIA
NOVEMBER 10, 2025
SERVICE MADE ON THE ABOVE DATE ON THE PERSONS LISTED BELOW AT
THEIR ADDRESSES SHOWN ON THE CURRENT OFFICIAL ADDRESS RECORD.
ELIZABETH STANFORD FOR ARTHUR STANFORD, (DEC’D)
TELLERIA, TELLERIA & LEVY, LLP
LOUIE & STETTLER
EDL/pm
I certify that I affixed the official seal of
the Workers’ Compensation Appeals Board
to this original decision on this date.
KL