2005 California Labor Code Sections 5400-5413 CHAPTER 2. LIMITATIONS OF PROCEEDINGS

5400.  Except as provided by sections 5402 and 5403, no claim to
recover compensation under this division shall be maintained unless
within thirty days after the occurrence of the injury which is
claimed to have caused the disability or death, there is served upon
the employer notice in writing, signed by the person injured or
someone in his behalf, or in case of the death of the person injured,
by a dependent or someone in the dependent's behalf.
5401.  (a) Within one working day of receiving notice or knowledge
of injury under Section 5400 or 5402, which injury results in lost
time beyond the employee's work shift at the time of injury or which
results in medical treatment beyond first aid, the employer shall
provide, personally or by first-class mail, a claim form and a notice
of potential eligibility for benefits under this division to the
injured employee, or in the case of death, to his or her dependents.
As used in this subdivision, "first aid" means any one-time
treatment, and any followup visit for the purpose of observation of
minor scratches, cuts, burns, splinters, or other minor industrial
injury, which do not ordinarily require medical care.  This one-time
treatment, and followup visit for the purpose of observation, is
considered first aid even though provided by a physician or
registered professional personnel.  "Minor industrial injury" shall
not include serious exposure to a hazardous substance as defined in
subdivision (i) of Section 6302.  The claim form shall request the
injured employee's name and address, social security number, the time
and address where the injury occurred, and the nature of and part of
the body affected by the injury.  Claim forms shall be available at
district offices of the Employment Development Department and the
division.  Claim forms may be made available to the employee from any
other source.
   (b) Insofar as practicable, the notice of potential eligibility
for benefits required by this section and the claim form shall be a
single document and shall instruct the injured employee to fully read
the notice of potential eligibility.  The form and content of the
notice and claim form shall be prescribed by the administrative
director after consultation with the Commission on Health and Safety
and Workers' Compensation.  The notice shall be easily understandable
and available in both English and Spanish.  The content shall
include, but not be limited to, the following:
   (1) The procedure to be used to commence proceedings for the
collection of compensation for the purposes of this chapter.
   (2) A description of the different types of workers' compensation
benefits.
   (3) What happens to the claim form after it is filed.
   (4) From whom the employee can obtain medical care for the injury.
   (5) The role and function of the primary treating physician.
   (6) The rights of an employee to select and change the treating
physician pursuant to subdivision (e) of Section 3550 and Section
4600.
   (7) How to get medical care while the claim is pending.
   (8) The protections against discrimination provided pursuant to
Section 132a.
   (9) The following written statements:
   (A) You have a right to disagree with decisions affecting your
claim.
   (B) You can obtain free information from an information and
assistance officer of the state Division of Workers' Compensation, or
you can hear recorded information and a list of local offices by
calling (applicable information and assistance telephone number(s)).
   (C) You can consult an attorney.  Most attorneys offer one free
consultation.  If you decide to hire an attorney, his or her fee will
be taken out of some of your benefits. For names of workers'
compensation attorneys, call the State Bar of California at
(telephone number of the State Bar of California's legal
specialization program, or its equivalent).
   (c) The completed claim form shall be filed with the employer by
the injured employee, or, in the case of death, by a dependent of the
injured employee, or by an agent of the employee or dependent.
Except as provided in subdivision (d), a claim form is deemed filed
when it is personally delivered to the employer or received by the
employer by first-class or certified mail.  A dated copy of the
completed form shall be provided by the employer to the employer's
insurer and to the employee, dependent, or agent who filed the claim
form.
   (d) The claim form shall be filed with the employer prior to the
injured employee's entitlement to late payment supplements under
subdivision (d) of Section 4650, or prior to the injured employee's
request for a medical evaluation under Section 4060, 4061, or 4062.
Filing of the claim form with the employer shall toll, for injuries
occurring on or after January 1, 1994, the time limitations set forth
in Sections 5405 and 5406 until the claim is denied by the employer
or the injury becomes presumptively compensable pursuant to Section
5402.  For purposes of this subdivision, a claim form is deemed filed
when it is personally delivered to the employer or mailed to the
employer by first-class or certified mail.
5401.7.  The claim form shall contain, prominently stated, the
following statement:
   "Any person who makes or causes to be made any knowingly false or
fraudulent material statement or material representation for the
purpose of obtaining or denying workers' compensation benefits or
payments is guilty of a felony."
