State Compensation Ins. Fund v. Workers' Comp. Appeals Bd

In State Compensation Ins. Fund v. Workers' Comp. Appeals Bd. (1995) 37 Cal.App.4th 675, the Court affirmed the WCAB's decision that the employer's failure to deny the injury claim within 90 days of being served with the claim form resulted in the employee's hypertension and kidney failure being presumed compensable, even though medical evidence indicated the condition was non-industrial. The Court found more persuasive the primary purpose of the 1989 amendment to section 5402, which was to expedite the entire claims process by limiting to 90 days the time for the employer to investigate without penalty for the delay. ( SCIF, supra, 37 Cal.App.4th at pp. 681-682.) The Court also found persuasive WCAB decisions which held that the presumption in section 5402 did not preclude evidence pertaining to issues other than compensability or that was unobtainable during the 90-day period with the exercise of due diligence. ( SCIF, supra, 37 Cal.App.4th at pp. 683-684.)