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Statue of Limitations
#1
Hello Folks

California claim.

Lets say an applicant has not used the 104 ttd cap, and the 5 year statue of limitations expires in July 2014.

The applicant has surgery and is expected to be ttd past the 5 year date.

Does the 5 years automatically MMI the applicant or does the applicant continue to receive TTD past the date because he/ she was already treating and didn't use the 104 week ttd cap.

I would think that an applicant still treating at the five year mark and not mmi would still be entitiled to his/ her pd rating when p and s past the five year date.

Hope I worded that correctly Smile

What do you folks know about this scenario . Any codes or CCR'S

Thanks

Shadow

 
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#2
by "statute of limitations" I assume you mean the statute limiting TD payments to a 104 weeks within a 5 yr period -- as there are many statutes of limitations.
"Aggregate disability payments for a single injury occurring on or after January 1, 2008, causing temporary disability shall not extend for more than 104 compensable weeks within a period of five years from the date of injury."
http://www.leginfo.ca.gov/cgi-bin/displa...=4650-4664

MMI is not determined by the termination or end of TD payments.
(http://www.dir.ca.gov/t8/9785.html)
the injured would be entitled to a PD rating at whatever point a physician believe the worker is MMI at 1 yr, 5 yrs or 25yrs regardless of when TD payments actually ended or whether there was any TD at all.

the extent of permanent disability and therefore a PD rating cannot be accurately determined until no further improvement is contemplated; before that point it would just be a guess or an estimate. the injured would not be entitled to a rating before they were MMI.

I think what you are asking is if TD payments less then the 104 limit can be paid after 5 yrs?
in that case you have to distinguish between continuous and broken periods.
if the TD payments resumed before the 5 yrs they could be paid continuously beyond the 5 yr point.
they could not be resumed after the 5yr point.

section 4656 of the Labor code has been added to, changed, and amended many times.
the california supreme court made the distinction between continuous and broken TD in the Nicklesberg case back in 1991.






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THANKS FOR POSTING.
 
Reply
#3
(03-05-2014, 02:45 AM)1171 Wrote: by "statute of limitations" I assume you mean the statute limiting TD payments to a 104 weeks within a 5 yr period -- as there are many statutes of limitations.
"Aggregate disability payments for a single injury occurring on or after January 1, 2008, causing temporary disability shall not extend for more than 104 compensable weeks within a period of five years from the date of injury."
http://www.leginfo.ca.gov/cgi-bin/displa...=4650-4664

MMI is not determined by the termination or end of TD payments.
(http://www.dir.ca.gov/t8/9785.html)
the injured would be entitled to a PD rating at whatever point a physician believe the worker is MMI at 1 yr, 5 yrs or 25yrs regardless of when TD payments actually ended or whether there was any TD at all.

the extent of permanent disability and therefore a PD rating cannot be accurately determined until no further improvement is contemplated; before that point it would just be a guess or an estimate. the injured would not be entitled to a rating before they were MMI.

I think what you are asking is if TD payments less then the 104 limit can be paid after 5 yrs?
in that case you have to distinguish between continuous and broken periods.
if the TD payments resumed before the 5 yrs they could be paid continuously beyond the 5 yr point.
they could not be resumed after the 5yr point.

section 4656 of the Labor code has been added to, changed, and amended many times.
the california supreme court made the distinction between continuous and broken TD in the Nicklesberg case back in 1991.

Wow !! Thankyou so much for such a detailed answer.

Yes TD in broken periods and resumed before the 5 year statue and continuing past the five year statue. Then of course MMI.

I will look up the court case and Labor code.

Thanks again.
 
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