   The statements required to be printed or displayed pursuant to
Sections 1871.2 and 1879.2 of the Insurance Code may, but are not
required to, appear on the claim form.
5402.  (a) Knowledge of an injury, obtained from any source, on the
part of an employer, his or her managing agent, superintendent,
foreman, or other person in authority, or knowledge of the assertion
of a claim of injury sufficient to afford opportunity to the employer
to make an investigation into the facts, is equivalent to service
under Section 5400.
   (b) If liability is not rejected within 90 days after the date the
claim form is filed under Section 5401, the injury shall be presumed
compensable under this division.  The presumption of this
subdivision is rebuttable only by evidence discovered subsequent to
the 90-day period.
   (c) Within one working day after an employee files a claim form
under Section 5401, the employer shall authorize the provision of all
treatment, consistent with Section 5307.27 or the American College
of Occupational and Environmental Medicine's Occupational Medicine
Practice Guidelines, for the alleged injury and shall continue to
provide the treatment until the date that liability for the claim is
accepted or rejected.  Until the date the claim is accepted or
rejected, liability for medical treatment shall be limited to ten
thousand dollars ($10,000).
   (d) Treatment provided under subdivision (c) shall not give rise
to a presumption of liability on the part of the employer.
5403.  The failure to give notice under section 5400, or any defect
or inaccuracy in a notice is not a bar to recovery under this
division if it is found as a fact in the proceedings for the
collection of the claim that the employer was not in fact misled or
prejudiced by such failure.
5404.  Unless compensation is paid within the time limited in this
chapter for the institution of proceedings for its collection, the
right to institute such proceedings is barred.  The timely filing of
an application with the appeals board by any party in interest for
any part of the compensation defined by Section 3207 renders this
chapter inoperative as to all further claims by such party against
the defendants therein named for compensation arising from that
injury, and the right to present such further claims is governed by
Sections 5803 to 5805, inclusive.
5404.5.  (a) Where a claim form has been filed prior to January 1,
1994, and where the claim is denied by the employer, the claim may be
dismissed if there has been no activity for the previous 180 days
and if the claims adjuster has served notice pursuant to Article 3
(commencing with Section 415.10) of Chapter 4 of Title 5 of the Code
of Civil Procedure.  The notice shall specify that the claim will be
dismissed by operation of law unless an application for adjudication
of the claim is filed within 180 days of service of the notice.
   (b) Where a claim form has been filed prior to January 1, 1994,
and where benefits have been furnished by the employer, the claim may
be dismissed if there has been no activity for the previous 180 days
and if the claims adjuster has served notice pursuant to Article 3
(commencing with Section 415.10) of Chapter 4 of Title 5 of the Code
of Civil Procedure.  The notice shall specify that the claim will be
dismissed by operation of law unless an application for adjudication
of the claim is filed within five years of the date of injury or
within one year of the last furnishing of benefits, whichever is
later.
   (c) The administrative director may adopt rules of practice and
procedure consistent with this section.
   (d) The provisions of subdivisions (a) and (b) do not limit the
jurisdiction of the appeals board.
   (e) This section is applicable to injuries occurring before
January 1, 1994.
5405.  The period within which proceedings may be commenced for the
collection of the benefits provided by  Article 2 (commencing with
Section 4600) or Article 3 (commencing with Section 4650), or both,
of Chapter 2 of Part 2 is one year from any of the following:
   (a) The date of injury.
   (b) The expiration of any period covered by payment under Article
3 (commencing with Section 4650) of Chapter 2 of Part 2.
   (c) The last date  on which any benefits provided for in Article 2
(commencing with Section 4600) of Chapter 2 of Part 2 were
furnished.
5406.  Except as provided in Section 5406.5 or 5406.6, 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:
   (a) The date of death where death occurs within one year from date
of injury; or
   (b) The date of last furnishing of any benefits under Chapter 2
(commencing with Section 4550) of Part 2, where death occurs more
than one year from the date of injury; or
   (c) The date of death, where death occurs more than one year after
the date of injury and compensation benefits have been furnished.
   No such proceedings may be commenced more than one year after the
date of death, nor more than 240 weeks from the date of injury.
5406.5.  In the case of the death of an asbestos worker or
firefighter from asbestosis, the period within which proceedings may
be commenced for the collection of the benefits provided by Article 4
(commencing with Section 4700) of Chapter 2 of Part 2 is one year
from the date of death.
5406.6.  (a) In the case of the death of a health care worker, a
worker described in Section 3212, or a worker described in Section
830.5 of the Penal Code from an HIV-related disease, the period
within which proceedings may be commenced for the collection of
benefits provided by Article 4 (commencing with Section 4700) of
Chapter 2 of Part 2 is one year from the date of death, providing
that one or more of the following events has occurred:
   (1) A report of the injury or exposure was made to the employer or
to a governmental agency authorized to administer industrial injury
claims, within one year of the date of the injury.
   (2) The worker has complied with the notice provisions of this
chapter and the claim has not been finally determined to be
noncompensable.
   (3) The employer provided, or was ordered to provide, workers'
compensation benefits for the injury prior to the date of death.
   (b) For the purposes of this section, "health care worker" means
an employee who has direct contact, in the course of his or her
employment, with blood or other bodily fluids contaminated with
blood, or with other bodily fluids identified by the Division of
Occupational Safety and Health as capable of transmitting HIV, who is
either (1) any person who is an employee of a provider of health
care, as defined in subdivision (d) of Section 56.05 of the Civil
Code, including, but not limited to, a registered nurse, licensed
vocational nurse, certified nurse aide, clinical laboratory
technologist, dental hygienist, physician, janitor, or housekeeping
worker, or (2) an employee who provides direct patient care.
5407.  The period within which may be commenced proceedings for the
collection of compensation on the ground of serious and willful
misconduct of the employer, under provisions of Section 4553, is as
follows:
   Twelve months from the date of injury.  This period shall not be
extended by payment of compensation, agreement therefor, or the
filing of application for compensation benefits under other
provisions of this division.
5407.5.  The period within which may be commenced proceedings for
the reduction of compensation on the ground of serious and willful
misconduct of the employee, under provisions of Section 4551, is as
follows:
   Twelve months from the date of injury.  However, this limitation
shall not apply in any case where the employee has commenced
proceedings for the increase of compensation on the ground of serious
and willful misconduct of the employer.
5408.  If an injured employee or, in the case of the employee's
death, any of the employee's dependents, is under 18 years of age or
incompetent at any time when any right or privilege accrues to such
employee or dependent under this division, a guardian or conservator
of the estate appointed by the court, or a guardian ad litem or
trustee appointed by the appeals board, may, on behalf of the
employee or dependent, claim and exercise any right or privilege with
the same force and effect as if no disability existed.
   No limitation of time provided by this division shall run against
any person under 18 years of age or any incompetent unless and until
a guardian or conservator of the estate or trustee is appointed.  The
appeals board may determine the fact of the minority or incompetency
of any injured employee and may appoint a trustee to receive and
disburse compensation payments for the benefit of such minor or
incompetent and his family.
5409.  The running of the period of limitations prescribed by this
chapter is an affirmative defense and operates to bar the remedy and
not to extinguish the right of the employee.  Such defense may be
waived.  Failure to present such defense prior to the submission of
the cause for decision is a sufficient waiver.
5410.  Nothing in this chapter shall bar the right of any injured
worker to institute proceedings for the collection of compensation,
including vocational rehabilitation services, within five years after
the date of the injury upon the ground that the original injury has
caused new and further disability or that the provision of vocational
rehabilitation services has become feasible because the employee's
medical condition has improved or because of other factors not
capable of determination at the time the employer's liability for
vocational rehabilitation services otherwise terminated.  The
jurisdiction of the appeals board in these cases shall be a
continuing jurisdiction within this period.  This section does not
extend the limitation provided in Section 5407.
5410.1.  Should any party to a proceeding institute proceedings to
reduce the amount of permanent disability awarded to an applicant by
the appeals board and be unsuccessful in such proceeding, the board
may make a finding as to the amount of a reasonable attorney's fee
incurred by the applicant in resisting such proceeding to reduce
permanent disability benefits previously awarded by the appeals board
and assess the same as costs upon the party instituting the
proceeding for the reduction of permanent disability benefits.
5411.  The date of injury, except in cases of occupational disease
or cumulative injury, is that date during the employment on which
occurred the alleged incident or exposure, for the consequences of
which compensation is claimed.
5412.  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.
5413.  A determination of facts by the appeals board under this
chapter has no collateral estoppel effect on a subsequent criminal
prosecution and does not preclude litigation of those same facts in
the criminal proceeding.